Volume 80, Issue 4
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645


During 1999–2006, 156 isolates of 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 community-wide increase in meningococcal disease incidence during this period, which was not recognized previously. All isolates 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.


Article metrics loading...

Loading full text...

Full text loading...



  1. World Health Organization, 2000. Meningococcal Disease. WHO Report on Global Surveillance of Epidemic Prone Infectious Disease. Geneva: World Health Organization. WHO/CDS/ CSR/ISR/2000.1.
  2. World Health Organization, 1999. Laboratory Methods for the Diagnosis of Meningitis Caused by Neisseria meningitidis, Streptococcus pneumoniae and Hemophilus influenzae. Geneva: World Health Organization, WHO/CDC/CSR/EDC/99.7.
  3. Youssef FG, El-Sakka H, Azab A, Eloun S, Chapman GD, Ismail T, Mansour H, Hallaj Z, Mahoney F, 2004. Etiology, antimicrobial susceptibility profiles, and mortality associated with bacterial meningitis among children in Egypt. Ann Epidemiol 14 : 44–48.
  4. Razafindralambo M, Ravelomanana N, Randriamiharisoa FA, Migliani R, Clouzeau J, Raobijaona H, Rasamoelisoa J, Pfister P, 2004. Haemophilus influenzae, the second cause of bacterial meningitis in children in Madagascar. Bull Soc Pathol Exot 97 : 100–103.
  5. Al-Mazrou YY, Al-Jeffri MH, Al-Haggar SH, Musa EK, Mohamed OM, Abdalla MN, 2004. Haemophilus type B meningitis in Saudi children under 5 years old. J Trop Pediatr 50 : 131–136.
  6. Dominguez A, Cardenosa N, Panella H, Orcau A, Companys M, Alseda M, Oviedo M, Carmona G, Minguell S, Salleras L, 2004. Working Group on the Study of Meningococcal Disease in Catalonia, 1990–1997. The case fatality rate of meningococcal disease in Catalonia, 1990–1997. Scand J Infect Dis 36 : 274–279.
  7. Cochi SL, Markowitz L, Joshi DD, Owens RC, Stenhouse DH, Regmi DN, Shresta RP, Lacharya I, Mandhar M, Gurubacharya VL, Owens D, Reingold A, 1987. Control of epidemic group A meningococcal meningitis in Nepal. Int J Epidemiol 16 : 91–97.
  8. Rosenstein NE, Perkins BA, Stephens DS, Lefkowitz L, Cartter ML, Danila R, Cieslak P, Shutt KA, Popovic T, Schuchat A, Harrison LH, Reingold AL, 1999. The changing epidemiology of meningococcal disease in the United States, 1992–1996. J Infect Dis 180 : 1894–1901.
  9. Mastrantonio P, Stefanelli P, Fazio C, Sofia T, Neri A, La RG, Marianelli C, Muscillo M, Caporali MG, Salmaso S, 2003. Serotype distribution, antibiotic susceptibility, and genetic relatedness of Neisseria meningitidis strains recently isolated in Italy. Clin Infect Dis 36 : 422–428.
  10. Yazdankhah SP, Kriz P, Tzanakaki G, Kremastinou J, Kalmusova J, Musilek M, Alvestad T, Jolley KA, Wilson DJ, McCarthy ND, Caugant DA, Maiden MC, 2004. Distribution of serogroups and genotypes among disease-associated and carried isolates of Neisseria meningitidis from the Czech Republic, Greece, and Norway. J Clin Microbiol 42 : 5146–5153.
  11. Pusponegoro HD, Oswari H, Astrawinata D, Fridawati V, 1998. Epidemiologic study of bacterial meningitis in Jakarta and Tangerang: preliminary report. Pediatr Infect Dis J 17 : S176–S178.
  12. Choo KE, Ariffin WA, Ahmad T, Lim WL, Gururaj AK, 1990. Pyogenic meningitis in hospitalized children in Kelantan, Malaysia. Ann Trop Paediatr 10 : 89–98.
  13. Manchanda V, Gupta S, Bhalla P, 2006. Meningococcal disease: history, epidemiology, pathogenesis, clinical manifestations, diagnosis, antimicrobial susceptibility and prevention. Indian J Med Microbiol 24 : 7–19.
  14. Singhal S, Purnapatre KP, Kalia V, Dube S, Nair D, Deb M, Aggarwal P, Gupta S, Upadhyay DJ, Rattan A, Raj VS, 2007. Ciprofloxacin resistant Neisseria meningitidis, Delhi, India. Emerg Infect Dis 13 : 1614–1616.
  15. Usman J, Butt T, Jamal S, 2007. Waterhouse-Friderichsen syndrome due to a meningococcal strain unusual in Pakistan. Pak J Pathol 18 : 71–72.
  16. Clinical and Laboratory Standard Institute (CLSI), 2005. Performance Standards for Antimicrobial Susceptibility Testing. Fifteenth Informational Supplement M100-S15; 25 (1). Wayne, PA: CLSI.
  17. Lingappa JR, Al-Rabeah MA, Hajjeh R, Mustafa T, Fatani A, Al-BassamT, Badukhan A, Turkistani AH, Makki S,Al-Hamdan N, Al-Jeffri M, Mazrou YA, Perkins BA, Popovic T, Mayer LW, Rosenstein NE, 2003. Serogroup W-135 meningococcal disease during the Hajj, 2000. Emerg Infect Dis 9 : 665–671.
  18. Aguilera JF, Perrocheau A, Meffre C, Hahne S, 2002. W135 Working Group. Outbreak of serogroup W135 meningococcal disease after the Hajj pilgrimage, Europe, 2000. Emerg Infect Dis 8 : 761–767.
  19. Lindsay AP, Hope V, Marshall RJ, Salinger J, 2002. Meningococcal disease and meteorological conditions in Auckland, New Zealand. Aust N Z Public Health 26 : 212–218.
  20. Jensen ES, Lundbye-Christensen S, Pedersen L, Sorensen HT, Schonheyder HC, 2003. Seasonal variation in meningococcal disease in Denmark: relation to age and meningococcal phenotype. Scand J Infect Dis 35 : 226–229.
  21. Brooks WA, Hossain A, Goswami D, Sharmeen AT, Nahar K, Alam K, Ahmed N, Naheed A, Nair GB, Luby S, Breiman RF, 2005. Bacteremic typhoid fever in children in an urban slum, Bangladesh. Emerg Infect Dis 11 : 326–329.
  22. Botha P, 1988. Penicillin-resistant Neisseria meningitidis in Southern Africa. Lancet ii : 54.
  23. Fontanals D, Pineda V, Pons I, Rojo JC, 1989. Penicillin-resistant beta-lactamase producing Neisseria meningitidis in Spain. Eur J Clin Microbiol Infect Dis 8 : 90–91.
  24. Florez C, Garcia-Lopez JL, Martin-Mazuelos E, 1997. Susceptibilities of 55 strains of Neisseria meningitidis isolated in Spain in 1993 and 1994. Chemotherapy 43 : 168–170.
  25. Canica M, Dias R, Nunes B, Carbalho L, Ferreira E, 2004. Meningococcal study group. Invasive culture-confirmed Neisseria meningitidis in Portugal: evaluation of serogroups in relation to different variables and antimicrobial susceptibility (2000–2001). J Med Microbiol 53 : 921–925.

Data & Media loading...

  • Received : 06 Apr 2008
  • Accepted : 03 Jan 2009

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error