Neisseria meningitidis isolates in the United States have been historically susceptible to penicillin and ciprofloxacin.

These two antibiotics have been used for treatment in people with confirmed meningococcal infections and for prophylaxis in those with close contact with infected patients. Quick treatment with antibiotics is considered essential, as the disease can cause death within hours. In January, Maryland Department of Health reported an isolate that produced a beta-lactamase enzyme (which breaks down beta-lactam antibiotics) and was resistant to penicillin and ciprofloxacin cultured from a meningococcal disease patient. This was followed by a second case in February.

The findings prompted the CDC to request isolates from meningococcal disease cases from state health departments and conduct a systematic analysis. “The detection of geographically diverse cases with penicillin-resistant and ciprofloxacin-resistant NmY isolates has implications for treatment and prophylaxis of meningococcal disease in the United States,” the authors wrote.

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