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Meningococcal disease: history, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial

V Manchanda1, S Gupta, P Bhalla

  • 1Department of Microbiology, Maulana Azad Medical College New Delhi-110 002, India. manchandavikas@hotmail.com

Indian Journal of Medical Microbiology
|March 1, 2006
PubMed

Insights

Meningococcal disease outbreaks, particularly in India, show Neisseria meningitidis resistance to cotrimoxazole and reduced susceptibility to ciprofloxacin. Continuous surveillance is crucial for managing this infectious disease.

Area of Science:

  • Microbiology
  • Epidemiology
  • Infectious Diseases

Background:

  • Meningococcal disease outbreaks pose a global health threat.
  • A significant surge in meningococcal disease cases occurred in Delhi, India, and surrounding regions in early 2005.
  • Neisseria meningitidis is the causative agent of meningococcal disease, including meningococcemia and meningitis.

Purpose of the Study:

  • To analyze the drug susceptibility patterns of Neisseria meningitidis during the 2005 Delhi outbreak.
  • To highlight the implications of antimicrobial resistance on treatment and chemoprophylaxis strategies.
  • To emphasize the need for ongoing surveillance of meningococcal disease.

Main Methods:

  • Microbiological investigation of probable cases of meningococcal disease.
  • Drug susceptibility testing using the MIC (minimum inhibitory concentration) method (E-test).
  • Analysis of isolates based on recently recommended NCCLS/CLSI breakpoints.

Main Results:

  • All Neisseria meningitidis isolates were susceptible to penicillin, ampicillin, rifampicin, and ceftriaxone.
  • Approximately two-thirds of isolates exhibited 'non-susceptibility' to ciprofloxacin.
  • All isolates demonstrated resistance to cotrimoxazole.

Conclusions:

  • The study underscores the emergence of antimicrobial resistance in Neisseria meningitidis.
  • Decreased susceptibility to ciprofloxacin, a common chemoprophylactic agent, necessitates careful consideration.
  • Consistent surveillance systems are essential for effective control and management of recurrent meningococcal disease outbreaks.

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