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Ciprofloxacin-resistant Neisseria meningitidis in Canada: likely imported strains
Raymond S W Tsang1, Dennis K S Law1, Saul Deng1
1a Vaccine Preventable Bacterial Diseases, National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB R3E 3R2, Canada.
Abstract:
The prevalence of ciprofloxacin-resistant Neisseria meningitidis in Canada was studied by testing 346 isolates received at the National Microbiology Laboratory during the calendar years 2013 to 2015. Of the 277 individual invasive and 69 noninvasive isolates tested, only 2 serogroup C (MenC) isolates were found to be resistant to ciprofloxacin. Both MenC were typed as sequence type (ST)-4821, a unique clone found mainly in China, thus suggesting both isolates might be from travel-related or imported cases. This prompted us to also examine 6 serogroup A (MenA) isolates in our collection, since MenA is not currently endemic in Canada. Three MenA from 2006 were resistant to ciprofloxacin and they were typed as ST-4789. A ciprofloxacin-resistant MenA strain of ST-4789 was responsible for a meningococcal disease outbreak in Delhi, India, in 2005 to 2006. The 2 MenC and 3 MenA ciprofloxacin-resistant N. meningitidis were from patients residing in British Columbia.
Insights
Ciprofloxacin resistance in Neisseria meningitidis is rare in Canada. Two ciprofloxacin-resistant meningococcal serogroup C isolates, possibly imported, were identified, alongside three older serogroup A isolates.
Area of Science:
- Microbiology
- Infectious Diseases
- Antimicrobial Resistance
Background:
- Neisseria meningitidis is a significant cause of bacterial meningitis.
- Ciprofloxacin is a key antibiotic for treating meningococcal infections.
- Monitoring antimicrobial resistance is crucial for public health.
Purpose of the Study:
- To determine the prevalence of ciprofloxacin-resistant Neisseria meningitidis in Canada.
- To characterize resistant isolates found in Canadian collections.
Main Methods:
- Testing 346 Neisseria meningitidis isolates (277 invasive, 69 non-invasive) collected between 2013-2015.
- Antimicrobial susceptibility testing for ciprofloxacin.
- Molecular typing (Sequence Type - ST) of resistant isolates.
Main Results:
- Only two ciprofloxacin-resistant Neisseria meningitidis isolates were detected: both serogroup C (MenC) and ST-4821.
- These MenC isolates were potentially linked to travel or import from China.
- Three older (2006) serogroup A (MenA) isolates of ST-4789 were also ciprofloxacin-resistant, a type linked to an Indian outbreak.
Conclusions:
- Ciprofloxacin resistance in Neisseria meningitidis appears uncommon in Canada based on recent isolates.
- The identification of specific resistant clones (ST-4821 MenC, ST-4789 MenA) suggests potential importation.
- Further surveillance is warranted to monitor emerging resistance patterns.
