Neisseria meningitidis: Difference between revisions

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''See [[meningitis]] for a general approach to the disease entity''
==Background==
==Background==
*[[Gram negative bacteria|Gram negative]] diplococci that causes [[bacterial meningitis]]
==Clinical Features==
[[File:Meningitis-Epidemics-World-Map.png|thumb|Epidemic meningitis geographic distribution showing "meningitis belt."]]
[[File:Charlotte Cleverley-Bisman Meningicoccal Disease.jpg|thumb|Severe [[meningococcal]] meningitis with classic petechial rash progressing to gangrene.]]
*A cause of [[meningitis]]
*Rash
**Approximately 2/3 of patients with [[meningococcemia]] develop rash.<ref>Sara Bode; Contagious Exanthematous Diseases. ''Quick References 2022''; 10.1542/aap.ppcqr.396150</ref>
**Can include erythematous, morbilliform, or urticarial macules and papules<ref>Sara Bode; Contagious Exanthematous Diseases. ''Quick References 2022''; 10.1542/aap.ppcqr.396150</ref>
**Most common hallmark is purpuric lesions with jagged edges. <ref>Sara Bode; Contagious Exanthematous Diseases. ''Quick References 2022''; 10.1542/aap.ppcqr.396150</ref>
==Post exposure prophylaxis==
{{Neisseria meningitis prophylaxis}}


==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
==[[Antibiotic Sensitivities]]<ref>Sanford Guide to Antimicrobial Therapy 2014</ref>==
{| class="wikitable"
{| class="wikitable"
 
| align="center" style="background:#f0f0f0;"|'''Category'''
| align="center" style="background:#f0f0f0;"|'''Antibiotic'''
| align="center" style="background:#f0f0f0;"|'''Sensitivity'''
|-
| [[Penicillins]]||[[Penicillin G]]||'''S'''
|-
| ||[[Penicillin V]]||R
|-
| [[Anti-Staphylocccal Penicillins]]||[[Methicillin]]||R
|-
| ||[[Nafcillin]]/[[Oxacillin]]||R
|-
| ||[[Cloxacillin]]/[[Diclox.]]||R
|-
| Amino-[[Penicillins]]||[[AMP]]/[[Amox]]||'''S'''
|-
| ||[[Amox-Clav]]||'''S'''
|-
| ||[[AMP-Sulb]]||'''S'''
|-
| Anti-Pseudomonal [[Penicillins]]||[[Ticarcillin]]||'''S'''
|-
| ||[[Ticar-Clav]]||'''S'''
|-
| ||[[Pip-Tazo]]||'''S'''
|-
| ||Piperacillin||'''S'''
|-
| [[Carbapenems]]||Doripenem||'''S'''
|-
| ||[[Ertapenem]]||'''S'''
|-
| ||[[Imipenem]]||'''S'''
|-
| ||[[Meropenem]]||'''S'''
|-
| ||[[Aztreonam]]||'''S'''
|-
| [[Fluroquinolones]]||[[Ciprofloxacin]]||'''S'''
|-
| ||[[Ofloxacin]]||'''S'''
|-
| ||Pefloxacin||'''S'''
|-
| ||[[Levofloxacin]]||'''S'''
|-
| ||[[Moxifloxacin]]||'''S'''
|-
| ||Gemifloxacin||X1
|-
| ||Gatifloxacin||'''S'''
|-
| 1st G [[Cephalo]]||[[Cefazolin]]||R
|-
| 2nd G. [[Cephalo]]||[[Cefotetan]]||I
|-
| ||[[Cefoxitin]]||I
|-
| ||[[Cefuroxime]]||'''S'''
|-
| 3rd/4th G. [[Cephalo]]||[[Cefotaxime]]||'''S'''
|-
| ||Cefizoxime||I
|-
| ||[[CefTRIAXone]]||'''S'''
|-
| ||Ceftaroline||'''S'''
|-
| ||[[CefTAZidime]]||I
|-
| ||[[Cefepime]]||'''S'''
|-
| Oral 1st G. [[Cephalo]]||Cefadroxil||R
|-
| ||[[Cephalexin]]||R
|-
| Oral 2nd G. [[Cephalo]]||Cefaclor/Loracarbef||I
|-
| ||Cefproxil||I
|-
| ||Cefuroxime axetil||I
|-
| Oral 3rd G. [[Cephalo]]||Cefixime||I
|-
| ||Ceftibuten||I
|-
| ||Cefpodox/Cefdinir/Cefditoren||X1
|-
| [[Aminoglycosides]]||[[Gentamicin]]||R
|-
| ||Tobramycin||R
|-
| ||[[Amikacin]]||R
|-
| ||[[Chloramphenicol]]||'''S'''
|-
| ||[[Clindamycin]]||R
|-
| [[Macrolides]]||Erythromycin||X2
|-
| ||[[Azithromycin]]||X2
|-
| ||Clarithromycin||X1
|-
| Ketolide||Telithromycin||X2
|-
| Tetracyclines||[[Doxycycline]]||'''S'''
|-
| ||Minocycline||'''S'''
|-
| Glycylcycline||Tigecycline||X1
|-
| ||Daptomycin||R
|-
| Glyco/Lipoclycopeptides||[[Vancomycin]]||R
|-
| ||Teicoplanin||R
|-
| ||Telavancin||R
|-
| ||Fusidic Acid||'''S'''
|-
| ||Trimethoprim||I
|-
| ||[[TMP-SMX]]||X2
|-
| Urinary Agents||[[Nitrofurantoin]]||X1
|-
| ||Fosfomycin||X1
|-
| Other||[[Rifampin]]||'''S'''
|-
| ||[[Metronidazole]]||R
|-
| ||Quinupristin dalfoppristin||R
|-
| ||[[Linezolid]]||R
|-
| ||Colistimethate||R
|}


