1887

Abstract

To prevent secondary invasive meningococcal disease (IMD) cases and outbreaks, antimicrobial prophylaxis of high-risk contacts is indicated. This study reports two ciprofloxacin-resistant Neisseria meningitidis strains in Brazil. The 3523 N. meningitidis isolates collected throughout Brazil from 2009 to 2016 were evaluated for antimicrobial resistance. Meningococcal isolates showing minimal inhibitory concentrations, MICs≥0.125µg ml to ciprofloxacin, were analysed to determine the presence of mutations in the quinolone resistance-determining regions (QRDRs) of gyrA and parC genes. Two ciprofloxacin-resistant N. meningitidis isolates were found, both presenting a single mutation in the quinolone resistance-determining region of the gyrA gene. These results confirmed that ciprofloxacin is still a first-line drug for chemoprophylaxis. However, we highlight the importance of continued surveillance to monitor the trends of N. meningitidis susceptibility profiles to the antimicrobials recommended for chemoprophylaxis and IMD treatment.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000685
2018-01-18
2019-10-23
Loading full text...

Full text loading...

/deliver/fulltext/jmm/67/3/286.html?itemId=/content/journal/jmm/10.1099/jmm.0.000685&mimeType=html&fmt=ahah

References

  1. Ministry of Health 2016; Meningococcal disease in Brazil. http://portalarquivos.saude.gov.br/images/pdf/2016/outubro/33/tabela-2000-2015_meningite.pdf (acessed 3 March 2017)
  2. Doença Meningocócica 2016; In: Health Surveillance Guide / Ministry of Health, Health Surveillance Secretary. Brasília: Ministry of Health Brazilhttp://bvsms.saude.gov.br/bvs/publicacoes/guia_vigilancia_saude_1ed_atual.pdf
    [Google Scholar]
  3. Rosenstein NE, Perkins BA, Stephens DS, Popovic T, Hughes JM. Meningococcal disease. N Engl J Med 2001;344:1378–1388 [CrossRef][PubMed]
    [Google Scholar]
  4. Popovic T, Ajello GW, Facklam RR. Laboratory Methods for the Diagnosis of Meningitis caused by Neisseria meningitidis, Streptococcus pneumoniae, and Haemophilus influenzae Atlanta,GA: Centers for Disease Control, World Health Organization; 1998
    [Google Scholar]
  5. Wedege E, Høiby EA, Rosenqvist E, Frøholm LO. Serotyping and subtyping of Neisseria meningitidis isolates by co-agglutination, dot-blotting and ELISA. J Med Microbiol 1990;31:195–201 [CrossRef][PubMed]
    [Google Scholar]
  6. Maiden MC, Bygraves JA, Feil E, Morelli G, Russell JE et al. Multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. Proc Natl Acad Sci USA 1998;95:3140–3145 [CrossRef][PubMed]
    [Google Scholar]
  7. Methods for dilution antimicrobial susceptibility tests for bacteria that grow aerobically; Approved Standard - seventh informational supplement. In: CLSI Document M7-A10 Wayne, PA: Clinical and Laboratory Standards Institute; 2015
    [Google Scholar]
  8. Performance Standards for Antimicrobial Disk Susceptibility Tests: Twelfth Edition.. In: CLSI Document M02-A12 2015
    [Google Scholar]
  9. Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Fifth informational supplement. In: CLSI Document M100-S27 Wayne, PA: Clinical and Laboratory Standards Institute; 2017
  10. Lindbäck E, Rahman M, Jalal S, Wretlind B. Mutations in gyrA, gyrB, parC, and parE in quinolone-resistant strains of Neisseria gonorrhoeae. APMIS 2002;110:651–657 [CrossRef][PubMed]
    [Google Scholar]
  11. Alcalá B, Salcedo C, de La Fuente L, Arreaza L, Uría MJ et al. Neisseria meningitidis showing decreased susceptibility to ciprofloxacin: first report in Spain. J Antimicrob Chemother 2004;53:409 [CrossRef][PubMed]
    [Google Scholar]
  12. Corso A, Faccone D, Miranda M, Rodriguez M, Regueira M et al. Emergence of Neisseria meningitidis with decreased susceptibility to ciprofloxacin in Argentina. J Antimicrob Chemother 2005;55:596–597 [CrossRef][PubMed]
    [Google Scholar]
  13. Enríquez R, Abad R, Salcedo C, Pérez S, Vázquez JA. Fluoroquinolone resistance in Neisseria meningitidis in Spain. J Antimicrob Chemother 2008;61:286–290 [CrossRef][PubMed]
    [Google Scholar]
  14. Wu HM, Harcourt BH, Hatcher CP, Wei SC, Novak RT et al. Emergence of ciprofloxacin-resistant Neisseria meningitidis in North America. N Engl J Med 2009;360:886–892 [CrossRef][PubMed]
    [Google Scholar]
  15. Weidlich L, Baethgen LF, Mayer LW, Moraes C, Klein CC et al. High prevalence of Neisseria meningitidis hypervirulent lineages and emergence of W135:P1.5,2:ST-11 clone in Southern Brazil. J Infect 2008;57:324–331 [CrossRef][PubMed]
    [Google Scholar]
  16. Sorhouet PC, Efron A, Gagetti P, Faccone D, Regueira M et al. Phenotypic and genotypic characteristics of Neisseria meningitidis disease-causing strains in Argentina, 2010. PlosOne 2013;8:1-7.e58065
    [Google Scholar]
  17. Gorla MC, de Lemos AP, Quaresma M, Vilasboas R, Marques O et al. Phenotypic and molecular characterization of serogroup C Neisseria meningitidis associated with an outbreak in Bahia, Brazil. Enferm Infecc Microbiol Clin 2012;30:56–59 [CrossRef][PubMed]
    [Google Scholar]
  18. Shultz TR, Tapsall JW, White PA, Newton PJ. An invasive isolate of Neisseria meningitidis showing decreased susceptibility to quinolones. Antimicrob Agents Chemother 2000;44:1116 [CrossRef][PubMed]
    [Google Scholar]
  19. Tsang RS, Law DK, Deng S, Hoang L. Ciprofloxacin-resistant Neisseria meningitidis in Canada: likely imported strains. Can J Microbiol 2017;63:265–268 [CrossRef][PubMed]
    [Google Scholar]
  20. Skoczynska A, Alonso JM, Taha MK. Ciprofloxacin resistance in Neisseria meningitidis, France. Emerg Infect Dis 2008;14:1322–1323 [CrossRef][PubMed]
    [Google Scholar]
  21. Hong E, Thulin Hedberg S, Abad R, Fazio C, Enríquez R et al. Target gene sequencing to define the susceptibility of Neisseria meningitidis to ciprofloxacin. Antimicrob Agents Chemother 2013;57:1961–1964 [CrossRef][PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000685
Loading
/content/journal/jmm/10.1099/jmm.0.000685
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error