Antimicrobial resistance surveillance in typhoidal Salmonella in Ahmedabad in an era of global antimicrobial resistance surveillance systems

Abstract

Introduction:India possibly carries the highest burden of antimicrobial resistant typhoidal salmonellae in the world. We report on the health-care ecosystem that produces data on antimicrobial resistance (AMR) testing and the resistance patterns of typhoidal Salmonella isolates in the city of Ahmedabad.Materials and Methods:Through municipality records and internet searches, we identified 1696 private and 83 public laboratories in the city; 4 medical colleges, 4 health-care institution attached laboratories, and 4 corporate laboratories (CLs) were performing culture and antibiotic sensitivity testing (AST), but only 2 medical colleges and 1 CL shared their data with us. There was considerable variation in culturing and sensitivity testing methodology across laboratories.Results:Out of 51,260 blood cultures, Salmonella isolates were detected in only 146 (0.28%). AST was conducted on 124 isolates, of which 67 (54%) were found resistant. Multidrug resistance was absent. Concurrent resistance to more than one antibiotic was very high, 88%, among the 67 resistant isolates. Ciprofloxacin resistance varied widely between the private and public sector laboratories. Notably, isolates from the private sector laboratory showed complete resistance to azithromycin.Conclusions:High resistance to ciprofloxacin and azithromycin observed in Ahmedabad may be due to the increased use of these two antibiotics in the public and private sectors, respectively. The need of the hour is to identify a representative sample of laboratories from both the public and the private sectors and encourage them to participate in the national AMR surveillance network.

Antimicrobial resistance of Salmonella enterica Typhi in the Western and Southern Regions of the Democratic Republic of the Congo: Phenotypic profile and molecular characterization of isolates associated with epidemics of Typhoid Fever

“…In front of those former first-line antimicrobials including RL, W, AMP and C, the Salmonella Typhi isolates of Western and Southern regions of the DRC and those of Kinshasa City and Bas-Congo particularly presented multidrug resistance rates of 59.5% (Table 3) and 61% (Table 7) respectively. Those results remain slightly above the 54% reported from an evaluation of the antimicrobial resistance surveillance system in the administrative area of Ahmedabad City in India [33]. Furthermore, our results confirm those reported in some Kenyan administrative entities during the period form 1988 to 2008 and from 2001 to 2008, with respective values of 60.4% and 60.0% [34].…”

State of the globe: Antimicrobial resistance: Need for de-compartmentalization of action

“…Article by Iyer V, et al on antimicrobial resistance surveillance in typhoidal Salmonella in Ahmedabad is in line with the broader ojective of reducing global antimicrobial resistance. [5]…”