rifampin and Meningococcal-Infections

Meningococcal disease is a contagious bacterial infection caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest risk of contracting the disease during the first week of a case being detected. Prophylaxis is considered for close contacts of people with a meningococcal infection and populations with known high carriage rates.. To study the effectiveness, adverse events and development of drug resistance of different antibiotics as prophylactic treatment regimens for meningococcal infection.. We searched CENTRAL 2013, Issue 6, MEDLINE (January 1966 to June week 1, 2013), EMBASE (1980 to June 2013) and LILACS (1982 to June 2013).. Randomised controlled trials (RCTs) or quasi-RCTs addressing the effectiveness of different antibiotics for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two review authors independently appraised the quality and extracted data from the included trials. We analysed dichotomous data by calculating the risk ratio (RR) and 95% confidence interval (CI) for each trial.. No new trials were found for inclusion in this update. We included 24 studies; 19 including 2531 randomised participants and five including 4354 cluster-randomised participants. There were no cases of meningococcal disease during follow-up in the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed.Mortality that was reported in one study was not related to meningococcal disease or treatment. Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.13 to 0.24), minocycline (RR 0.28; 95% CI 0.21 to 0.37) and penicillin (RR 0.47; 95% CI 0.24 to 0.94) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. Rifampin (RR 0.20; 95% CI 0.14 to 0.29), ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) and penicillin (RR 0.63; 95% CI 0.51 to 0.79) still proved effective at one to two weeks. Rifampin was effective compared to placebo up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but rifampin was less effective than ceftriaxone after one to two weeks of follow-up (RR 5.93; 95% CI 1.22 to 28.68). Mild adverse events associated with treatment were observed.. Using rifampin during an outbreak may lead to the circulation of resistant isolates. Use of ciprofloxacin, ceftriaxone or penicillin should be considered. All four agents were effective for up to two weeks follow-up, though more trials comparing the effectiveness of these agents for eradicating N. meningitidis would provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Meningococcal disease is a contagious bacterial infection caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest risk of contracting the disease during the first week of a case being detected. Prophylaxis is considered for close contacts of people with a meningococcal infection and populations with known high carriage rates.. To study the effectiveness of different prophylactic treatment regimens.. We searched the Cochrane Central Register of Controlled Trials (CENTRAL 2011, Issue 2) which contains the Cochrane Acute Respiratory Infections Group Specialised Register, MEDLINE (January 1966 to May Week 3, 2011), EMBASE (1980 to May 2011) and LILACS (1982 to May 2011).. Randomised controlled trials (RCTs) or quasi-RCTs addressing the effectiveness of different antibiotics for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two review authors independently appraised the quality and extracted data from the included trials. We analysed dichotomous data by calculating the risk ratio (RR) and 95% confidence interval (CI) for each trial.. We included 24 studies; 19 including 2531 randomised participants and five including 4354 cluster-randomised participants. There were no cases of meningococcal disease during follow up in the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed.Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.13 to 0.24), minocycline (RR 0.28; 95% CI 0.21 to 0.37) and penicillin (RR 0.47; 95% CI 0.24 to 0.94) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. Rifampin (RR 0.20; 95% CI 0.14 to 0.29), ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) and penicillin (RR 0.63; 95% CI 0.51 to 0.79) still proved effective at one to two weeks. Rifampin was effective compared to placebo up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but ceftriaxone was more effective than rifampin after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68). Mild adverse events associated with treatment were observed.. Using rifampin during an outbreak may lead to the circulation of resistant isolates. Use of ciprofloxacin, ceftriaxone or penicillin should be considered. All four agents were effective for up to two weeks follow up, though more trials comparing the effectiveness of these agents for eradicating N. meningitidis would provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Topics: Adolescent; Adult; Anti-Infective Agents; Ceftriaxone; Child; Ciprofloxacin; Disease Outbreaks; Humans; Male; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Practice Guidelines as Topic; Rifampin; United States; Vaccines, Conjugate

Meningococcal disease is a contagious bacterial disease caused by Neisseria meningitidis (N. meningitidis). Household contacts have the highest documented risk of the disease during the first seven days of a case being detected. Prophylaxis is, therefore, considered for those in close contact with people with a meningococcal infection and in populations with known high carriage rates as carriers are at increased risk of disease and may pose a risk of infection to others.. To study the effectiveness of different prophylactic treatment regimens in: (1) preventing secondary cases of meningococcal disease after contact with someone with the disease; (2) preventing cases of meningococcal disease in populations with a high rate of N. meningitidis carriers; (3) eradicating N. meningitidis from the pharynx in healthy carriers of N. meningitidis. This review also addresses the issues of adverse effects of prophylaxis and development of drug resistance.. Electronic searches on the Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 3, 2006), MEDLINE (January 1966 to June 2006), EMBASE (1980 to June 2006), LILACS (1982 to June 2006); and searching of references of all identified studies were performed.. Randomised or quasi-randomised clinical trials addressing the effectiveness of different antibiotic treatments for: (a) prophylaxis against meningococcal disease; (b) eradication of N. meningitidis.. Two reviewers independently appraised the quality of each trial and extracted data from the included trials. Dichotomous data were analysed by calculating the relative risk (RR) and 95% confidence interval for each trial.. There were no cases of meningococcal disease during follow up in any of the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed. Ciprofloxacin (RR 0.04; 95% CI 0.01 to 0.12), rifampin (rifampicin) (RR 0.17; 95% CI 0.12 to 0.24), minocycline (RR 0.30; 95% CI 0.19 to 0.45) and ampicillin (RR 0.41; 95% CI 0.25 to 0.66) proved effective at eradicating N. meningitidis one week after treatment when compared with placebo. However, only rifampin (RR 0.20; 95% CI 0.14 to 0.29) and ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) still proved effective at one to two weeks. Rifampin continued to be effective compared to placebo for up to four weeks after treatment but resistant isolates were seen following prophylactic treatment. No trials evaluated ceftriaxone against placebo but ceftriaxone was more effective than rifampin after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68).. Given the fact that the use of rifampin in an outbreak setting might lead to the circulation of isolates resistant to rifampin, use of ciprofloxacin or ceftriaxone should be considered. Evidence suggests that all three agents are effective with up to two weeks follow up. Placebo-controlled trials do not seem ethical as prophylactic treatment has been proven to reduce the risk of disease among household contacts. More trials comparing the effectiveness of ceftriaxone, ciprofloxacin and rifampin for eradicating N. meningitidis would provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ceftriaxone; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Meningococcal disease is a contagious bacterial disease caused by Neisseria meningitidis (N. meningitidis). The highest documented risk of disease is for household contacts during the first seven days of a case being detected. Prophylaxis is considered for those in close contact with people with a meningococcal infection and in populations with known high carriage rates as carriers are at increased risk of disease and may pose a risk of infection to others.. To study the effectiveness of different prophylactic treatment regimens in: (1) preventing secondary cases of meningococcal disease after contact with a case; (2) preventing cases of meningococcal disease in populations with a high rate of N. meningitidis carriers; (3) eradicating N. meningitidis from the pharynx in healthy carriers of N. meningitidis;This review also addresses the issues of adverse affects and development of drug resistance.. Electronic searches on The Cochrane Central Register of Controlled Trials (CENTRAL) (The Cochrane Library Issue 2, 2004), MEDLINE (January 1966 to July 2004), EMBASE (1980 to September 2004), LILACS (1982 to July 2004), and searches of references of all identified studies.. Randomised or quasi-randomised clinical trials addressing the effectiveness of different antibiotic treatments for (a) prophylaxis of/against meningococcal disease; (b) eradication of N. meningitidis.. Two reviewers independently appraised the quality of each trial and extracted data from the included trials. Dichotomous data were analysed by calculating the relative risk (RR) and 95% confidence interval for each trial.. There were no cases of meningococcal disease during follow up in any of the trials, thus effectiveness regarding prevention of future disease cannot be directly assessed. Ciprofloxacin (relative risk (RR) 0.04; 95% CI 0.01 to 0.12), rifampin (RR 0.17; 95% CI 0.12 0.24), minocycline (RR = 0.30; 95% CI 0.19 to 0.45) and ampicillin (RR 0.41; 95% CI 0.25 0.66) proved effective at eradicating N. meningitidis one week after treatment, compared with placebo. However, after one to two weeks only rifampin (RR 0.20; 95% CI 0.14 to 0.29) and ciprofloxacin (RR 0.03; 95% CI 0.00 to 0.42) still proved effective. No trials evaluated ceftriaxone against placebo. Ceftriaxone was more effective than rifampin, after one to two weeks of follow up (RR 5.93; 95% CI 1.22 to 28.68). Rifampin continued to be effective compared to placebo until up to four weeks of post treatment follow up but resistant isolates were seen following prophylactic treatment.. Given the fact that the use of rifampin in an outbreak setting might lead to the circulation of isolates resistant to rifampin, use of ciprofloxacin or ceftriaxone should be considered.Placebo-controlled trials do not seem ethical as prophylactic treatment has been proven to reduce the risk of disease among household contacts. More trials comparing the effectiveness of ceftriaxone, ciprofloxacin and rifampin for eradicating N. meningitidis could provide important insights.

