Imported Ciprofloxacin-Resistant<i>Neisseria meningitidis</i>

Lapadula, Giuseppe; Vigano, F.; Fortuna, Paolo; Dolara, Alberto; Bramati, Simone; Soria, Alessandro; Foresti, Sergio; Gori, Andrea

doi:10.3201/eid1511.090833

Cited by 19 publications

(13 citation statements)

References 7 publications

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“…To date, reduced susceptibility or resistance to fluoroquinolones in Neisseria meningitidis remains rare (13). Nevertheless, sporadic cases have been reported in Europe, India, and North and South America (16,17,26).…”

Section: Discussionmentioning

confidence: 99%

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Bertrand

Carion

Wintjens

et al. 2012

Antimicrob Agents Chemother

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bThis study was conducted to evaluate the evolution of the antimicrobial susceptibility of Neisseria meningitidis causing invasive diseases in Belgium in the period of January 2000 to December 2010. A total of 1,933 cases of N. meningitidis from invasive infections were analyzed by antimicrobial susceptibility testing at the Belgian Meningococcal Reference Centre. The majority of strains were susceptible to antibiotics that are currently used for the treatment and prophylaxis of meningococcal disease, but the prevalence of clinical isolates with reduced susceptibility to penicillin increased over the years. The phenotyping, genotyping, and determination of MICs of penicillin G were performed. The systematic shift of the curves toward higher penicillin MICs in the susceptible population indicated that this population became less sensitive to penicillin in this period. A 402-bp DNA fragment in the 3= end of penA was sequenced for the 296 nonsusceptible meningococcal strains isolated between 2000 and 2010 to examine the genetic diversity and evolution of their penA gene. In conclusion, the data obtained in our study support the statement that the position of penicillin G as a first choice in the treatment of invasive meningococcal diseases in Belgium should be reexamined. Despite an important number of isolates displaying a reduced susceptibility to penicillin, at present the expandedspectrum cephalosporins, such as ceftriaxone, are not affected. The follow-up of the evolutionary changes in antimicrobial resistance has also proved to be essential for the recommendation of an appropriate antimicrobial treatment for invasive meningococcal diseases.

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Section: Discussionmentioning

confidence: 99%

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Bertrand

Carion

Wintjens

et al. 2012

Antimicrob Agents Chemother

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“…A recent case of drug-resistant IMD in Italy was diagnosed in a man following a 10-day business trip in India with a stopover at Frankfurt airport, thus presenting multiple opportunities for transmission 46. The meningococcal strain affecting this patient was resistant to ciprofloxacin, levofloxacin, and trimethoprim + sulfamethoxazole.…”

Section: Possibility Of Antibiotic-resistant Meningococcal Strainsmentioning

confidence: 95%

Critical appraisal of a quadrivalent CRM197 conjugate vaccine against meningococcal serogroups A, C W-135 and Y (Menveo®) in the context of treatment and prevention of invasive disease

Bröker

Cooper²,

DeTora

et al. 2011

IDR

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Worldwide, invasive meningococcal disease affects about 500,000 people annually. Case fatality in developed countries averages 10%, and higher rates are reported in less prosperous regions. According to the World Health Organization, the most important pathogenic serogroups are A, B, C, W-135, X, and Y. Clinical features of invasive meningococcal disease make diagnosis and management difficult. Antibiotic measures are recommended for prophylaxis after exposure and for treatment of invasive meningococcal disease cases; however, resistant strains may be emerging. Vaccines are generally regarded as the best preventative measure for invasive meningococcal disease. Polysaccharide vaccines against serogroups A, C, W-135, and Y using protein conjugation technology have clear advantages over older plain polysaccharide formulations without a protein component. The first quadrivalent meningococcal conjugate vaccine (MenACWY-D) was licensed in the US in 2005. More recently, MenACWY-CRM (Menveo®) was licensed in Europe, the US, the Middle East, and Latin America. MenACWY-CRM uses cross-reactive material 197, a nontoxic mutant of diphtheria toxin, as the carrier protein. MenACWY-CRM offers robust immunogenicity in all age groups, with a tolerability profile similar to that of a plain polysaccharide vaccine. Given its potential for protecting persons from infancy to old age, MenACWY-CRM offers the opportunity to protect broad populations against invasive meningococcal disease. The most optimal strategy for use of the vaccine has to be assessed country by country on the basis of local epidemiology, individual health care systems, and need.

