Increasing Isolations of Neisseria meningitides Serogroup A from Blood and Cerebrospinal Fluid in Dhaka, Bangladesh, 1999–2006

During 1999-2006, 156 isolates of Neisseria meningitidis grew from culture of blood or cerebrospinal fluid at International Centre for Diarrhoeal Disease Research, Bangladesh, in Dhaka, Bangladesh. Serogroup A was the most prevalent strain (97.7%); the rest were serogroup B (2.3%). Most cases of invasive meningococcal disease (88.5%) were identified in 2002-2004 and most (87.5%) occurred in children, teenagers, and young adults, which reflected a commu- nity-wide increase in meningococcal disease incidence during this period, which was not recognized previously. All iso- lates were susceptible to penicillin, ampicillin, chloramphenicol, ciprofloxacin, and ceftriaxone. Cotrimoxazole resistance steadily increased from 50% to 100% during 2002-2006. Resistance to azithromycin emerged in 2002 (5%), increased to 31% in 2004, but isolates in 2005-2006 were susceptible. Information from broader hospital settings and population-based data would precisely assess trends and impact to define strategies for optimal prevention and empiric therapy.