Topics: Ampicillin; Anti-Bacterial Agents; Ciprofloxacin; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Randomized Controlled Trials as Topic; Rifampin

Topics: Adolescent; Adult; Bacterial Vaccines; Canada; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Communicable Disease Control; Female; Humans; Infant; Infant, Newborn; Meningococcal Infections; Meningococcal Vaccines; Pregnancy; Public Health; Rifampin; Vaccination

Topics: Anti-Bacterial Agents; Carrier State; Ceftriaxone; Ciprofloxacin; Half-Life; Humans; Meningococcal Infections; Pharynx; Rifampin; Risk Factors

Topics: Bacterial Vaccines; Carrier State; Humans; Meningococcal Infections; Minocycline; Nasopharynx; Neisseria meningitidis; Rifampin; Risk; Sulfonamides; Vaccination

Topics: Humans; Infant; Meningococcal Infections; Polysaccharides, Bacterial; Rifampin; Sulfadiazine; Sulfonamides; Vaccines

Topics: Agglutination Tests; Bacteriological Techniques; Carrier State; England; Humans; Immunization; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Netherlands; Penicillin G; Rifampin; Skin Manifestations; Sulfonamides; United States; Wales

Topics: Abnormalities, Drug-Induced; Anti-Bacterial Agents; Anti-Infective Agents; Bacterial Infections; Chemical and Drug Induced Liver Injury; Drug Interactions; Drug Resistance, Microbial; Endocarditis, Bacterial; Gonorrhea; Humans; Intestinal Absorption; Leprosy; Meningococcal Infections; Mycobacterium; Respiratory Tract Infections; Rifampin; Thrombocytosis; Tuberculosis; Tuberculosis, Pulmonary; Urologic Diseases; Viruses

The efficacy of ceftriaxone in eliminating nasopharyngeal carriage of Neisseria meningitidis was compared with that of rifampicin during an epidemic of serogroup B meningococcal disease in Auckland, New Zealand. Household contacts of cases had a throat swab taken and were randomized to treatment. Carriers had a repeat swab taken 6 days later to determine efficacy of treatment. Ceftriaxone (98.2%) was equivalent to rifampicin (97.6%) in eliminating serogroup B N. meningitidis. It is cheaper than rifampicin and has the advantage of full compliance and fewer contraindications, but its acceptability by patients may limit its use as a first-line prophylactic agent.

Topics: Adolescent; Adult; Antibiotics, Antitubercular; Carrier State; Ceftriaxone; Cephalosporins; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Rifampin; Serotyping

To evaluate the efficacy and safety of azithromycin compared with rifampin for eradication of nasopharyngeal carriage of Neisseria meningitidis. Pharyngeal swabs were obtained from 500 students attending nursing school in Cairo, Egypt, to determine the colonization rate with N. meningitidis. Colonized individuals were randomized to receive azithromycin (500 mg once) or rifampin (600 mg twice daily for four doses). Subjects were then recultured 1 and 2 weeks posttreatment to determine the effectiveness of the antibiotic therapy for eradication of meningococcal nasopharyngeal colonization.. Individuals treated with azithromycin had a 93% eradication rate at 1 and 2 weeks posttreatment comparable with 95 and 91%, respectively, for rifampin. No significant side effects were reported by any subjects treated with either antibiotic.. Azithromycin is effective in the eradication of N. meningitidis from the nasopharynx of asymptomatic colonized individuals and deserves further evaluation for use as prophylaxis against N. meningitidis.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Antibiotics, Antitubercular; Azithromycin; Carrier State; Humans; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Rifampin

Topics: Clinical Trials as Topic; Double-Blind Method; Drug Administration Schedule; Humans; Meningococcal Infections; Methods; Random Allocation; Rifampin

The results of the epidemiological control experiment on the efficacy of rifampicin in sanation of meningococci carriers are presented. The preliminary study of rifampicin sensitivity of 41 freshly isolated nasopharyngeal meningococcal strains showed that the MIC of the drug for 63 per cent of the isolates was 0.04--0.1 gamma/ml. Sanation was performed for 2 days; 1.2 g of the drug was used during the treatment course. The results of examination of 91 meningococci carriers showed that 4 days after the sanation the specific weight of the persons isolating no meningococci was reliably higher in the experimental group than that in the control group. The coefficient of rifampicin efficiency was 70.8 per cent. 10 days after sanation the difference in the level of the carriers isolating no meningococci in the experimental and the control groups was statistically insignificant. Therefore, the carriers treated with the drug received temporary protection from the causative agent at an average for 1 week. Later on they could become carriers again. As a result of sanation no changes in the meningococcal sensitivity to rifampicin was observed.

Topics: Adolescent; Adult; Carrier State; Clinical Trials as Topic; Drug Evaluation; Humans; Meningococcal Infections; Neisseria meningitidis; Rifampin

Topics: Adolescent; Adult; Carrier State; Clinical Trials as Topic; Drug Resistance, Microbial; Humans; Male; Meningococcal Infections; Microbial Sensitivity Tests; Military Medicine; Nasopharynx; Neisseria meningitidis; Placebos; Rifampin

Topics: Administration, Oral; Carrier State; Clinical Trials as Topic; Drug Resistance, Microbial; Humans; Meningococcal Infections; Neisseria meningitidis; Placebos; Rifampin; Saliva; Sulfadiazine

Topics: Adult; Carrier State; Clinical Trials as Topic; Drug Resistance, Microbial; Female; Humans; Meningococcal Infections; Neisseria meningitidis; Placebos; Rifampin; Sulfadiazine

This study examined the antimicrobial susceptibility of invasive meningococcal disease (IMD)-associated Neisseria meningitidis recovered in the Republic of Ireland between 1996 and 2016. In total, 1359 isolates representing over one-third of all laboratory-confirmed cases of IMD diagnosed each epidemiological year (EY; July 1-June 30) were analysed. All isolates were susceptible to ciprofloxacin, rifampicin and cefotaxime and 74% and 87% were susceptible to sulphonamide and penicillin, respectively. The proportion of isolates exhibiting reduced susceptibility to penicillin increased significantly during the study with no evidence of major clonal expansion or horizontal spread of a specific penA allele. Greater diversity observed among recently recovered meningococci and specifically among isolates exhibiting reduced penicillin susceptibility contributed to the overall increase in penA allele diversity throughout. The emergence and dissemination of strains with phenotypic and genotypic reduced susceptibility to penicillin increase the need for continued surveillance of antimicrobial susceptibility of meningococci in the Republic of Ireland especially in view of the recommendation of penicillin G as empiric treatment of choice for pre-hospital management.

Topics: Anti-Bacterial Agents; Bacterial Proteins; Ciprofloxacin; Genotype; Humans; Ireland; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillins; Rifampin

Invasive meningococcal disease (IMD) is a notifiable disease in Australia, and both probable and laboratory-confirmed cases of IMD are reported to the National Notifiable Diseases Surveillance System (NNDSS). In 2019, there were 206 notifications of IMD. Of these, 202 were laboratory-confirmed cases analysed by the reference laboratories of the Australian National Neisseria Network (NNN). Of the 202 laboratory-confirmed cases of IMD, 167 were confirmed by bacterial culture and 35 by nucleic acid amplification testing, and all had the serogroup determined. Fine typing was available on 146 samples (146/202, 72%). Neisseria meningitidis serogroup B (MenB) infections accounted for 50.0% (101/202); MenW for 26.2% (53/202); MenY for 20.8% (42/202) and MenC for 3.0% of cases (6/202). Of the MenW cases, 88% were PorA antigen type P1.5,2, and 65% of these (24/37) were sequence type 11, the hypervirulent strain reported in recent outbreaks in Australia and overseas. The primary peaks of IMD notifications in Australia in 2019 were observed in infants less than 1 year of age (36/202, 18%) and in adults aged 65 years or older (39/202, 19%). MenB infections predominated in those aged less than 5 years and those aged 15-19 years, whereas MenW and MenY infections predominated in those aged 45 years or more. All 167 IMD isolates were tested for antimicrobial susceptibility. One isolate out of these 167 (0.6%) was resistant to penicillin with an MIC ≥ 1mg/L; 154/167 isolates (92%) had decreased susceptibility to penicillin. All isolates were susceptible to ceftriaxone and ciprofloxacin, and one isolate was resistant to rifampicin.

Topics: Adolescent; Adult; Aged; Anti-Bacterial Agents; Australia; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Female; History, 21st Century; Humans; Infant; Male; Meningococcal Infections; Microbial Sensitivity Tests; Middle Aged; Neisseria meningitidis; Penicillins; Public Health Surveillance; Rifampin; Serogroup; Serotyping; Young Adult

Invasive meningococcal disease (IMD) persists in military units in Vietnam despite the availability of antibiotics and vaccines. A hindrance to reducing the incidence of IMD in Vietnam is a lack of molecular data from isolates of the causative agent, Neisseria meningitidis from this country. Here, we characterized key genetic and epidemiological features of an invasive N. meningitidis isolate from a military unit in Vietnam using whole-genome sequencing.. Neisseria meningitidis was isolated from a conscript admitted for meningitis and tested against seven antibiotics. DNA from the isolate was extracted and sequenced using the Illumina HiSeq platform. Denovo assembly and scaffolding were performed to construct a draft genome assembly, from which genes were predicted and functionally annotated. Genome analysis included epidemiological characterization, genomic composition and identification of antibiotic resistance genes.. Susceptibility testing of the isolate showed high levels of resistance to chloramphenicol and diminished susceptibility to ampicillin and rifampicin. A draft genome of ~ 2.1 Mb was assembled, containing 2451 protein coding sequences, 49 tRNAs and 3 rRNAs. Fifteen coding sequences sharing ≥ 84% identity with known antibiotic resistance genes were identified. Genome analysis revealed abundant repetitive DNAs and two prophages. Epidemiological typing revealed newly described sequence type, antigenic finetype and Bexsero. Our results present the first genome assembly of an invasive N. meningitidis isolate from a military unit in Vietnam. This study illustrates the usefulness of whole genome sequencing (WGS) analysis for epidemiological and antibiotic resistance studies and surveillance of IMD in Vietnam.

