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Unlike\n            <jats:italic>Neisseria gonorrhoeae<\/jats:italic>\n            , antibiotic resistance in\n            <jats:italic>Nm<\/jats:italic>\n            has developed slowly. However, in the last two decades and with the reemergence of IMD following the COVID-19 pandemic, antibiotic-resistant\n            <jats:italic>Nm<\/jats:italic>\n            isolates, especially to penicillin and fluoroquinolones, have progressively increased. Recent worldwide studies of penicillin intermediate and resistant\n            <jats:italic>Nm<\/jats:italic>\n            isolates and the PubMLST global database reveal a notable increase in fully penicillin-resistant isolates since 2016, mediated by mosaic\n            <jats:italic>penA<\/jats:italic>\n            alleles or the \u03b2-lactamase genes\n            <jats:italic>bla<\/jats:italic>\n            <jats:sub>ROB-1<\/jats:sub>\n            and\n            <jats:italic>\n              bla\n              <jats:sub>TEM-1<\/jats:sub>\n            <\/jats:italic>\n            . Fluoroquinolone-resistant isolates, mediated by\n            <jats:italic>gyrA<\/jats:italic>\n            mutations, have increased since 2005. Also, while still exceptionally rare, four\n            <jats:italic>Nm<\/jats:italic>\n            isolates have been identified with third-generation cephalosporin-resistance since 2011. We review the emergence of antibiotic resistance determinants and lineages in\n            <jats:italic>Nm,<\/jats:italic>\n            the resistance to agents previously or currently used in treatment or chemoprophylaxis, and summarize updated treatment and prevention guidelines for IMD. Special populations (e.g., individuals on complement inhibitors) and antibiotic resistance in\n            <jats:italic>Nm<\/jats:italic>\n            urethritis isolates are also reviewed. The increasing number of resistant\n            <jats:italic>Nm<\/jats:italic>\n            isolates worldwide affects chemoprophylaxis and treatment options for IMD and emphasizes the need for enhanced global surveillance of antibiotic resistance in\n            <jats:italic>Nm<\/jats:italic>\n            .\n          <\/jats:p>","DOI":"10.1128\/cmr.00215-24","type":"journal-article","created":{"date-parts":[[2025,1,31]],"date-time":"2025-01-31T14:06:09Z","timestamp":1738332369000},"update-policy":"https:\/\/doi.org\/10.1128\/asmj-crossmark-policy-page","source":"Crossref","is-referenced-by-count":19,"title":["Progression of antibiotic resistance in\n            <i>Neisseria meningitidis<\/i>"],"prefix":"10.1128","volume":"38","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2633-6090","authenticated-orcid":true,"given":"Emilio","family":"Rodriguez","sequence":"first","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7950-8197","authenticated-orcid":true,"given":"Yih-Ling","family":"Tzeng","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Isha","family":"Berry","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca","family":"Howie","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lucy","family":"McNamara","sequence":"additional","affiliation":[{"name":"Division of Bacterial Diseases, National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8174-660X","authenticated-orcid":true,"given":"David S.","family":"Stephens","sequence":"additional","affiliation":[{"name":"Division of Infectious Diseases, Department of Medicine, Emory University School of Medicine","place":["Atlanta, USA"]},{"name":"Department of Microbiology and Immunology, Emory University School of Medicine","place":["Atlanta, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"235","reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.1007\/s40265-013-0079-2"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(07)61016-2"},{"key":"e_1_3_3_4_2","first-page":"1","article-title":"Prevention and control of meningococcal disease: recommendations of the Advisory Committee on Immunization Practices (ACIP)","volume":"62","author":"Cohn AC","year":"2013","unstructured":"Cohn AC, MacNeil JR, Clark TA, Ortega-Sanchez IR, Briere EZ, Meissner HC, Baker CJ, Messonnier NE, Centers for Disease Control and Prevention (CDC). 2013. 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