Emerging ciprofloxacin resistant Neisseria meningitidis serogroup B among prison outbreak in Nan province; case series

Abstract

The Gram-negative bacterium, Neisseria meningitidis, is a human pathogen that colonizes the nasopharyngeal mucosa. It can cause invasive meningococcal disease (IMD) by passing into the bloodstream via the mucosal membrane. Close contacts of case patients are at increased risk for disease, and chemoprophylaxis is an urgent intervention for the prevention of the disease. Ciprofloxacin and rifampicin are acceptable antimicrobial agents. Ciprofloxacin is more commonly used than rifampicin because of its convenience. However, the emergence of ciprofloxacin-resistant N. meningitidis has been reported in many countries and Thailand. This case series from the outbreak within the Nan provincial prison aims to describe the clinical manifestations, laboratory culture results, and drug resistance profile of the N. meningitidis resistance to ciprofloxacin.