Topics: Ampicillin; Anti-Bacterial Agents; Bacterial Proteins; Drug Resistance, Bacterial; Genome, Bacterial; Humans; Male; Meningococcal Infections; Military Personnel; Neisseria meningitidis; Rifampin; Vietnam; Whole Genome Sequencing; Young Adult

Determination of the major serogroups is an important step for establishing a vaccine programme and management strategy targeting Neisseria meningitidis. From April 2010 to November 2016, a total of 25 N. meningitidis isolates were collected in South Korea, in collaboration with the Korean Society of Clinical Microbiology. Among isolates, 19 isolates were recovered from blood and/or cerebrospinal fluid (CSF) in 46 patients who suffered from invasive meningococcal disease (IMD), and six isolates were found in sputum or the throat. The most common serogroup was serogroup B (overall, 36%, n = 9/25; IMD, 37%, n = 7/19), which was isolated in every year of the research period except for 2011. There were five serogroup W isolates recovered from patients in military service. W was no longer isolated after initiation of a vaccine programme for military trainees, but serogroup B caused meningitis in an army recruit training centre in 2015. In MLST analysis, 14 sequence types were found, and all isolates belonging to W showed the same molecular epidemiologic characteristics (W:P1.5-1, 2-2:F3-9:ST-8912). All isolates showed susceptibility to ceftriaxone, meropenem, ciprofloxacin, minocycline, and rifampin; however, the susceptibility rates to penicillin and ampicillin for isolates with W and C capsules were 22% and 30%, respectively.

Topics: Adolescent; Adult; Aged; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Drug Resistance, Bacterial; Female; Humans; Infant; Male; Meningitis, Meningococcal; Meningococcal Infections; Meropenem; Microbial Sensitivity Tests; Middle Aged; Minocycline; Multilocus Sequence Typing; Neisseria meningitidis; Neisseria meningitidis, Serogroup B; Neisseriaceae Infections; Prevalence; Republic of Korea; Rifampin; RNA, Ribosomal, 16S; Serogroup

To describe the antimicrobial resistance profile of Neisseria meningitidis isolates causing invasive disease in Brazil from 2009 to 2016.. Among 3548 N. meningitidis isolates received, 2888 (81.4 %) were analysed for antimicrobial resistance using the broth microdilution technique, as recommended by the Clinical and Laboratory Standards Institute. Isolates were tested for ciprofloxacin, chloramphenicol, ceftriaxone, penicillin G, ampicillin and rifampin.. All the isolates tested were susceptible to ceftriaxone, while 953 (33.0 %), 1307 (45.3 %) and 2 (0.07 %) isolates were penicillin G-, ampicillin- and rifampin-intermediate, respectively. Resistance to rifampin, ciprofloxacin and chloramphenicol was shown by three isolates (0.1 %), two isolates (0.07 %) and one (0.03 %) isolate, respectively. Although no isolates were resistant to penicillin G in the period of 2009-2016, our results show an upward trend in minimum inhibitory concentrations (MICs) for this drug as of 2010 (P<0.001). There was no significant difference between different gender and age groups of patients for reduced susceptibility to penicillin G. There was a higher frequency of isolates with reduced susceptibility to penicillin G in the South and Southeast regions (P<0.001). This reduced susceptibility was also associated with serotype 19 inside serogroup B (P<0.001).. Despite the decrease in susceptibility to penicillin G and ampicillin observed from 2010, the overall resistance of N. meningitidis isolates to the antimicrobials tested remained uncommon and sporadic, confirming their efficacy for chemoprophylaxis or treatment of invasive meningococcal disease (IMD) in Brazil. Continued surveillance of N. meningitidis antimicrobial susceptibility profiles is important in order to monitor variations in resistance either geographically, over time or in association with emergent clones.

Topics: Adolescent; Ampicillin; Anti-Infective Agents; Brazil; Ceftriaxone; Child; Child, Preschool; Chloramphenicol; Ciprofloxacin; Drug Resistance, Bacterial; Epidemiological Monitoring; Female; Humans; Infant; Male; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillin G; Rifampin

In 2013, there were 143 laboratory-confirmed cases of invasive meningococcal disease (IMD) analysed by the Australian National Neisseria Network (NNN). This was the lowest number of laboratory confirmed IMD cases referred to the NNN since the inception of the Australian Meningococcal Surveillance Programme in 1994. Probable and laboratory confirmed IMD is notifiable in Australia. There were 149 IMD cases notified to the National Notifiable Diseases Surveillance System in 2013. Meningococcal serogrouping was determined for 139/143 laboratory confirmed IMD cases; 74.8% (104 cases) were serogroup B infections; 5.8% (8 cases) were serogroup C infections; 8.6% (12 cases) were serogroup W135; and 10.8% (15 cases) were serogroup Y. Primary and secondary disease peaks were observed, respectively, in those aged 4 years or less, and in adolescents (15-19 years). Serogroup B cases predominated in all jurisdictions and age groups, except for those aged 65 years or over where serogroup Y predominated. The overall proportion and number of IMD caused by serogroup B decreased from previous years. The number of cases of IMD caused by serogroup C was low, and has been proportionally stable over recent years. The number of IMD cases caused by W135 and Y serogroups was similar to previous years but the proportion has increased with the overall reduction in numbers of IMD cases. Molecular typing was performed on 92 of the 93 IMD isolates, and 23 of the 50 cases confirmed by nucleic acid amplification testing. In 2013, the most common porA genotype circulating in Australia was P1.7-2,4. All IMD isolates tested were susceptible to ceftriaxone; ciprofloxacin and rifampicin. Decreased susceptibility to penicillin was observed in 78.5% of isolates.

Topics: Adolescent; Adult; Age Distribution; Aged; Annual Reports as Topic; Anti-Bacterial Agents; Australia; beta-Lactam Resistance; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Epidemiological Monitoring; Gene Expression; Genotype; Humans; Infant; Meningococcal Infections; Microbial Sensitivity Tests; Middle Aged; Neisseria meningitidis; Penicillins; Phenotype; Porins; Rifampin; Serotyping

In April 2012, a cluster of two cases of meningococcal disease caused by rifampicin-resistant C meningococci was reported in the Champagne-Ardenne region, France. The two cases occurred in a student population living in the same town but studying at different schools. Bacteriological and epidemiological investigations of cases have shown that the isolates of both cases were non-differentiable.

Topics: Amoxicillin; Antibiotics, Antitubercular; Cefotaxime; Cluster Analysis; Contact Tracing; Drug Resistance, Bacterial; Female; France; Genotype; Humans; Male; Meningococcal Infections; Meningococcal Vaccines; Multilocus Sequence Typing; Neisseria meningitidis, Serogroup B; Rifampin; Young Adult

Published data on the epidemiology of meningococcal disease in Latin America and the Caribbean region is scarce and, when available, it is often published in Spanish and/or in non-peer-reviewed journals, making it difficult for the international scientific community to have access.. Laboratory data on 4,735 Neisseria meningitidis strains was collected and reported by the National Reference Laboratories in 19 Latin American countries and the Caribbean Epidemiology Centre (CAREC) between 2006 and 2010 as part of the work carried out by the SIREVA II network. Serogroup and MIC to penicillin, rifampin and chloramphenicol were determined.. Isolates were mainly obtained from patients <5 years, but each year around 25% of isolates came from adult patients. Serogroup distribution was highly variable among countries. Serogroup C was the main cause of disease in Brazil; the majority of disease seen in the Southern cone was caused by serogroup B, but serogroup W135 strains have increased in recent years. In the Andean and Mexico, Central America and Caribbean regions, serogroups B and C were equally present, and serogroup Y was frequently isolated. Isolates were generally susceptible to chloramphenicol, penicillin and rifampin, but almost 60% of isolates characterized in Southern cone countries presented intermediate resistance to penicillin. Five rifampin-resistant isolates have been isolated in Uruguay and Brazil.. Serogroup distribution is highly variable among countries, but some geographic structuring can be inferred from these data. Epidemiological and laboratory data are scarce among Andean and Mexico, Central America and Caribbean countries. Evaluation and implementation of corrective measures on disease surveillance and reporting systems and the implementation of molecular diagnostic techniques and molecular characterization on meningococcal isolates are advised.

Topics: Adolescent; Adult; Age Distribution; Anti-Bacterial Agents; Caribbean Region; Child; Child, Preschool; Clinical Laboratory Techniques; Humans; Infant; Infant, Newborn; Latin America; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillins; Population Surveillance; Rifampin; Serotyping; Young Adult

Among 3904 meningococcal isolates collected between October 2002 and June 2007 by the French Meningococcal Reference Centre, eight (0.20%) were resistant to rifampicin (Rif-R; MIC >1 mg/L) and 27 (0.69%) were intermediate-resistant to rifampicin (Rif-I; MICs between 0.38 mg/L and 1 mg/L) according to the E-test method. The MICs determined by agar dilution were lower, eliminating the E-test intermediate category. All Rif-R isolates had mutations in the rpoB gene, resulting in substitutions at or near amino acid position 552, which were absent in non-resistant isolates. These data suggest that a rifampicin clinical breakpoint of 1.0 mg/L should be adopted for Neisseria meningitidis.

