A Hungarian soldier previously immunized against Neisseria meningitidis by quadrivalent polysaccharide vaccine was twice infected with meningococci within six weeks. The patient was treated with ceftriaxone during both episodes and he successfully recovered. His close contacts received rifampicin prophylaxis. An investigation was performed to characterize the genetic background of the pathogens to ascertain if the recurrent invasive meningococcal disease was caused by the same strain and to find out the reason for reinfection. Both meningococci belonged to the fine type Y:P1.5-2,10-1:F4-1:ST-23. This is the first description of the Europe-wide prevalent N. meningitidis serogroup Y in Hungary. In the first episode, we found wild-type rpoB allele in the non-culturable sample implying the susceptibility to rifampicin. The culturable isolate from the second episode proved resistant to rifampicin and had a point mutation in the rpoB gene. The rifampicin resistance might have evolved during the prophylactic treatment of contacts. Previous immunization of the patient with polysaccharide vaccine was ineffective due to his immunodeficiency, thus immunization with conjugate vaccine was proposed. We have proposed the implementation of centralized rifampicin susceptibility testing of N. meningitidis strains within a defined time frame to intervene and administer appropriate prophylaxis to close contacts.

中文翻译：

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匈牙利首次对耐利福平的脑膜炎奈瑟氏球菌血清Y株进行了描述。

以前用四价多糖疫苗免疫脑膜炎奈瑟菌的匈牙利士兵在六周内两次感染了脑膜炎球菌。该患者在两次发作期间均接受头孢曲松治疗，并成功康复。他的亲密接触者接受了利福平预防。进行了一项研究，以鉴定病原体的遗传背景，以确定复发性侵袭性脑膜炎球菌病是否由同一菌株引起，并找出再次感染的原因。两种脑膜炎球菌均属于优良类型Y：P1.5-2,10-1：F4-1：ST-23。这是匈牙利在欧洲流行的脑膜炎奈瑟氏球菌血清群Y的首次描述。在第一集中，我们在不可培养的样本中发现了野生型rpoB等位基因，这暗示了对利福平的敏感性。第二次发作的可培养分离株证明对利福平具有抗性，并且在rpoB基因中存在点突变。在预防性接触治疗期间，可能对利福平产生了耐药性。由于多糖缺乏症，以前用多糖疫苗免疫患者无效，因此提出用结合疫苗进行免疫。我们建议在规定的时间范围内对脑膜炎奈瑟氏菌菌株进行集中的利福平药敏试验，以干预和采取适当的预防措施以密切接触。由于多糖缺乏症，以前用多糖疫苗免疫患者无效，因此提出用结合疫苗进行免疫。我们建议在规定的时间范围内对脑膜炎奈瑟氏菌菌株进行集中的利福平药敏试验，以干预和采取适当的预防措施以密切接触。由于多糖缺乏症，以前用多糖疫苗免疫患者无效，因此提出用结合疫苗进行免疫。我们建议在规定的时间范围内对脑膜炎奈瑟氏菌菌株进行集中的利福平药敏试验，以干预和采取适当的预防措施以密切接触。