Ciprofloxacin-resistant Neisseria meningitidis in Canada: likely imported strains

The prevalence of ciprofloxacin-resistant Neisseria meningitidis in Canada was studied by testing 346 isolates received at the National Microbiology Laboratory during the calendar years 2013 to 2015. Of the 277 individual invasive and 69 noninvasive isolates tested, only 2 serogroup C (MenC) isolates were found to be resistant to ciprofloxacin. Both MenC were typed as sequence type (ST)-4821, a unique clone found mainly in China, thus suggesting both isolates might be from travel-related or imported cases. This prompted us to also examine 6 serogroup A (MenA) isolates in our collection, since MenA is not currently endemic in Canada. Three MenA from 2006 were resistant to ciprofloxacin and they were typed as ST-4789. A ciprofloxacin-resistant MenA strain of ST-4789 was responsible for a meningococcal disease outbreak in Delhi, India, in 2005 to 2006. The 2 MenC and 3 MenA ciprofloxacin-resistant N. meningitidis were from patients residing in British Columbia.