Antimicrobial Susceptibility of Neisseria meningitidis Causing Meningococcal Meningitis in Taiwan, 2004–2021

DOI: 10.6524/EB.202410_40(19).0001

Shu-Man Yao, Ying-Yan Chen, Sheng-Ping Chou, Tzu-Chieh Wei, Yu-Chun Wang, Chuen-Sheue Chiang^*

2024 Vol.40 NO.19

Correspondence Author： Chuen-Sheue Chiang^*

Abstract：

        An outbreak of meningococcal meningitis occurred in a military camp in northern Taiwan in July 2017. Later, ^{Neisseria meningitidis} isolates from blood and cerebrospinal fluid from confirmed cases were found to be resistant to ciprofloxacin, resulting in giving azithromycin to many close contacts who were previously given ciprofloxacin for antimicrobial chemoprophylaxis. Therefore, we began to test the antimicrobial susceptibility of all newly obtained N. meningitidis isolates causing meningococcal meningitis and strains in our collection. Among the 118 isolates collected from 2004 to 2021 against 9 antimicrobial agents, the susceptibility rates to azithromycin, cefotaxime, ceftriaxone, rifampicin, and meropenem were 100%, while the susceptibility rates to chloramphenicol, ciprofloxacin, penicillin G and trimethoprim/sulfamethoxazole were 99.2%, 88.1%, 59.3% and 5.9%, respectively. The first ciprofloxacin non-susceptible N. meningitidis isolate appeared in 2006 and has appeared every year since 2016. The first penicillin G non-susceptible N. meningitidis isolate appeared in 2004 and appeared every year except 2009. By DNA sequencing of related genes, the T91I mutation in the DNA gyrase A encoding gene gyrA and multiple mutations in the end portion of the penicillin-binding protein 2 (PBP2) encoding gene penA was likely responsible for antimicrobial resistance to ciprofloxacin and penicillin G, respectively.