Topics: Anti-Bacterial Agents; DNA-Directed RNA Polymerases; Drug Resistance, Bacterial; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Mutation; Neisseria meningitidis; Rifampin

This paper outlines the risk assessment and communication strategy carried out by the Lothian Health Protection Team after notification of a probable case of meningococcal disease (later confirmed as Neisseria meningitidis) in a resident of a city centre backpackers hostel. Six close contacts were identified from the hostel and given rifampicin prophylaxis. Two days after commencing rifampicin one of these contacts was admitted to hospital with a purpuric/petechial rash and thrombocytopenia. The final diagnosis for this contact was thrombocytopenia, either idiopathic or secondary to rifampicin. This example and the potential side effects of administering rifampicin prophylaxis highlight the importance of a thorough risk assessment of contacts of a case to avoid prescribing prophylaxis to anyone other than those at highest risk of becoming a subsequent case.

Topics: Antibiotic Prophylaxis; Community-Acquired Infections; Contact Tracing; Female; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Neisseria meningitidis, Serogroup W-135; Rifampin; Risk Assessment; Risk Factors; Scotland

Topics: Anti-Bacterial Agents; Azithromycin; Ceftriaxone; Ciprofloxacin; Drug Resistance, Bacterial; Meningococcal Infections; Meningococcal Vaccines; Minnesota; Neisseria meningitidis; North Dakota; Rifampin

Topics: Arthritis, Infectious; Cefotaxime; Child; Complement C2; Female; Genetic Diseases, Inborn; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Rifampin; Serotyping

Rifampin-resistant meningococcal disease occurred in a child who had completed rifampin chemoprophylaxis for exposure to a sibling with meningococcemia. Susceptibility testing of 331 case isolates found only 1 other case of rifampin-resistant disease in Minnesota, USA, during 11 years of statewide surveillance. Point mutations in the RNA polymerase Beta subunit (rpoB) gene were found in isolates from each rifampin-resistant case-patient.

Topics: Anti-Bacterial Agents; Bacteremia; Child; DNA-Directed RNA Polymerases; Drug Resistance, Bacterial; Female; Humans; Infant; Male; Meningococcal Infections; Microbial Sensitivity Tests; Minnesota; Neisseria meningitidis; Point Mutation; Population Surveillance; Rifampin

Meningococci responsible for significant morbidity and mortality rates in children are found in the oropharynx and nasopharynx and communicated with droplets. In this study, the prevalence of nasopharyngeal Neisseria meningitidis carriage, serogroup distribution and antibiotic resistance were determined among healthy children in Cankaya municipality of Ankara province. The study involved 1155 students aged 7-19 years. Systematic sampling method was used for sample selection. To isolate N. meningitidis, modified Thayer-Martin medium was used. The antibiotic susceptibilities of N. meningitidis isolates were determined by agar dilution method for penicillin, sulfadiazine, rifampicin, and azithromycin. N. meningitidis carriage prevalence was found as 10.4% with serogroup B being the most predominant (47.5%). The prevalence of N. meningitidis carriage was found to be closely associated with living conditions however, tonsillectomy, tonsillar hypertrophy, passive or active smoking did not affect the rate of carriage. Overcrowded life style, use of old-fashioned stoves for heating, and living in shanty housing were determined as risk factors increasing N. meningitidis carriage. None of the strains showed beta-lactamase activity, and five strains (4.2%) had decreased sensitivity to penicillin. The resistance against sulfadiazine was 54.4%, while it was 26.9% against azithromycin. No rifampicin-resistant strain were detected. It can be concluded that the prevalence of meningococcal carriage in this study was similar to that of other European countries. Rifampicin should be the first drug of choice both for the treatment of meningococcal carriers and for the prophylaxis of the subjects who had been in contact with patients with meningococcal infection.

Topics: Adolescent; Adult; Anti-Bacterial Agents; Azithromycin; Carrier State; Child; Female; Humans; Male; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Penicillins; Prevalence; Rifampin; Risk Factors; Serotyping; Sulfadiazine; Turkey

To ascertain whether isolates of Neisseria meningitidis in South Australia (SA) have become less susceptible to antimicrobial agents. The patients studied were children and adults in SA with either meningococcal bacteraemia or meningitis or both.. The susceptibility of meningococci to 11 antimicrobial agents, including sulphonamides, penicillin and rifampicin, was tested by agar dilution, and in the case of six of the drugs, by E test also.. Resistance to folate antagonists emerged in 1979 and became very common. Resistance peaked in 1995 at 76% of strains. Relative insusceptibility to penicillin was first encountered amongst strains isolated in 1985, and, while the incidence of such strains increased slightly, the overall incidence was low at 10 (5.2%) of 190 strains tested. Meningococci relatively insusceptible to rifampicin were encountered as early at 1971 and did not become more common. The incidence of such strains at 26 (13.7%) of 189 strains tested was higher than that for penicillin. For the 11-year period 1989-1999 of > or= 84 strains tested all were susceptible to ceftriaxone, chloramphenicol and ciprofloxacin; 98% were susceptible to azithromycin and 97% were susceptible to minocycline. Shifts in MIC values for these drugs were not detected.. Resistance was common to sulphonamides and co-trimoxazole, however >or=95% meningococci tested were susceptible to drugs commonly used in the treatment of meningococcal disease, including penicillin and ceftriaxone. Relative insusceptibility to rifampicin was more common but did not increase during the 29-year period. For all drugs tested, except rifampicin, there was good agreement between agar dilution and E test results.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Child, Preschool; Drug Resistance; Humans; Infant; Meningococcal Infections; Microbial Sensitivity Tests; Middle Aged; Neisseria meningitidis; Penicillins; Rifampin; Serotyping; South Australia

Neisseria meningitidis is an uncommon cause of acute bacterial conjunctivitis. One case of primary meningococcal conjunctivitis in a healthy 6-year-old boy is reported. The patient was initially treated with a topical instillation of polymyxin B, neomycin and gramicidin in ophthalmic solution, and this was followed by systemic rifampin once the diagnosis had been established. No ocular or systemic complications developed.

Topics: Administration, Oral; Administration, Topical; Anti-Bacterial Agents; Child; Conjunctivitis, Bacterial; Gramicidin; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Neomycin; Polymyxin B; Rifampin

Mutations in the rpoB gene affecting two amino acids were found in eight rifampicin-resistant Neisseria meningitidis group B and C strains isolated in Italy. The Asp542-->Val substitution, documented for the first time in N. meningitidis, was found in four of the isolates; the His552-->Tyr or Asn substitution in the other four resistant strains. Mutations in the mtr gene did not seem to be involved in the resistance since the same mutations occurred in both resistant and susceptible strains. Two different clusters were identified among these resistant strains, without any correlation with the specific mutations detected in the rpoB gene.

Topics: Antibiotics, Antitubercular; DNA Fingerprinting; DNA-Directed RNA Polymerases; Drug Resistance, Microbial; Drug Resistance, Multiple; France; Genotype; Humans; Meningococcal Infections; Molecular Sequence Data; Mutation; Neisseria meningitidis; Phenotype; Plant Proteins; Polymerase Chain Reaction; Polymorphism, Restriction Fragment Length; Rifampin; Serotyping

A total of 1434 strains of Neisseria meningitidis isolated from cases of invasive meningococcal disease (IMD) in Australia between 1994 and 1999 were examined by standard methods for susceptibility to antibiotics used for treatment and prophylaxis. The proportion of isolates fully susceptible to penicillin decreased from 45% in 1994 to 26% in 1999 (P<0.001). All the other isolates were less sensitive to penicillin except for two meningococci with a penicillin MIC of 1 mg/l. The geometric mean penicillin MIC increased from 0.045 to 0.065 mg/l from 1994 to 1999. There was no significant difference in the geometric mean penicillin MICs of serogroup B and serogroup C meningococci. Penicillin susceptibility was significantly associated with a poorer outcome. Isolates from survivors of IMD had a higher geometric mean penicillin MIC (0.06 mg/l) than those from fatal cases (0.048 mg/l) (P< 0.001). This suggests that factors other than the decrease in susceptibility to penicillin observed were more relevant to outcome in IMD. All isolates were fully susceptible to ceftriaxone. Rifampicin resistance was infrequent (eight isolates in 6 years) and sporadic. A single isolate had decreased quinolone susceptibility. Despite the significant shift in susceptibility to penicillin recorded, this group of antibiotics remains a suitable treatment for IMD in Australia.

Topics: 4-Quinolones; Anti-Infective Agents; Australia; Ceftriaxone; Dose-Response Relationship, Drug; Drug Resistance; Humans; Meningococcal Infections; Neisseria meningitidis; Penicillins; Population Surveillance; Rifampin

This study evaluated whether certain antimicrobial agents used in the treatment of community-acquired respiratory infection were effective against the pathogen Neisseria meningitidis, whose natural habitat is the nasopharyngeal mucosa. Antimicrobial agents commonly use in primary healthcare (betalactams, cephalosporins and macrolides), quinolones and rifampicin were studied by determining minimal inhibitory and bactericidal concentrations, time-kill curves and postantibiotic effect. All of them showed bactericidal activity 24 h after incubation. We therefore believe that they are able to empirically eliminate the causative agent of meningococcal meningitis. However, the only antimicrobial agents capable of inducing a significant postantibiotic effect in the tested strain were the quinolones, which slowed down the growth of the microorganism for over 1 h.

