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

J Infect Dis. 2022 Jun 1;225(11):1871-1875. doi: 10.1093/infdis/jiac046.


Background: Historically, antimicrobial resistance has been rare in US invasive meningococcal disease cases.

Methods: 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.

Results: 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.

Conclusions: Penicillin- and ampicillin-intermediate isolates were common, but resistance to clinically relevant antibiotics remained rare.

Keywords: Neisseria meningitidis; penA; antibiotic resistance; antimicrobial susceptibility; ciprofloxacin; invasive meningococcal disease; penicillin.

Publication types

  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Ampicillin
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use
  • Ceftriaxone / pharmacology
  • Ciprofloxacin / pharmacology
  • Humans
  • Meningococcal Infections* / epidemiology
  • Microbial Sensitivity Tests
  • Neisseria meningitidis* / genetics
  • Penicillins
  • United States / epidemiology


  • Anti-Bacterial Agents
  • Penicillins
  • Ciprofloxacin
  • Ceftriaxone
  • Ampicillin