Emerging Infectious Disease ISSN: 1080-6059

Ciprofloxacin-Resistant Neisseria meningitidis, Delhi, India

Smita Singhal*, Kedar P. Purnapatre*, Vandana Kalia*, Smita Dube*, Deepti Nair†, Monorama Deb†, Pushpa Aggarwal‡, Sunil Gupta§, Dilip J. Upadhyay*, Awdhesh Kalia¶, and V. Samuel Raj*

Author affiliations: *Ranbaxy Research Laboratories, Gurgaon, India; †Vardhman Mahaveer Medical College and Safdarjung Hospital, New Delhi, India; ‡Ministry of Health and Family Welfare, New Delhi, India; §National Institute of Communicable Diseases, Delhi, India; ¶Caribbean Epidemiology Centre, Port of Spain, Trinidad and Tobago;

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Figure 2

Figure 2. Comparison of GyrA quinolone-resistance–determining region (QRDR) for the alteration of amino acids in Neisseria meningitidis isolates. GyrA QRDR 1, ciprofloxacin-sensitive strains RRL-1, RRL-2, SFDJ 723, Ap-II 420; GyrA QRDR 2, ciprofloxacin-resistant strains SFDJ E-100, SFDJ E-79, SFDJ E-63, NICD 18, SFDJ E-95, IR-I 442; GyrA QRDR 3, ciprofloxacin-resistant strain IR-II 440. Ciprofloxacin-sensitive RRL-1 and RRL-2 were the reference strains, and the other 9 strains were from the outbreak. The shaded positions of the amino acids denote changes in GyrA QRDR of ciprofloxacin-resistant N. meningitidis in Thr-91 → Ile, Asn-103 → Asp, Ile-111 → Val, and Val-120 → Ile. The mutation of amino acid at conservative position 91 (Thr-91 → Ile) is responsible for the decreased susceptibility to fluoroquinolones, and the other 3 changes are synonymous.

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