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“…For instance, Lapadula et al reported the importation of ciprofloxacin-resistant N. meningitidis to Italy via a traveller who visited India. 58 The isolate was of the same sequence type as the ciprofloxacin-resistant N. meningitidis serogroup A that caused outbreaks in India in 2005 and 2006. 17 Annually, thousands of pilgrims visit Saudi Arabia from India for Hajj and Umrah, in addition to a large resident workforce from the country.…”

Section: Antibiotic Chemoprophylaxismentioning

confidence: 99%

“…Even though antibiotic resistance in N. meningitidis is uncommon, resistance or reduced susceptibility to agents used for the treatment and chemoprophylaxis of patients with MD and their contacts have been reported. 15,17,58 Concerns over the development of antibiotic resistance are justified because of the severity of the disease caused by the organism and the need for immediate treatment of infected patients. Effective chemoprophylaxis is also crucial for close contact of cases to prevent secondary cases and reduce morbidity and mortality.…”

Section: Antibiotic Chemoprophylaxismentioning

confidence: 99%

Prevention of meningococcal disease during the Hajj and Umrah mass gatherings: past and current measures and future prospects

Yezli

Saeed

Assiri

et al. 2016

International Journal of Infectious Diseases

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The Kingdom of Saudi Arabia (KSA) has a long history of instituting preventative measures against meningococcal disease (MD). KSA is at risk of outbreaks of MD due to its geographic location, demography, and especially because it hosts the annual Hajj and Umrah mass gatherings. Preventative measures for Hajj and Umrah include vaccination, targeted chemoprophylaxis, health awareness and educational campaigns, as well as an active disease surveillance and response system. Preventative measures have been introduced and updated in accordance with changes in the epidemiology of MD and available preventative tools. The mandatory meningococcal vaccination policy for pilgrims has possibly been the major factor in preventing outbreaks during the pilgrimages. The policy of chemoprophylaxis for all pilgrims arriving from the African meningitis belt has also probably been important in reducing the carriage and transmission of Neisseria meningitidis in KSA and beyond. The preventative measures for Hajj and Umrah are likely to continue to focus on vaccination, but to favour the conjugate vaccine for its extra benefits over the polysaccharide vaccines. Additionally, the surveillance system will continue to be strengthened to ensure early detection and response to cases and outbreaks; ongoing disease awareness campaigns for pilgrims will continue, as will chemoprophylaxis for target groups. Local and worldwide surveillance of the disease and drug-resistant N. meningitidis are crucial in informing future recommendations for vaccination, chemoprophylaxis, and treatment. Preventative measures should be reviewed regularly and updated accordingly, and compliance with these measures should be monitored and enhanced to prevent MD during Hajj and Umrah, as well as local and international outbreaks.

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Imported Ciprofloxacin-ResistantNeisseria meningitidis

Cited by 19 publications

References 7 publications

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Critical appraisal of a quadrivalent CRM197 conjugate vaccine against meningococcal serogroups A, C W-135 and Y (Menveo®) in the context of treatment and prevention of invasive disease

Prevention of meningococcal disease during the Hajj and Umrah mass gatherings: past and current measures and future prospects

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Imported Ciprofloxacin-ResistantNeisseria meningitidis

Cited by 19 publications

References 7 publications

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Evolutionary Changes in Antimicrobial Resistance of Invasive Neisseria meningitidis Isolates in Belgium from 2000 to 2010: Increasing Prevalence of Penicillin Nonsusceptibility

Critical appraisal of a quadrivalent CRM197 conjugate vaccine against meningococcal serogroups A, C W-135 and Y (Menveo&reg;) in the context of treatment and prevention of invasive disease

Prevention of meningococcal disease during the Hajj and Umrah mass gatherings: past and current measures and future prospects

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Product

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Critical appraisal of a quadrivalent CRM197 conjugate vaccine against meningococcal serogroups A, C W-135 and Y (Menveo®) in the context of treatment and prevention of invasive disease