Ciprofloxacin-Resistant Meningitis Identified

February 27, 2008

The first reported North American cluster of ciprofloxacin-resistant meningoccocal disease occurred in 2007-2008 in North Dakota and Minnesota, according to a report published in the Feb. 22 issue of the U.S. Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report.

<p>WEDNESDAY, Feb. 27 (HealthDay News) -- The first reported North American cluster of ciprofloxacin-resistant meningoccocal disease occurred in 2007-2008 in North Dakota and Minnesota, according to a report published in the Feb. 22 issue of the U.S. Centers for Disease Control and Prevention's <i>Morbidity and Mortality Weekly Report</i>.</p><p>Jean Rainbow, of the Minnesota Department of Health, and colleagues identified three cases of fluoroquinolone-resistant serogroup B meningococcal disease that occurred in 2007-2008 along the North Dakota-Minnesota border, including a child from eastern North Dakota who made a full recovery, an adult resident of western Minnesota who died, and a college senior from western Minnesota who made a full recovery. In all three cases, fluoroquinolone-resistant serogroup B <i>Neisseria meningitidis</i> was isolated from cerebrospinal fluid.</p><p>The researchers found the first case was a student at a daycare center where a worker developed fluoroquinolone-susceptible meningococcal disease in 2006 and died on the first day of hospitalization. Although these two cases had closely related molecular features, the researchers found that the 2006 case lacked the <i>gyrA</i> gene mutation that causes fluoroquinolone resistance.</p><p>"Although isolated cases of ciprofloxacin-resistant meningoccocal disease have been described in Argentina, Australia, China, France, India and Spain, resistance has not been reported in North America," the authors write. "Until further notice, ciprofloxacin should not be used for chemoprophylaxis of close contacts of persons with meningococcal disease in selected counties in North Dakota and Minnesota. Ceftriaxone, rifampin and azithromycin are alternative agents."</p><p><a href="http://www.cdc.gov/mmwr/preview/mmwrhtml/mm5707a2.htm" target="_new">More Information</a></p>

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