Antimicrobial Susceptibility Survey of Invasive Neisseria meningitidis, United States 2012-2016.

Abstract

Historically, antimicrobial resistance has been rare in US invasive meningococcal disease cases. Meningococcal isolates (n = 695) were collected through population-based surveillance, 2012-2016, and national surveillance, 2015-2016. Antimicrobial susceptibility was assessed by broth microdilution. Resistance mechanisms were characterized using whole-genome sequencing. All isolates were susceptible to 6 antibiotics (cefotaxime, ceftriaxone, meropenem, rifampin, minocycline, and azithromycin). Approximately 25% were penicillin or ampicillin intermediate; among these, 79% contained mosaic penA gene mutations. Less than 1% of isolates were penicillin, ampicillin, ciprofloxacin, or levofloxacin resistant. Penicillin- and ampicillin-intermediate isolates were common, but resistance to clinically relevant antibiotics remained rare.