Progression of Antibiotic Resistance in

Overview

Journal Clin Microbiol Rev

Publisher American Society for Microbiology

Date 2025 Jan 31

PMID 39887238

Authors

Emilio Rodriguez

Yih-Ling Tzeng

Isha Berry

Rebecca Howie

Lucy McNamara

David S Stephens

Affiliations

Soon will be listed here.

Abstract

SUMMARYThe human pathogen () is the causative agent of invasive meningococcal disease (IMD), usually presenting as meningitis, bacteremia, or sepsis. Unlike , antibiotic resistance in has developed slowly. However, in the last two decades and with the reemergence of IMD following the COVID-19 pandemic, antibiotic-resistant isolates, especially to penicillin and fluoroquinolones, have progressively increased. Recent worldwide studies of penicillin intermediate and resistant isolates and the PubMLST global database reveal a notable increase in fully penicillin-resistant isolates since 2016, mediated by mosaic alleles or the β-lactamase genes and . Fluoroquinolone-resistant isolates, mediated by mutations, have increased since 2005. Also, while still exceptionally rare, four isolates have been identified with third-generation cephalosporin-resistance since 2011. We review the emergence of antibiotic resistance determinants and lineages in the resistance to agents previously or currently used in treatment or chemoprophylaxis, and summarize updated treatment and prevention guidelines for IMD. Special populations (e.g., individuals on complement inhibitors) and antibiotic resistance in urethritis isolates are also reviewed. The increasing number of resistant isolates worldwide affects chemoprophylaxis and treatment options for IMD and emphasizes the need for enhanced global surveillance of antibiotic resistance in .

References

Fairbrother R . Cerebrospinal Meningitis. The Use of Sulphonamide Derivatives in Prophylaxis. Br Med J. 2010; 2(4172):859-62. PMC: 2180130. DOI: 10.1136/bmj.2.4172.859. View

Chen M, Shao Y, Luo J, Yuan L, Wang M, Chen M . Penicillin and Cefotaxime Resistance of Quinolone-Resistant Neisseria meningitidis Clonal Complex 4821, Shanghai, China, 1965-2020. Emerg Infect Dis. 2023; 29(2):341-350. PMC: 9881793. DOI: 10.3201/eid2902.221066. View

McNamara L, Potts C, Blain A, Retchless A, Reese N, Swint S . Detection of Ciprofloxacin-Resistant, β-Lactamase-Producing Neisseria meningitidis Serogroup Y Isolates - United States, 2019-2020. MMWR Morb Mortal Wkly Rep. 2020; 69(24):735-739. PMC: 7302475. DOI: 10.15585/mmwr.mm6924a2. View

McNamara L, Topaz N, Wang X, Hariri S, Fox L, MacNeil J . High Risk for Invasive Meningococcal Disease Among Patients Receiving Eculizumab (Soliris) Despite Receipt of Meningococcal Vaccine. MMWR Morb Mortal Wkly Rep. 2017; 66(27):734-737. PMC: 5687588. DOI: 10.15585/mmwr.mm6627e1. View

Bazan J, Tzeng Y, Bischof K, Satola S, Stephens D, Edwards J . Antibiotic Susceptibility Profile for the US Urethritis Clade. Open Forum Infect Dis. 2023; 10(1):ofac661. PMC: 9835751. DOI: 10.1093/ofid/ofac661. View

Willerton L, Lucidarme J, Campbell H, Caugant D, Claus H, Jacobsson S . Geographically widespread invasive meningococcal disease caused by a ciprofloxacin resistant non-groupable strain of the ST-175 clonal complex. J Infect. 2020; 81(4):575-584. DOI: 10.1016/j.jinf.2020.08.030. View

Roy C, Tirado M, REIG R, Hermida M, Fontanals D, Esteva C . [Type TEM beta-lactamase activity in a Neisseria meningitidis strain]. Enferm Infecc Microbiol Clin. 1989; 7(4):206-9. View

Zhou Z, Alikhan N, Sergeant M, Luhmann N, Vaz C, Francisco A . GrapeTree: visualization of core genomic relationships among 100,000 bacterial pathogens. Genome Res. 2018; 28(9):1395-1404. PMC: 6120633. DOI: 10.1101/gr.232397.117. View

Gorla M, Cassiolato A, Pinhata J, de Moraes C, Corso A, Gagetti P . Emergence of resistance to ciprofloxacin in Neisseria meningitidis in Brazil. J Med Microbiol. 2018; 67(3):286-288. DOI: 10.1099/jmm.0.000685. View

10.

