A case report and review of the literature: Ciprofloxacin resistant Salmonella enterica serovar Typhi in India

Harish, Belgode Narasimha; Menezes, Godfred Antony; Sarangapani, Kengamuthu; Parija, Subhash Chandra

doi:10.3855/jidc.229

Cited by 26 publications

(29 citation statements)

References 20 publications

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“…A single mutation in quinolone-resistance-determining region of gyr A gene is sufficient to confer resistance to NA and reduced susceptibility to fluoroquinolones. The continued use of ciprofloxacin against NA R strains has led to a steady creep in ciprofloxacin MICs [7,16,19] along with further mutations at the same locus, resulting in recent emergence of fully resistant strains [7,8,[20][21][22]. Saha et al, in 2006, reported a highly ciprofloxacin-resistant S. Typhi strain with the MIC as high as 512 μg/mL from Bangladesh [23].…”

Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance among blood culture isolates of Salmonella enterica in New Delhi

Jain

Chugh

2013

J Infect Dev Ctries

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Introduction: Enteric fever is a global public health problem, especially in developing countries. Antimicrobial resistance is a major issue enteric fever management. This study examined current pattern of antimicrobial susceptibility among Salmonella enterica isolates from enteric fever cases at a tertiary care centre in New Delhi, India. Methodology: Blood cultures from patients with enteric fever during January 2010-July 2012 were processed using the BACTEC automated system. Antimicrobial susceptibility was tested using Kirby Bauer's disc diffusion method and/or Phoenix 100 automated system. Results: Of 344 isolates of Salmonella enterica, 266 (77.3%) were S. Typhi, 77 (22.4%) were S. Paratyphi A, and one (0.3%) was S. Paratyphi B. Resistance to nalidixic acid (NA R ) (96.7%) was most common, followed by ciprofloxacin (37.9%), and azithromycin (7.3%). Multi-drug resistance was observed only in S. Typhi (3.4%). Among NA R strains, 61.8% were sensitive, 11.1% were moderately sensitive, and 23.9% were resistant to ciprofloxacin (0.8%, 57.4%, and 37.9% respectively according to revised CLSI breakpoint criteria for ciprofloxacin). Resistance to third-generation cephalosporin was found in seven (2%) strains of S. enterica. Conclusion: Increasing rates of nalidixic acid, fluoroquinolone and azithromycin resistance among S. enterica, particularly in S. Paratyphi A strains, is of concern, as S. Paratyphi A infection is becoming increasingly common and is not prevented by current vaccinations. Our results favour use of cefexime or possibly chloramphenicol as first choice for uncomplicated enteric fever. MICs for third-generation cephalosporins and susceptibility pattern must be closely monitored in view of its emerging resistance among Salmonella enterica.

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Section: Discussionmentioning

confidence: 99%

Antimicrobial resistance among blood culture isolates of Salmonella enterica in New Delhi

Jain

Chugh

2013

J Infect Dev Ctries

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“…Similarly, an increase in Salmonella serovar Paratyphi A isolates with ciprofloxacin MICs of Ն2 g/ml was reported from New Delhi in 2000 (347), and a ciprofloxacin-resistant isolate with a MIC of 128 g/ml was isolated in Japan in 2002 (348). By 2008, there were reports of ciprofloxacin-resistant Salmonella serovar Typhi from multiple centers in India (349)(350)(351)(352). In 2010, a tertiary hospital in Chandigarh, India, reported that 13.6% of isolates were ciprofloxacin resistant (353).…”

Section: Development Of Antimicrobial Resistance Among Typhoidal Salmmentioning

confidence: 99%

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

et al. 2015

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SUMMARY Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica , initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.

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“…In 2008, there were reports of high level ciprofloxacinresistant Salmonella enteric from many centres in India, 21,22 including our study, prevalence was found to be 14.32%. By in vitro antibiotic sensitivity testing, our data also confirm that resistance to antimicrobial agents (Nalidixic acid, ciprofloxacin, trimethoprim, and sulfamethoxazole) has continued to increase at an alarming pace.…”

Section: Discussionmentioning

confidence: 83%

Enteric Fever in Bastar Tribal Region-Prevalence and Sensitivity Patterns

Yadav¹,

Kiran²,

Sharma³

2016

jemds

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OBJECTIVECurrently, antibiotic resistance in bacterial populations is one of the greatest challenges to the effective management of infectious diseases. The aim of this research was to study the prevalence of salmonella species and its sensitivity pattern in a tertiary care medical college hospital in Bastar, Chhattisgarh. MATERIAL AND METHODSFrom the clinical samples cultured from Jan 2010 to June 2014. 690 cases of enteric fever were isolated and investigations were carried out for antibiotic susceptibility pattern of S. typhi and S. Paratyphi Result: Antimicrobial susceptibility pattern of S. typhi against various antibiotics tested were chloramphenicol 37%-52%, co-trimoxazole 22-33%, ampicillin 28-46%, ciprofloxacin 14-29%, ofloxacin 80-95%, amikacin 89%-97%, cefotaxime 56%-88%, ceftriaxone 69%-72%, ceftazidime 86-93%, and nalidixic 93-86%. Sensitivity pattern of S. Paratyphi showed 100% resistance to co-trimoxazole, 40% to ciprofloxacin while they were 100% sensitive to ofloxacin and amikacin.

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A case report and review of the literature: Ciprofloxacin resistant Salmonella enterica serovar Typhi in India

Cited by 26 publications

References 20 publications

Antimicrobial resistance among blood culture isolates of Salmonella enterica in New Delhi

Antimicrobial resistance among blood culture isolates of Salmonella enterica in New Delhi

Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections

Enteric Fever in Bastar Tribal Region-Prevalence and Sensitivity Patterns

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