Topics: Amoxicillin; Anti-Infective Agents; Ciprofloxacin; Clarithromycin; Community-Acquired Infections; Drug Resistance; Fluoroquinolones; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Naphthyridines; Nasopharynx; Neisseria meningitidis; Respiratory Tract Infections; Rifampin; Time Factors

Invasive meningococcal disease is a significant cause of mortality and morbidity in the UK. Administration of chemoprophylaxis to close contacts reduces the risk of a secondary case. However, unnecessary chemoprophylaxis may be associated with adverse reactions, increased antibiotic resistance and removal of organisms, such as Neisseria lactamica, which help to protect against meningococcal disease. Limited evidence exists to suggest that overuse of chemoprophylaxis may occur. This study aimed to evaluate prescribing of chemoprophylaxis for contacts of meningococcal disease by general practitioners and hospital staff.. Retrospective case note review of cases of meningococcal disease was conducted in one health district from 1st September 1997 to 31st August 1999. Routine hospital and general practitioner prescribing data was searched for chemoprophylactic prescriptions of rifampicin and ciprofloxacin. A questionnaire of general practitioners was undertaken to obtain more detailed information.. Prescribing by hospital doctors was in line with recommendations by the Consultant for Communicable Disease Control. General practitioners prescribed 118% more chemoprophylaxis than was recommended. Size of practice and training status did not affect the level of additional prescribing, but there were significant differences by geographical area. The highest levels of prescribing occurred in areas with high disease rates and associated publicity. However, some true close contacts did not appear to receive prophylaxis.. Receipt of chemoprophylaxis is affected by a series of patient, doctor and community interactions. High publicity appears to increase demand for prophylaxis. Some true contacts do not receive appropriate chemoprophylaxis and are left at an unnecessarily increased risk.

Topics: Anti-Infective Agents; Antibiotic Prophylaxis; Antibiotics, Antitubercular; Ciprofloxacin; Contact Tracing; Drug Utilization Review; Family Practice; Humans; Medical Staff, Hospital; Meningococcal Infections; Physicians, Family; Practice Patterns, Physicians'; Retrospective Studies; Rifampin; Surveys and Questionnaires; United Kingdom

In the early 1990s a rise in the incidence of meningococcal disease was observed in Galicia, Spain, most cases of which were caused by serogroup C meningococcal strains. As part of the epidemiological analysis of this epidemic wave, two studies of asymptomatic carriers of neisseria meningitidis were carried out: the first took place during the period of maximum incidence and coincided with a massive immunization campaign (December 1996 to January 1997); and the second was conducted one year later (January 1998). A total of 1234 meningococcal strains were isolated in both studies (789 in the first and 445 in the second study) and the susceptibility to rifampin, ciprofloxacin, ceftriaxone and sulfadiazine was determined. The susceptibility to rifampin, ciprofloxacin and cetriaxone was high among the strains isolated in both studies. For sulfadiazine, the percentage of resistant strains was 92.6% for the first and 86.3% for the second study.

Topics: Adolescent; Adult; Bacterial Vaccines; Carrier State; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Disease Outbreaks; Drug Resistance, Microbial; Humans; Incidence; Infant; Meningococcal Infections; Meningococcal Vaccines; Microbial Sensitivity Tests; National Health Programs; Neisseria meningitidis; Rifampin; Spain; Sulfadiazine; Time Factors; Vaccination

Two brothers presented with meningococcal infection in a five day period, the first with a rifampicin sensitive strain and the second, who had received rifampicin chemoprophylaxis, with a resistant strain. Secondary cases of meningococcal disease can occur despite chemoprophylaxis, and may be rifampicin resistant. Close contacts should be informed of the early symptoms of meningococcal disease and of the need to seek medical advice urgently if they occur.

Topics: Antibiotic Prophylaxis; Child, Preschool; Drug Resistance, Microbial; Family Health; Humans; Male; Meningococcal Infections; Nucleic Acid Synthesis Inhibitors; Rifampin

Topics: Adolescent; Child, Preschool; Disease Outbreaks; Fatal Outcome; Female; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Rifampin; Sepsis; Serotyping; United Kingdom

To determine the prevalence of the pathogenic strain of Neisseria meningitidis in contacts of patients with meningococcal disease, and to determine which contact groups are likely to be carriers and warrant chemoprophylaxis.. Population based study.. Norwegian county of Telemark.. 1535 primary contacts of 48 patients with meningococcal disease, and 78 secondary contacts.. Carriers of the pathogenic strain were treated with rifampicin. All household members and kissing contacts under 15 years of age were treated with oral penicillin. Contacts were taught to recognise the symptoms of meningococcal disease.. In 27 of 48 cases investigated, contacts carrying the pathogenic strain of N meningitidis were found. A total of 42 such contacts were identified. Contacts were stratified into three classes according to the assumed closeness of contact with patients. In class 1 (household members and kissing contacts) the prevalence of the pathogenic strain was 12.4% (95% confidence interval 5.5% to 19.3%). In classes 2 and 3 the prevalence was 1.9% (0.9% to 3.4%) and 1.6% (0.14% to 3.1%).. There is a high rate of carriage of the pathogenic strain of N meningitidis in patients' household members and kissing contacts, and this supports the practice of giving chemoprophylaxis to these contacts. The prevalence of carriage among other contacts is 2-3 times that found in the general population (0.7%); the benefits of chemoprophylaxis to these contacts may be marginal.

Topics: Adolescent; Adult; Aged; Antibiotics, Antitubercular; Carrier State; Child; Child, Preschool; Contact Tracing; Humans; Infant; Infant, Newborn; Meningococcal Infections; Middle Aged; Neisseria meningitidis; Norway; Pharynx; Population Surveillance; Prevalence; Rifampin

These recommendations update information regarding the polysaccharide vaccine licensed in the United States for use against disease caused by Neisseria meningitidis serogroups A, C, Y, and W-135, as well as antimicrobial agents for chemoprophylaxis against meningococcal disease (superseding MMWR 1985;34:255-9). This report provides additional information regarding meningococcal vaccines and the addition of ciprofloxacin and ceftriaxone as acceptable alternatives to rifampin for chemoprophylaxis in selected populations.

Topics: Adolescent; Anti-Bacterial Agents; Antibiotic Prophylaxis; Bacterial Vaccines; Ceftriaxone; Child; Child, Preschool; Ciprofloxacin; Contraindications; Humans; Infant; Meningococcal Infections; Meningococcal Vaccines; Neisseria meningitidis; Rifampin; Vaccination

Topics: Adolescent; Adult; Antibiotics, Antitubercular; Carrier State; Child; Child, Preschool; Humans; Infant; Meningococcal Infections; Rifampin; Risk Factors; Vaccination

Topics: Bacteremia; Cefotaxime; Child, Preschool; Drug Therapy, Combination; Female; Hemodiafiltration; Humans; Male; Meningococcal Infections; Penicillin G; Rifampin

A vaccine for prevention of serogroup B meningococcal disease is not available in the United States, and indications for the use of mass chemoprophylaxis for control of meningococcal outbreaks are not well-defined. In response to an outbreak of six cases of enzyme type 5 serogroup B meningococcal disease among students at a middle school, we implemented a program of mass rifampin prophylaxis and evaluated the effectiveness of this preventive measure.. Oropharyngeal cultures were obtained from 351 of the 900 students before prophylaxis; 196 participants were recultured 3 weeks later. Meningococcal isolates were subtyped and tested for rifampin susceptibility, and risk factors for disease or carriage among students were evaluated.. No cases occurred after prophylaxis. Before prophylaxis 10% (34 of 351) of students were meningococcal carriers and 3.4% (12 of 351) carried the epidemic strain. After prophylaxis 2.5% (5 of 196) were carriers and 1.0% (2 of 196) carried the epidemic strain. Rifampin was 85% effective in eradicating carriage, and the rate of acquisition of carriage during the 3-week period was low (0.5%). Carriage persisted after prophylaxis in 4 students; 3 of these postprophylaxis isolates were rifampin-resistant. Rifampin resistance thus developed in 12% (3 of 26) of preprophylaxis isolates. Disease/epidemic strain carriage was associated with enrollment in the school band and certain other classes.. These findings suggests that mass chemoprophylaxis may be effective and should be considered for control of school serogroup B meningococcal outbreaks. This approach is less likely to be effective for control of outbreaks affecting larger, less well-defined populations and is associated with the rapid development of antibiotic resistance.

Topics: Adolescent; Antibiotics, Antitubercular; Carrier State; Child; Disease Outbreaks; Drug Resistance, Microbial; Female; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Oropharynx; Rifampin; Risk Factors; Schools; Serotyping

A total of 234 strains of Neisseria meningitidis obtained from hospitalized patients living in the province of Québec during the period 1991 to 1992 were characterized according to their serogroup, serotype, subtype, electrophoretic type, and antimicrobial susceptibility. All these strains were recovered from sterile body fluids, except for one strain that was isolated postmortem from a cutaneous lesion. For both years, serogroup C was the most prevalent (69.7%), followed by serogroup B (27.4%). Serotype 2a represented 80.3% of serogroup C isolates, and P1.2 was the most common subtype associated with this serotype. Clone ET 15 accounted for 76.5% of serogroup C isolates and 90.0% of serotype 2a strains. Although meningococcal disease occurred mostly in children under the age of 5 (9.7 cases per 100,000 children), with a peak incidence for children under 1 (20.3 cases per 100,000 children), most fatalities occurred among teenagers (12 to 19 years old). The total fatality rate was 11.5%, and serogroup C strains were responsible for 88.9% of these fatalities. Thirteen strains had a reduced susceptibility to penicillin G, and 28 strains were resistant to sulfadiazine. One strain was resistant to both rifampin and sulfadiazine and showed a reduced susceptibility to penicillin G.