Saito R, Nakajima J, Prah I, Morita M, Mahazu S, Ota Y . Penicillin- and Ciprofloxacin-Resistant Invasive Neisseria meningitidis Isolates from Japan. Microbiol Spectr. 2022; 10(3):e0062722. PMC: 9241714. DOI: 10.1128/spectrum.00627-22. View

11.

Galimand M, Gerbaud G, Guibourdenche M, Riou J, Courvalin P . High-level chloramphenicol resistance in Neisseria meningitidis. N Engl J Med. 1998; 339(13):868-74. DOI: 10.1056/NEJM199809243391302. View

12.

Stephens D, Greenwood B, Brandtzaeg P . Epidemic meningitis, meningococcaemia, and Neisseria meningitidis. Lancet. 2007; 369(9580):2196-2210. DOI: 10.1016/S0140-6736(07)61016-2. View

13.

Zhao S, Tobiason D, Hu M, Seifert H, Nicholas R . The penC mutation conferring antibiotic resistance in Neisseria gonorrhoeae arises from a mutation in the PilQ secretin that interferes with multimer stability. Mol Microbiol. 2005; 57(5):1238-51. PMC: 2673695. DOI: 10.1111/j.1365-2958.2005.04752.x. View

14.

Maiden M, Bygraves J, Feil E, Morelli G, Russell J, Urwin R . Multilocus sequence typing: a portable approach to the identification of clones within populations of pathogenic microorganisms. Proc Natl Acad Sci U S A. 1998; 95(6):3140-5. PMC: 19708. DOI: 10.1073/pnas.95.6.3140. View

15.

Asturias E, Bai X, Bettinger J, Borrow R, Castillo D, Caugant D . Meningococcal disease in North America: Updates from the Global Meningococcal Initiative. J Infect. 2022; 85(6):611-622. PMC: 11091909. DOI: 10.1016/j.jinf.2022.10.022. View

16.

Garcia-Cobos S, Arroyo M, Campos J, Perez-Vazquez M, Aracil B, Cercenado E . Novel mechanisms of resistance to β-lactam antibiotics in Haemophilus parainfluenzae: β-lactamase-negative ampicillin resistance and inhibitor-resistant TEM β-lactamases. J Antimicrob Chemother. 2013; 68(5):1054-9. DOI: 10.1093/jac/dks525. View

17.

Gardner P . Clinical practice. Prevention of meningococcal disease. N Engl J Med. 2006; 355(14):1466-73. DOI: 10.1056/NEJMcp063561. View

18.

du Plessis M, von Gottberg A, Cohen C, de Gouveia L, Klugman K . Neisseria meningitidis intermediately resistant to penicillin and causing invasive disease in South Africa in 2001 to 2005. J Clin Microbiol. 2008; 46(10):3208-14. PMC: 2566094. DOI: 10.1128/JCM.00221-08. View

19.

Potts C, Retchless A, McNamara L, Marasini D, Reese N, Swint S . Acquisition of Ciprofloxacin Resistance Among an Expanding Clade of β-Lactamase-Positive, Serogroup Y Neisseria meningitidis in the United States. Clin Infect Dis. 2021; 73(7):1185-1193. PMC: 9250101. DOI: 10.1093/cid/ciab358. View

20.

SCHOENBACH E, PHAIR J . The sensitivity of meningococci to sulfadiazine. Am J Hyg. 1948; 47(2):177-86. DOI: 10.1093/oxfordjournals.aje.a119194. View