An Outbreak of Ciprofloxacin-Resistant Serogroup B Meningococcal Disease in a Military Base, 2017

On July 23, 2017, a hospital in Taoyuan reported a suspected case of meningococcal disease, who was a soldier in a military base, to Taoyuan Department of Health. After investigation, another two soldiers who served in the same base with the index case developed symptoms of meningitis and were reported subsequently. Blood cultures from all three cases yielded serogroup B Neisseria meningitidis with indistinguishable pulsed-field gel electrophoresis patterns. A total of 114 contacts received chemoprophylaxis with rifampin or ciprofloxacin. Nevertheless, the hospital laboratory found that the isolate from the index case was resistant to ciprofloxacin. Of the 98 contacts receiving ciprofloxacin as initial chemoprophylaxis, 54 contacts were offered azithromycin while the rest 44 contacts declined. No secondary cases were identified in the contacts during the one-month follow-up period. The outbreak underscores the importance of antimicrobial surveillance of Neisseria meningitidis. The antimicrobial profiles of isolates from the cases should be reviewed and taken into consideration in terms of chemoprophylaxis for contacts.