06/19/2020: Lab Advisory: Detection of Ciprofloxacin-resistant, β-lactamase-producing Neisseria meningitidis Serogroup Y Isolates, United States, 2019–2020

CDC's Laboratory Outreach Communication System (LOCS)

Audience: Clinical Laboratory Professionals

Level: Laboratory Advisory

Detection of Ciprofloxacin-resistant, β-lactamase-producing Neisseria meningitidis Serogroup Y Isolates, United States, 2019–2020

Meningococcal disease, which typically presents as meningitis or meningococcemia, is a life-threatening illness that requires prompt antibiotic treatment for patients, and antibiotic prophylaxis for their close contacts. Neisseria meningitidis isolates in the United States have been largely susceptible to the antibiotics recommended for treatment and prophylaxis. However, 11 meningococcal disease cases reported in the United States during 2019–2020 had isolates that contained a blaROB-1 β-lactamase gene associated with penicillin resistance, as well as mutations associated with ciprofloxacin resistance. An additional 22 cases reported during 2013–2020 contained a blaROB-1 β-lactamase gene, but did not have mutations associated with ciprofloxacin resistance.

Laboratories should be aware that CDC recommends that healthcare providers use antimicrobial susceptibility testing (AST) to determine susceptibility of all meningococcal isolates to penicillin before changing from empirical treatment with cefotaxime or ceftriaxone to penicillin or ampicillin.

For more information, read the official CDC Health Advisory.

Online resources:

Laboratory Outreach Communication System | Division of Laboratory Systems (DLS)

Center for Surveillance, Epidemiology, and Laboratory Services (CSELS)

Centers for Disease Control and Prevention (CDC)

LOCS@cdc.gov

www.cdc.gov/csels/dls/locs

Page last reviewed: June 19, 2020