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Neisseria meningitidis has been recognized as a cause of serious disease for centuries, but changing epidemiology and advances in treatment and prevention strategies mandate that providers be aware of ongoing developments with regard to this infection. Given the high burden of disease in adolescents, it is important for clinicians to be familiar with current recommendations regarding N. meningitidis.Adolescents and young adults continue to have the second highest incidence of disease from N. meningitidis. New diagnostic techniques, including polymerase chain reaction, have shown promise for enhancing detection of meningococcal infection in selected scenarios. Whereas most isolates of meningococcus remain penicillin-susceptible, fluoroquinolone resistance has now been documented in the US for the first time. Routine immunization using the meningococcal conjugate vaccine continues to be recommended, despite ongoing concern about a possible association between vaccination and Guillain–Barré syndrome. Active research is ongoing to develop a serogroup B vaccine and meningococcal vaccines that are immunogenic in infants and toddlers.Given the increased incidence of meningococcal infection among adolescents and the substantial morbidity and mortality associated with invasive disease, adolescent health providers must be familiar with current antibiotic treatment and prophylaxis guidelines and ongoing developments regarding meningococcal vaccination.