Topics: Adolescent; Adult; Child; Child, Preschool; Disease Outbreaks; Humans; Immunization Programs; Infant; Inpatients; Meningococcal Infections; Microbial Sensitivity Tests; Middle Aged; Neisseria meningitidis; Penicillin G; Quebec; Retrospective Studies; Rifampin; Serotyping; Sulfadiazine

To determine recent trends in its epidemiology and the need to reconsider prophylactic interventions, meningococcal disease in the Israel Defense Force (IDF) from 1975 through 1993 was studied. All cases of meningitis or meningococcemia were included. A considerable increase in the number of cases has been observed since 1991, with serogroup C becoming predominant (76% of cases) since then. Serogroup Y was the second most frequent serogroup during this period, while serogroup B, predominant in the civilian population of Israel, was rare. Most cases occurred during the first 6 months of military service. Seasonality was important, with most of the cases occurring between December and March, although a small summer peak was also noted. Since 1992, three small clusters of meningococcal disease were encountered in the IDF, for the first time, with all cases caused by group C meningococci. In one cluster, the emergence of rifampicin resistance resulted in failure of chemoprophylaxis. The rise in group C and Y cases since 1991, and the occurrence of rifampicin resistance, necessitate considering meningococcal vaccines and new antimicrobial agents for prophylaxis.

Topics: Bacterial Vaccines; Disease Outbreaks; Drug Resistance, Microbial; Humans; Israel; Male; Meningococcal Infections; Meningococcal Vaccines; Military Personnel; Prevalence; Rifampin; Seasons

Topics: Antibiotic Prophylaxis; Antibiotics, Antitubercular; Child Care; Guidelines as Topic; Humans; Infant; Meningococcal Infections; Rifampin; Treatment Failure; United Kingdom

Moderately penicillin-resistant Neisseria meningitidis was responsible for an outbreak of meningococcal disease in Saskatoon, Saskatchewan, Canada in 1993. We tested fully susceptible and moderately resistant strains of N. meningitidis against ciprofloxacin, cefotaxime, ceftriaxone, chloramphenicol, penicillin, and rifampin. Eighteen percent of the isolates were moderately resistant to penicillin (MIC > or = 0.06 microgram/ml) whereas susceptibility was 100% for the other agents tested.

Topics: Anti-Bacterial Agents; Anti-Infective Agents; Canada; Cefotaxime; Ceftriaxone; Cephalosporins; Chloramphenicol; Ciprofloxacin; Disease Outbreaks; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillin Resistance; Rifampin

We describe the epidemiology of meningococcal disease in Somerset and a community outbreak in one district. Fifty-seven cases of meningococcal disease occurred in residents of Somerset between 1 May 1990 and 30 April 1993 (incidence 4.7/100,000/year), of whom six died. Thirteen of the cases occurred in one local authority area in a six month period from 1 November 1992 to 30 April 1993; an incidence of 26.6/100,000/year. Twenty-seven patients were given benzyl-penicillin before admission to hospital. General practitioners were significantly more likely to give benzylpenicillin to patients with rashes. The proportion that received prophylaxis tended to increase after a press release was issued and general practitioners were advised. The number of cases was too small to demonstrate the protective effect of early administration of benzylpenicillin. In five cases the consultant in communicable disease control was not informed for over 12 hours. Thirty-seven of the 48 index cases for whom information was available received rifampicin prophylaxis before discharge from hospital.

Topics: Adolescent; Adult; Child; Child, Preschool; Disease Outbreaks; England; Female; Humans; Incidence; Infant; Male; Meningococcal Infections; Neisseria meningitidis; Penicillin G; Rifampin; Survival Rate; Wales

We present three cases of primary meningococcal conjunctivitis associated with systemic sepsis. The management of such patients should include combined topical and parenteral therapy with appropriate chemoprophylaxis for close contacts of cases.

Topics: Aged; Aged, 80 and over; Anti-Bacterial Agents; Child; Chloramphenicol; Conjunctivitis; Contact Tracing; Drug Therapy, Combination; Female; Humans; Infant; Male; Meningococcal Infections; Penicillin G; Rifampin

Topics: Contraindications; Female; Haemophilus Infections; Humans; Infant, Newborn; Infectious Disease Transmission, Vertical; Meningococcal Infections; Pregnancy; Pregnancy Complications, Infectious; Rifampin; Tuberculosis, Pulmonary

A case of sepsis and meningitis caused by Neisseria meningitidis with relative resistance to penicillin occurred in North Carolina in August 1992. This isolate was relatively resistant due to decreased affinity of its penicillin-binding protein 2 for penicillin. Such isolates have been reported in Spain, elsewhere in Europe, in South Africa, and in Canada, but invasive disease caused by meningococcal isolates relatively resistant to penicillin was not recognized in the United States before a preliminary report of this case in October 1992. The Centers for Disease Control and Prevention recently retrospectively identified 3 additional cases from 1991. A fifth case occurred in Kentucky in 1993. Surveillance studies of penicillin susceptibility of N. meningitidis isolates suggest such meningococci have existed sporadically in the past. Increases in prevalence and magnitude of penicillin resistance among strains of N. meningitidis would require reconsideration of current clinical practice with regard to treatment of meningococcal disease.

Topics: Amoxicillin; Bacteremia; Bacterial Proteins; Carrier Proteins; Ceftriaxone; Drug Therapy, Combination; Female; Hexosyltransferases; Humans; Infant; Meningitis, Meningococcal; Meningococcal Infections; Multienzyme Complexes; Muramoylpentapeptide Carboxypeptidase; Neisseria meningitidis; North Carolina; Otitis Media; Penicillin G; Penicillin Resistance; Penicillin-Binding Proteins; Peptidyl Transferases; Rifampin

A random selection of Neisseria meningitidis strains isolated in Sweden in the period 1981-1990 were investigated for plasmid carriage and susceptibility to antimicrobial agents commonly used for treatment and prophylaxis of meningococcal disease. The MICs were determined by the agar dilution method for penicillin V, penicillin G, rifampicin, sulfadiazine, erythromycin and tetracycline. In 13% of the invasive strains the MIC of penicillin V was > or = 0.5 mg/l which may cause concern regarding the usefulness of penicillin V in prophylaxis. In strains isolated from the urogenital tract the MICs of penicillin V and penicillin G were higher than in the invasive strains. In about 82% of the strains isolated in 1987-1988 the MIC of tetracycline was > or = 0.5 mg/l whereas no such strains were found in 1981-1982. Plasmids were found in 2 of 119 invasive strains, in 1 of 50 strains from the respiratory tract and in 1 of 19 strains from the urogenital tract. The plasmid sizes were 1.3, 2.6, 25 and 40 Mda. None of these strains were beta-lactamase producing and no relation to a high degree antibiotic resistance was observed.

Topics: Anti-Bacterial Agents; Erythromycin; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillin G; Penicillin V; Plasmids; Rifampin; Sulfadiazine; Sweden; Tetracycline

Topics: Carrier State; Humans; Meningococcal Infections; Rifampin; Risk Factors

Epidemiological features of an outbreak of group B:15:P1.16 meningococcal disease (MD) in Frederiksborg county, Denmark, 1987-9, were investigated. The study comprised 149 cases notified during the outbreak and the two preceding years; 115 were confirmed by the isolation of Neisseria meningitidis. In 1989 the incidence had increased to 14.1 per 100,000 population. Among group B strains, B:15:P1.16 accounted for 80% (77/97). The overall mortality rate was 10% (15/149). Regarding cases due to group B:15:P1.16 strains a significant time-space clustering, which exclusively occurred within the 10-19 years age group, was demonstrated. The link between cases within clusters was indirect or unknown, except for ten patients with contact to one particular school. The prophylactic measures used included administration of rifampicin to household contacts. During the outbreak the proportion of secondary cases was high (6-15%). All secondary cases occurred outside the household indicating that the household had been protected.

Topics: Adolescent; Adult; Age Factors; Bacteremia; Child; Child, Preschool; Cluster Analysis; Denmark; Disease Outbreaks; Female; Humans; Infant; Male; Meningitis, Meningococcal; Meningococcal Infections; Neisseria meningitidis; Prevalence; Rifampin; Seasons; Serotyping; Sex Factors; Suburban Population

In Norway, the use of chemoprophylaxis after cases of meningococcal disease is not recommended. Instead, household members less than 15 years are treated with penicillin for 7 days. Failures of this treatment have been reported. We therefore used DNA fingerprinting to identify the disease-causing strain in healthy contacts combined with selective rifampicin prophylaxis to these carriers to prevent secondary cases. During a 2-year period (1987-89) there were 13 cases of meningococcal disease in the County of Telemark (165000 inhabitants). 65 (14.7%) out of 441 contacts to these 13 patients harbored meningococci in their throat; 16 (3.6%) carried the disease-causing strain. Only 1 carrier fulfilled the criteria for being treated with penicillin; 8 were adults and the remaining 7 were not household members. No secondary cases of meningococcal disease occurred during the study period or the following 12 months. During the 4-year period (1984-87) preceding the study period there were 39 cases of meningococcal disease in Telemark; 7 of them were index cases for 12 bacteriologically verified and 4 clinically suspected secondary cases of meningococcal disease. We conclude that selective prophylaxis with rifampicin seems to be more efficient that penicillin treatment of household members less than 15 to prevent secondary cases of meningococcal disease.

Topics: Adolescent; Adult; Aged; Bacteremia; Carrier State; Child; Child, Preschool; DNA Fingerprinting; DNA, Bacterial; Female; Humans; Infant; Male; Meningitis, Meningococcal; Meningococcal Infections; Middle Aged; Neisseria meningitidis; Norway; Penicillins; Pharynx; Rifampin; Serotyping

Topics: Adolescent; Carrier State; Child; Child, Preschool; Humans; Infant; Meningococcal Infections; Rifampin

Following the occurrence of a case of meningococcal disease in a kibbutz, extensive preventive measures were instituted, consisting of alternate courses of rifampicin (10 mg/kg for 2 consecutive days) and ceftriaxone (single IM injection of 125 mg). Throughout the observation period Neisseria meningitidis was absent from oropharyngeal secretions of all those treated, but was found in those of an untreated control group. The alternate use of rifampicin and ceftriaxone should be considered for the long-term prevention of the occurrence of oropharyngeal carriers of Neisseria meningitidis.

