CDC - Emergence of Fluoroquinolone-Resistant Neisseria meningitidis ― Minnesota and North Dakota, 2007-2008

Antimicrobial resistance is a growing problem and each new example stresses the importance of judicious use of antibiotics. The problem of ciprofloxacin-resistant N. meningitidis appears to be isolated to the North Dakota/Minnesota border region, and alternative medications are available. CDC is working to rapidly determine the extent of the problem. This report describes three cases of ciprofloxacin-resistant meningococcal disease that occurred among residents in selected counties of the border area of North Dakota and Minnesota during January 2007-January 2008. Until further notice, ciprofloxacin should not be used for prevention of disease in close contacts of those with meningococcal disease in those counties. Alternative medications are Ceftriaxone, rifampin, and azithromycin. Meningococcal disease causes substantial morbidity and mortality; approximately 10 percent of cases are fatal. Carrying N. meningitidis in the nose and throat is a precursor to developing the disease; however, most carriers do not develop the disease. Ciprofloxacin is one of several medications used to eliminate the carrying of N. meningitidis in close contacts. Although isolated cases of ciprofloxacin-resistant meningococcal disease have been described in other countries, until now, resistance to the medication had not been reported in North America.
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