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The Centers for Disease Control and Prevention yesterday issued a warning of an uptick over the last year in meningococcal disease in which isolates show the gene associated with penicillin resistance and mutations associated with ciprofloxacin resistance.

CDC said the majority of cases were in Hispanic individuals.

The agency recommends the following for providers and clinicians:

• Health care providers should perform antimicrobial susceptibility testing to determine susceptibility of all meningococcal isolates to penicillin before changing from empirical treatment with cefotaxime or ceftriaxone to penicillin or ampicillin.
• In states that have experienced meningococcal disease cases caused by ciprofloxacin-resistant strains within the past 1–2 years, clinicians and public health staff should consider AST on meningococcal isolates to inform prophylaxis decisions. AST should not delay the initiation of prophylaxis with ciprofloxacin, rifampin or ceftriaxone.