{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,14]],"date-time":"2026-10-14T17:51:48Z","timestamp":1792000308258,"version":"4.4.0"},"reference-count":32,"publisher":"Akademiai Kiado Zrt.","issue":"2","content-domain":{"domain":["www.akjournals.com"],"crossmark-restriction":true},"short-container-title":["AMICR"],"published-print":{"date-parts":[[2026,5,29]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:p>\n                    We describe a case of meningococcal bloodstream infection complicated by purpura fulminans in a 49-year-old woman in Tunisia in May 2025, caused by a ciprofloxacin-resistant\n                    <jats:italic>Neisseria meningitidis<\/jats:italic>\n                    . The patient presented with rapidly progressive purpura and septic shock requiring intensive care and empirical cefotaxime therapy. Blood cultures, molecular testing, and whole-genome sequencing (WGS) were investigated to characterize the\n                    <jats:italic>N. meningitidis<\/jats:italic>\n                    isolate. The strain was non-groupable and belonged to ST-175 (cc175), with BAST profile 3645 and a MenDeVAR Index indicating insufficient evidence for vaccine coverage. WGS identified\n                    <jats:italic>pen<\/jats:italic>\n                    A mutations (F504L, A510V, I515V, H541N, I566V) associated with reduced amoxicillin susceptibility and a\n                    <jats:italic>gyr<\/jats:italic>\n                    A T91I mutation conferring ciprofloxacin resistance. Comparative genomic analysis showed close relatedness to European isolates, representing the first genomic documentation of cc175 in Tunisia. This case underscores the value of genomic analysis for detecting emerging antimicrobial resistance and monitoring unusual meningococcal lineages in adult patients.\n                  <\/jats:p>","DOI":"10.1556\/030.2026.02923","type":"journal-article","created":{"date-parts":[[2026,4,1]],"date-time":"2026-04-01T12:31:38Z","timestamp":1775046698000},"page":"182-185","update-policy":"https:\/\/doi.org\/10.1556\/policypage.crossmark.crossref.2","source":"Crossref","is-referenced-by-count":1,"title":["Emergence of ciprofloxacin-resistant Neisseria meningitidis ST-175 in Tunisia: Clinical case description and genomic characterization"],"prefix":"10.1556","volume":"73","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-6441-1077","authenticated-orcid":true,"given":"Sana","family":"Ferjani","sequence":"first","affiliation":[{"name":"Charles Nicolle Hospital, Laboratory of Microbiology, Boulevard 9 Avril, Tunis 1006, Tunisia"},{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lamia","family":"Kanzari","sequence":"additional","affiliation":[{"name":"Charles Nicolle Hospital, Laboratory of Microbiology, Boulevard 9 Avril, Tunis 1006, Tunisia"},{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aymen","family":"Zoubli","sequence":"additional","affiliation":[{"name":"Charles Nicolle Hospital, Emergency Department, Boulevard 9 Avril, Tunis 1006, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zaineb","family":"Hamzaoui","sequence":"additional","affiliation":[{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Khaoula","family":"Mefteh","sequence":"additional","affiliation":[{"name":"Children's Hospital B\u00e9chir Hamza, Laboratory of Microbiology, Beb Saadoun, Tunis 1007, Tunisia"},{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR18ES39, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hanen","family":"Smaoui","sequence":"additional","affiliation":[{"name":"Children's Hospital B\u00e9chir Hamza, Laboratory of Microbiology, Beb Saadoun, Tunis 1007, Tunisia"},{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR18ES39, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sarra","family":"Jouini","sequence":"additional","affiliation":[{"name":"Charles Nicolle Hospital, Emergency Department, Boulevard 9 Avril, Tunis 1006, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilhem","family":"Boutiba Ben Boubaker","sequence":"additional","affiliation":[{"name":"Charles Nicolle Hospital, Laboratory of Microbiology, Boulevard 9 Avril, Tunis 1006, Tunisia"},{"name":"University of Tunis El Manar, Faculty of Medicine of Tunis, LR99ES09, 1007, Tunis, Tunisia"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"425","reference":[{"key":"B1","series-title":"CDC manual for surveillance of vaccine-preventable\u00a0diseases","article-title":"Chapter 8: meningococcal disease","author":"Centers for Disease Control and Prevention","year":"2024","unstructured":"Centers for Disease Control and Prevention. 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