Topics: Carrier State; Ceftriaxone; Drug Administration Schedule; Humans; Meningitis, Meningococcal; Meningococcal Infections; Neisseria meningitidis; Oropharynx; Rifampin

Topics: Administration, Oral; Ciprofloxacin; Humans; Infant; Male; Meningococcal Infections; Penicillins; Rifampin; Vomiting

An outbreak of Neisseria meningitidis sero-group C disease occurred in four eighth grade students and in a younger sibling of another eighth grade student attending an intermediate school (seventh and eighth grades) in Santa Clara County, CA. Four cases had onset within 3 days in January, 1989, with the fifth case occurring approximately 10 days later. A case-control study was performed to determine risk factors associated with serogroup C meningococcal infection (disease or carriage) in this eighth grade class. Students were more likely to be infected if they had had a preceding viral-like respiratory illness characterized by fever (odds ratio (OR) 5.3, P = 0.03) or cough (OR 5.1, P = 0.048). A ski trip (OR 6.3, P = 0.01) and a poster-making session for a school dance (OR 3.7, P = 0.08) were identified as possible settings for a common exposure. Spending time with two specific students during lunchtime or outside of school was associated with an increased risk of infection (OR 7.0, P = 0.054; OR 5.8, P = 0.04).

Topics: Adolescent; California; Carrier State; Case-Control Studies; Child, Preschool; Disease Outbreaks; Female; Humans; Interviews as Topic; Male; Meningococcal Infections; Neisseria meningitidis; Pharynx; Rifampin; Risk Factors; Surveys and Questionnaires

Topics: Adult; Child; Child, Preschool; Humans; Infant; Infant, Newborn; Meningococcal Infections; Rifampin

On the Faroe Islands (45,000 inhabitants), a total of 203 cases of meningococcal disease (MD) were recorded during the period 1978-1985. The peak incidence was 95/100,000 in 1981. MD mainly attacked children, 30% were below two years and 75% were below 11 years of age. The lethality rate was 5.4% (11 deaths). In 1981, rifampicin was introduced as a prophylactic treatment against secondary cases and at the same time, a decrease in incidence occurred. The decrease was more pronounced in the part of the country where the number of prescribed prophylactic doses per case of MD was greatest. These observations indicate that the introduction of rifampicin may have modified the course of the epidemic. None of the MD-patients had received prophylactic treatment with rifampicin. Of 132 examined, one patient with complement deficiency was identified, indicating that complement deficiencies were not a major risk factor in the epidemic of MD on the Faroe Islands.

Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Denmark; Female; Humans; Male; Meningitis, Meningococcal; Meningococcal Infections; Middle Aged; Rifampin

To determine the incidence of secondary meningococcal infection in close family and household contacts of index patients and to review the efficacy of chemoprophylaxis the records of 3256 cases occurring from 1984 through 1987 were examined. Seventeen secondary cases (0.5%) of infection were identified among these groups. The median interval between index and secondary cases was seven weeks. Fourteen secondary cases occurred more than one week after the disease was diagnosed in the index case. Three secondary cases had not received chemoprophylaxis and in another case the infecting strain had acquired resistance to rifampicin. Prophylaxis for the close contacts of 10 out of 11 of the remaining index patients failed to fulfil all the criteria of an optimal regimen. Even after optimal chemoprophylaxis the medical practitioner and the family should be aware of the increased and prolonged risk of secondary meningococcal infection among close contacts of patients with the disease.

Topics: Adult; Child; Child, Preschool; England; Family; Family Health; Female; Humans; Male; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Penicillin G; Penicillin Resistance; Retrospective Studies; Rifampin; Risk Factors; Time Factors; Wales

Topics: Aged; Carrier State; Cross Infection; Denmark; Disease Outbreaks; Female; Humans; Male; Meningococcal Infections; Middle Aged; Personnel, Hospital; Rifampin; Vaccination

Topics: Carrier State; Family Health; Humans; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Rifampin

Topics: Cross Infection; Humans; Meningococcal Infections; Personnel, Hospital; Rifampin

Topics: Adult; Blood Bactericidal Activity; Diseases in Twins; Drug Resistance, Microbial; Humans; Male; Meningococcal Infections; Neisseria meningitidis; Rifampin; Sepsis; Twins, Monozygotic

Topics: Drug Resistance, Microbial; Female; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Middle Aged; Neisseria meningitidis; Rifampin; Risk Factors; Time Factors

Topics: Humans; Meningococcal Infections; Neisseria meningitidis; Rifampin; Saudi Arabia; Serotyping; Travel; United States

Topics: Adolescent; Child; Drug Resistance, Microbial; Female; Humans; Meningococcal Infections; Neisseria meningitidis; Rifampin

Topics: Humans; Meningococcal Infections; New Zealand; Rifampin

Topics: Adult; Child, Preschool; Disease Outbreaks; Female; Humans; Infant; Male; Meningococcal Infections; Rifampin; Time Factors

An epidemic of meningococcal disease after an influenza outbreak in a community of 49 boys (14-18 years) and 8 adults in a boarding-school is reported. The first patient died with all symptoms of the Waterhouse-Friderichsen syndrome. Several hours later, two other boys developed severe septicemia with meningitis and meningitis respectively. N. meningitidis group B susceptible to penicillin and rifampin was isolated. Within the next 8 hours, chemoprophylaxis with rifampin (600 mg twice daily) was started and maintained for 4 days for the whole community. Throat cultures had not been obtained before prophylaxis. Ten other symptomatic boys were admitted to the hospital and treated by penicillin infusion. The results of blood and cerebrospinal fluid cultures were negative, and treatment was therefore discontinued. Five days after the death of the first boy, another boy died with full-blown Waterhouse-Friderichsen syndrome while on chemoprophylaxis. The neisseriae isolated from this patient were rifampin-resistant. Serological investigations in all patients admitted to hospital revealed the existence of concomitant epidemic infection with influenza A and B in this school. We assume that the viral infection made way for the outbreak of the meningococcal disease and for the high rate of secondary meningococcal infection. Chemoprophylaxis with rifampin should not be continued for longer than 2 to 3 days, otherwise the risk of occurrence of rifampin resistant strains of N. meningitidis increases. Hitherto such strains have rarely been isolated in clinically manifest disease.

Topics: Adolescent; Adult; Disease Outbreaks; Humans; Influenza, Human; Male; Meningitis, Meningococcal; Meningococcal Infections; Neisseria meningitidis; Penicillin Resistance; Penicillins; Rifampin; Schools; Switzerland; Waterhouse-Friderichsen Syndrome

Topics: Adolescent; Bacterial Vaccines; Child; Child, Preschool; Humans; India; Infant; Meningococcal Infections; Meningococcal Vaccines; Rifampin; Risk; Sulfadiazine

Topics: Anti-Bacterial Agents; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Male; Meningococcal Infections; Neisseria meningitidis; Rifampin

Topics: Carrier State; Drug Resistance, Microbial; Drug Synergism; Erythromycin; Humans; Meningococcal Infections; Neisseria meningitidis; Rifampin

Topics: Bacterial Vaccines; Humans; Meningococcal Infections; Rifampin; Sulfadiazine

Satisfactory permeability of rifampicin through the hematoencephalic barrier was shown in experimental rabbit meningococcal meningitis and in treatment of patients with meningococcal meningitis. The antibiotic level and retention time in the liquor depended on the drug dose and acidity of gastric juice. The dose of 10 mg/kg bw administered at 8--10-hour intervals was the most optimal. The high therapeutic efficacy of rifampicin in treatment of patients with the generalized forms of meningococcal meningitis enables its recommendation for the use as a reserve drug. Rifampicin may be used alone when penicillin is intolerable or ineffective. It also may be used for additional treatment of the patients after penicillin therapy. Rifampicin in combination with penicillin may be used in treatment of purulent meningitis and meningoencephalitis of a dubious etiology.

Topics: Animals; Blood-Brain Barrier; Dose-Response Relationship, Drug; Drug Evaluation; Drug Evaluation, Preclinical; Humans; Kinetics; Meningitis, Meningococcal; Meningococcal Infections; Rabbits; Rifampin; Time Factors

Topics: Child, Preschool; Humans; Infant; Male; Meningococcal Infections; Penicillins; Rifampin; Sulfadiazine

During 1978 there was a marked increase in the number of patients with meningococcal infection in the Hamilton area. Of 21 patients admitted to St. Joseph's Hospital, Hamilton, two thirds were under 5 years of age. Four patients died. All the isolates were sulfonamide-sensitive strains of serogroup B Neisseria meningitidis. Although no infections developed in contacts, several errors were made in the management of the hospital and household contacts of the infected patients: chemoprophylaxis was given to many contacts not considered to be at risk; ineffective antibiotics, particularly penicillin, were given for chemoprophylaxis; and chemoprophylaxis was often delayed while the results of cultures of nasopharyngeal and throat secretions were awaited. Circulation to local physicians of guidelines on proven prophylactic regimens was followed by a reduction in the frequency of these errors.

