Drug resistance in Salmonella typhi in North India with special reference to ciprofloxacin

Nath, Gopal

doi:10.1093/jac/46.1.149

Cited by 24 publications

(18 citation statements)

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“…Similar findings were reported by Nath et al Tankhiwale et al and Sheorey et al from Varanasi, Nagpur and Mumbai respectively. [7][8][9] Probably these drugs could once again be used in the future for enteric fever. 4,10 However, with the recent threat for emergence of multidrug resistant strains of S.typhi, which show resistance to ampicillin and trimethoprim as well, the efficacy of these drugs is also diminishing.…”

Section: Discussionmentioning

confidence: 99%

Changing trends in the antibiograms of salmonella isolates at a tertiary care hospital in Hyderabad

Lakshmi¹,

Ashok²,

Susmita³

et al. 2006

Indian J Med Microbiol

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The present study was undertaken to compare the changing trends of antibiograms of Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A isolates. A total of 80 isolates of salmonella obtained from blood cultures between 2001-2004 were included in the study. Identification and antibiotic sensitivities of the isolates were performed by using mini API (bio Merieux, France). Sixty isolates were identified as Salmonella enterica serovar Typhi and 20 were identified as Salmonella enterica serovar Paratyphi A. More than 67% of S.typhi and 80% of S.paratyphi A isolates were sensitive to chloramphenicol. Sensitivity of S.typhi isolates to cephalosporins was found to have increased from [2001][2002][2003][2004] while that of S.paratyphi A showed a decline. With increasing resistance to ciprofloxacin and the possibility of re-emergence of sensitivity to chloramphenicol, the policy of empirical treatment of enteric fever needs to be rationalized.

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Section: Discussionmentioning

confidence: 99%

Changing trends in the antibiograms of salmonella isolates at a tertiary care hospital in Hyderabad

Lakshmi¹,

Ashok²,

Susmita³

et al. 2006

Indian J Med Microbiol

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“…The increased quinolone MICs is not surprising since, within the last 5 years, the quinolones, especially norfloxacin and ciprofloxacin, have become the mainstay treatment choices for typhoid fever after resistance developed to previously commonly available antibiotics, including chloramphenicol and cotrimoxazole. The high prevalence of MDR serovar Typhi strains for which the nalidixic acid and ciprofloxacin MICs are high compared to those for sensitive strains means that soon resistance may emerge that renders these drugs ineffective, as has happened in Southeast Asia (4,17,18,28), where even moderate rises in MICs has led to clinical treatment failure. The major concern in Kenya has been the unregulated over-the-counter sale of the quinolones and indeed other antibiotics mainly for self-treatment of suspected infection in humans and, to a lesser extent, for use in animals without prescription, which will inevitably lead to the emergence and rapid dissemination of resistance.…”

Section: Discussionmentioning

confidence: 99%

Characterization of Multidrug-Resistant Typhoid Outbreaks in Kenya

et al. 2004

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We characterized by antibiotic susceptibility, plasmid analysis, incompatibility grouping, and pulsed-field gel electrophoresis (PFGE) of XbaI-and SpeI-digested DNA 102 Salmonella enterica serovar Typhi (serovar Typhi) isolated from recent outbreaks of typhoid in three different parts of Kenya. Only 13.7% were fully susceptible, whereas another 82.4% were resistant to each of the five commonly available drugs: ampicillin, chloramphenicol, and tetracycline (MICs of >256 g/ml); streptomycin (MIC, >1,024 g/ml); and cotrimoxazole (MIC of >32 g/ml). Resistance to these antibiotics was encoded on a 110-kb self-transferable plasmid of IncHI1 incompatibility group. The MICs of nalidixic acid (MIC, 8 to 16 g/ml) and ciprofloxacin (MIC of 0.25 to 0.38 g/ml) for 41.7% of the 102 serovar Typhi isolates were 5-and 10-fold higher, respectively, than for sensitive strains. Amplification by PCR and sequencing of the genes coding for gyrase (gyrA and gyrB) and topoisomerase IV (parE and parC) within the quinolone resistance-determining region revealed that the increase in the MICs of the quinolones had not resulted from any significant mutation. Analysis of genomic DNA from both antimicrobial agent-sensitive and multidrug-resistant serovar Typhi by PFGE identified two distinct subtypes that were in circulation in the three different parts of Kenya. As the prevalence of multidrugresistant serovar Typhi increases, newer, more expensive, and less readily available antimicrobial agents will be required for the treatment of typhoid in Kenya.

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“…60 % sensitive and both effective. 20 Our results are more optimistic for Cefipime, 4 th generation Cephalosporin with 96.5 % sensitivity. Parenteral 3 rd generation are commonly prescribed for typhoid fever 14 though they stand inferior to Quinolones according to other studies.…”

Section: 1314mentioning

confidence: 62%

Emerging Resistance; Antibiograms of Salmonella Strains

Shoaib

Choudry

Aamir

et al. 2016

TPMJ

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ABSTRACT… Objectives:To study the bacteriological profile of enteric fever and their antibiotic sensitivity pattern to commonly used antibiotics in view of emerging resistance at Civil Hospital Karachi (C.H.K.) and provide a guideline for making a protocol for empirical antibiotic therapy where culture facilities are not available. Methodology: Design: Descriptive laboratory Based study. Place and Duration of study: The study was conducted from 1 st January, 2010 till 30 th June, 2012 at the Central Lab, Civil Hospital Karachi. Patients and Methods: A cross sectional analysis was done on a total of 37,805 blood specimens sent for C/S from the entire inpatient and outpatient departments to the central lab, CHK. All blood cultures were inoculated in thioglycolate broth and incubated at 37° for 7 days. Positive blood cultures were processed, colonies were identified using standard biochemical tests and antibiotic susceptibility was checked by KirbyBauer disc diffusion method as per CLSI criteria. Results: Out of these specimens, 430 samples were found positive for the salmonella strains, among them 395 (91.86%) were Salmonella typhi and 35 (8.14%) were Salmonella paratyphi A. Salmonella infection was more common in male (55.85%) and more prevalent in children under 10 years of age (34.88%). The resistance pattern for Amoxicillin, Chloramphenicol, Co-trimoxazole, was (29%), (41%) and (5%) respectively; while the resistance was found to be higher in the commonly prescribed drugs belonging to first and second generation of cephalosporins and flouroquinolones. Conclusion: Amoxicillin and Chloramphenicol, the first line of drugs for the treatment of enteric fever are losing their efficacy and most of the organisms have developed resistance. Also, resistance against the second line of therapy, involving the use of cephalosporins and quinolones is rapidly emerging.

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Drug resistance in Salmonella typhi in North India with special reference to ciprofloxacin

Cited by 24 publications

References 1 publication

Changing trends in the antibiograms of salmonella isolates at a tertiary care hospital in Hyderabad

Changing trends in the antibiograms of salmonella isolates at a tertiary care hospital in Hyderabad

Characterization of Multidrug-Resistant Typhoid Outbreaks in Kenya

Emerging Resistance; Antibiograms of Salmonella Strains

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