===Key===
===Key===

Latest revision as of 20:38, 2 November 2022

See meningitis for a general approach to the disease entity

Background

Clinical Features

Epidemic meningitis geographic distribution showing "meningitis belt."
Severe meningococcal meningitis with classic petechial rash progressing to gangrene.
  • A cause of meningitis
  • Rash
    • Approximately 2/3 of patients with meningococcemia develop rash.[1]
    • Can include erythematous, morbilliform, or urticarial macules and papules[2]
    • Most common hallmark is purpuric lesions with jagged edges. [3]

Post exposure prophylaxis

  • Ceftriaxone 250mg IM once (if less than 15yr then 125mg IM)
  • Ciprofloxacin 500mg PO once
  • Rifampin 600 mg PO BID x 2 days
    • if < 1 month old then 5mg/kg PO BID x 2 days
    • if ≥ 1 month old then 10mg/kg (max at 600mg) PO BID x 2 days

Antibiotic Sensitivities[4]

Category Antibiotic Sensitivity
Penicillins Penicillin G S
Penicillin V R
Anti-Staphylocccal Penicillins Methicillin R
Nafcillin/Oxacillin R
Cloxacillin/Diclox. R
Amino-Penicillins AMP/Amox S
Amox-Clav S
AMP-Sulb S
Anti-Pseudomonal Penicillins Ticarcillin S
Ticar-Clav S
Pip-Tazo S
Piperacillin S
Carbapenems Doripenem S
Ertapenem S
Imipenem S
Meropenem S
Aztreonam S
Fluroquinolones Ciprofloxacin S
Ofloxacin S
Pefloxacin S
Levofloxacin S
Moxifloxacin S
Gemifloxacin X1
Gatifloxacin S
1st G Cephalo Cefazolin R
2nd G. Cephalo Cefotetan I
Cefoxitin I
Cefuroxime S
3rd/4th G. Cephalo Cefotaxime S
Cefizoxime I
CefTRIAXone S
Ceftaroline S
CefTAZidime I
Cefepime S
Oral 1st G. Cephalo Cefadroxil R
Cephalexin R
Oral 2nd G. Cephalo Cefaclor/Loracarbef I
Cefproxil I
Cefuroxime axetil I
Oral 3rd G. Cephalo Cefixime I
Ceftibuten I
Cefpodox/Cefdinir/Cefditoren X1
Aminoglycosides Gentamicin R
Tobramycin R
Amikacin R
Chloramphenicol S
Clindamycin R
Macrolides Erythromycin X2
Azithromycin X2
Clarithromycin X1
Ketolide Telithromycin X2
Tetracyclines Doxycycline S
Minocycline S
Glycylcycline Tigecycline X1
Daptomycin R
Glyco/Lipoclycopeptides Vancomycin R
Teicoplanin R
Telavancin R
Fusidic Acid S
Trimethoprim I
TMP-SMX X2
Urinary Agents Nitrofurantoin X1
Fosfomycin X1
Other Rifampin S
Metronidazole R
Quinupristin dalfoppristin R
Linezolid R
Colistimethate R

Key

  • S susceptible/sensitive (usually)
  • I intermediate (variably susceptible/resistant)
  • R resistant (or not effective clinically)
  • S+ synergistic with cell wall antibiotics
  • U sensitive for UTI only (non systemic infection)
  • X1 no data
  • X2 active in vitro, but not used clinically
  • X3 active in vitro, but not clinically effective for Group A strep pharyngitis or infections due to E. faecalis
  • X4 active in vitro, but not clinically effective for strep pneumonia

Table Overview

Gram Positives
Cocci
Clusters
Pairs/Chains
Other
Rods
Gram Negatives
Cocci
Rods
Lactose Fermenters
Lactose Non-Fermenters
Other
Rods/Cocci
Anaerobes

See Also

References

  1. ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
  2. ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
  3. ↑ Sara Bode; Contagious Exanthematous Diseases. Quick References 2022; 10.1542/aap.ppcqr.396150
  4. ↑ Sanford Guide to Antimicrobial Therapy 2014
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