Topics: Adolescent; Cerebrospinal Fluid; Child; Child, Preschool; Female; Humans; Infant; Male; Medication Errors; Meningococcal Infections; Neisseria meningitidis; Ontario; Penicillin G; Rifampin; Sulfadiazine

Topics: Age Factors; Humans; Infant; Infant, Newborn; Italy; Meningococcal Infections; Neisseria meningitidis; Penicillin G; Rifampin; Sepsis

Three hundred twenty-six reported cases of meningococcal disease in the United States from November 1973 through March 1974 were investigated. Three household members became ill with meningococcal disease following onset of the initial case in their household. The secondary attack rate was approximately 3/1,000 household members. In 60% of the households, members were given an antimicrobial drug as chemoprophylaxis for meningococcal disease, but only 35% received minocycline hydrochloride or rifampin, the two drugs now available for the eradication of sulfonamide-resistant meningococci from the nasopharynx. Only 26% given chemoprophylaxis received the drug within 24 hours after the patient's hospital admission. Survey results indicate that the secondary attack rate of meningococcal disease may justify the use of chemoprophylaxis, but that frequently in the United States, the drugs given are likely to be ineffective, give too late, or administered to persons who are not at high risk to meningococcal disease.

Topics: Adolescent; Adult; Ampicillin; Anti-Bacterial Agents; Blood; Child; Child, Preschool; Humans; Male; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillins; Recurrence; Rifampin; Sulfonamides; Tetracyclines; United States; Urine

Topics: Carrier State; Drug Resistance, Microbial; Drug Therapy, Combination; Humans; Meningococcal Infections; Neisseria meningitidis; Rifampin; Risk; Sulfonamides

In 1971, rifampin was approved for treatment of pulmonary tuberculosis and asymptomatic carriers of Neisseria meningitidis. At present, the approved indications remain the same. However, rifampin in conjunction with at least one other antituberculous drug may be of great value in therapy of extrapulmonary tuberculosis and infections due to other susceptible mycobacteria. In addition, results of clinical trials in leprosy have been highly encouraging. Rifampin appears to induce light chain proteinuria in a majority of patients and has been implicated in suppression of both humoral and cell-mediated immune responses. However, these effects appear to have been of little consequence to treated patients. A variety of possibly immunologically mediated reactions to rifampin has been closely associated with irregular administration of the drug. These reactions and hepatic toxcity may be preventable in many patients. Rifampin or one of its congeners, alone or in combination with other antibiotics, may prove useful in treatment of various infectious, and possibly malignant, diseases.

Topics: Animals; Antibody Formation; Antineoplastic Agents; Antiviral Agents; Chemical and Drug Induced Liver Injury; Drug Interactions; Drug Resistance, Microbial; Drug Therapy, Combination; Forecasting; Humans; Immunity, Cellular; Immunosuppressive Agents; Leprosy; Liver; Meningococcal Infections; Mycobacterium Infections; Rifampin; Tuberculosis; Tuberculosis, Pulmonary

Topics: Humans; Male; Meningitis, Meningococcal; Meningococcal Infections; Middle Aged; Minocycline; Rifampin; Sepsis

Topics: Female; Humans; Male; Meningococcal Infections; Minocycline; Personnel, Hospital; Rifampin

Topics: Age Factors; Anti-Bacterial Agents; Carrier State; Child; Child, Preschool; Drug Therapy, Combination; Humans; Immunotherapy; Infant; Meningitis, Meningococcal; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillin G; Penicillin Resistance; Rifampin; Sulfonamides; United States

The frequency of healthy carriers of meningococci in Greece in 1973 has been studied by examining 1105 nasopharyngeal swabs from 731 recruits, during the four recruitment periods of this year. The frequency of healthy carriers among inductees within 24 hours from the arrival in the Camp was 38.9%. After a stay of 35 to 40 days in the training Camp the frequency of healthy carriers rose to 66.4%. Among all the soldiers examined, 24.5% were carriers of meningococci of group B, 13.2% of non-typable strains, 8.1% of autoagglutinable strains, 4.1% of meningococci of group A, 3.7% of meningococci of group C and smaller percentages of strains of groups X, Y, Z and of cross-agglutinating strains. The prevalence of carriers of meningococci of groups A and C and of autoagglutinable strains was higher among recruits who have been in the Camp for 35 to 40 days. The prevalence of carriers of the other serogroups was about the same among the inductees and the other recruits. No significant differences were found in the frequency of carriers of each serogroup among soldiers on their arrival, who were permanent residents of urban or rural areas of various parts of the country. No significant seasonal variation was noted in the frequency of carriers of each serogroup. Frequent changes of the group of meningococci harboured were noted among 374 recruits examined upon their arrival, as well as after 35 to 40 days of residence in the training Camp. Among 534 strains of meningococci examined none was resistant to either minocycline or rifampicin. Among 226 strains isolated from inductees, 44.7% were resistant to 1 mug/ml of sulphadiazine, while among 235 strains isolated from recruits after they have been in the Camp for 35 to 40 days, 57.9% were resistant to that sulphonamide.

Topics: Carrier State; Drug Resistance, Microbial; Greece; Humans; Male; Meningococcal Infections; Military Personnel; Minocycline; Nasopharynx; Neisseria meningitidis; Rifampin; Rural Population; Seasons; Serotyping; Sulfadiazine; Tetracyclines; Time Factors; Urban Population

Topics: Humans; Meningococcal Infections; Minocycline; Rifampin; Tetracyclines

Topics: Carrier State; Humans; Meningococcal Infections; Rifampin

Topics: Disease Outbreaks; Drug Evaluation; Drug Resistance, Microbial; Humans; In Vitro Techniques; London; Meningococcal Infections; Minocycline; Neisseria meningitidis; Rifampin; Sulfonamides

Topics: Adult; Child; Child, Preschool; Humans; Meningococcal Infections; Minocycline; Neisseria meningitidis; Penicillin Resistance; Penicillins; Rifampin; Sulfadiazine; Sulfonamides; United Kingdom

Topics: Adolescent; Animals; Anti-Bacterial Agents; Brazil; Carrier State; Child; Child, Preschool; Disease Outbreaks; Drug Resistance, Microbial; Drug Synergism; Drug Therapy, Combination; Follow-Up Studies; Humans; Infant; Meningococcal Infections; Microbial Sensitivity Tests; Minocycline; Neisseria meningitidis; Rabbits; Rifampin; Sulfadiazine

Topics: Adolescent; Adult; Age Factors; Antibodies, Bacterial; Carrier State; Cerebrospinal Fluid; Child; Child, Preschool; Disease Outbreaks; Drug Resistance, Microbial; Florida; Hemagglutination Tests; Housing; Humans; Immune Sera; Infant; Meningococcal Infections; Nasopharynx; Neisseria meningitidis; Rifampin; Socioeconomic Factors; Sulfonamides

Topics: Drug Resistance, Microbial; Humans; London; Meningococcal Infections; Minocycline; Rifampin; Sulfonamides

Topics: Adolescent; Adult; Bacteriological Techniques; Carrier State; Florida; Humans; Male; Meningococcal Infections; Minocycline; Nasopharynx; Naval Medicine; Neisseria meningitidis; Rifampin; Tetracycline

Topics: Adolescent; Carrier State; Child; Child, Preschool; Drug Resistance, Microbial; Female; Humans; Infant; Male; Meningitis, Meningococcal; Meningococcal Infections; Middle Aged; Nasopharynx; Neisseria meningitidis; Rifampin

Topics: Anti-Bacterial Agents; In Vitro Techniques; Leucomycins; Meningococcal Infections; Neisseria meningitidis; Oxacillin; Penicillin G; Penicillin Resistance; Rifampin; Sulfamethoxazole; Tetracycline; Trimethoprim

Topics: Carrier State; Drug Resistance, Microbial; Humans; Male; Meningococcal Infections; Microbial Sensitivity Tests; Military Medicine; Minocycline; Mutation; Nasopharyngeal Diseases; Neisseria meningitidis; Rifampin; Tetracycline

Topics: Antibody Formation; Antigens, Bacterial; Bacterial Vaccines; Carrier State; Disease Outbreaks; Humans; Immunization; Immunotherapy; Meningitis, Meningococcal; Meningococcal Infections; Military Medicine; Minocycline; Neisseria meningitidis; Polysaccharides, Bacterial; Rifampin; Sepsis; Sulfadiazine; United States

Topics: Drug Interactions; Humans; Meningococcal Infections; Microbial Sensitivity Tests; Rifampin; Tuberculosis, Pulmonary; Virus Diseases

Topics: Adolescent; Adult; Antibodies, Bacterial; Child; Child, Preschool; Female; Humans; Immunoglobulin M; Immunologic Deficiency Syndromes; Infant; Male; Meningitis; Meningococcal Infections; Rifampin; Sulfadiazine

Topics: Carrier State; Drug Resistance, Microbial; Humans; Male; Mass Screening; Meningococcal Infections; Methylamines; Military Medicine; Neisseria meningitidis; Rifampin; Tetracycline

Topics: Adult; Ampicillin; Blood Group Antigens; Cephalothin; Child; Female; Humans; Male; Meningococcal Infections; Microbial Sensitivity Tests; Neisseria meningitidis; Penicillin Resistance; Penicillins; Rifampin; Sulfadiazine; Sulfonamides

Topics: Adolescent; Adult; Carrier State; Drug Resistance, Microbial; Humans; Male; Meningococcal Infections; Microbial Sensitivity Tests; Military Medicine; Nasopharyngeal Diseases; Neisseria meningitidis; Rifampin; Sulfadiazine

Topics: Carrier State; Humans; Meningococcal Infections; Rifampin; Sulfonamides

Topics: Carrier State; Drug Resistance, Microbial; Meningococcal Infections; Nasopharynx; Rifampin; Saliva

Topics: Carrier State; Drug Resistance, Microbial; Humans; Meningococcal Infections; Neisseria meningitidis; Pharynx; Rifampin