High-level ciprofloxacin resistance in Salmonella enterica serotype Typhi in India

Renuka, K; Sood, Seema; Das, Bimal Kumar; Kapil, Arti

doi:10.1099/jmm.0.45966-0

Cited by 62 publications

(55 citation statements)

References 11 publications

(7 reference statements)

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“…The emergence of multi-drug resistant S. Typhi strains subsequently led to the widespread use of fluoroquinolones, such as ciprofloxacin and ofloxacin, in countries where MDR is a problem. However, outbreaks of nalidixic acid-resistant typhoid with isolates showing reduced susceptibility to fluoroquinolones started to occur in Vietnam [10] and Tajikistan [23] in the early 1990s and then spread to Pakistan and India and several other countries in Southeast Asia [12,24,25,26], Kuwait [27], and Nepal [28]; often treatment of these infections with a fluoroquinolone resulted in a delay in clinical response and sometimes treatment failure. Fluoroquinolone resistance is now common in countries such as India [29] and Bangladesh [30].…”

Section: Discussionmentioning

confidence: 99%

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Kariuki

2008

J Infect Dev Ctries

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Typhoid fever, caused by Salmonella enterica serovar Typhi (S. Typhi), is a disease transmitted by the faecal-oral route. It continues to be a public health problem in many developing countries in sub-Saharan Africa. School-age children, especially those from resource-poor settings with inadequate water and sanitation systems, are disproportionately affected. It is estimated that a total of 400,000 cases occur annually in Africa, an incidence of 50 per 100,000 persons per year. Lack of effective diagnosis often leads to inappropriate treatment and management of these infections. Additionally, the emergence and spread of S. Typhi strains having multiple resistance to nearly all commonly available drugs in most developing countries has been a major challenge to health care systems, reducing the effective treatment options for the disease, increasing treatment costs and increasing the risk of complications and death. Although not much data from sub-Saharan Africa has been published, it seems clear that typhoid is common in Nigeria, Mali, Ethiopia and Kenya. Given the importance of information on disease incidence for targeting control measures, including improved sanitation and water supply, vaccination and assessing impact, priority should be given to strengthening surveillance systems for typhoid fever.

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Section: Discussionmentioning

confidence: 99%

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Kariuki

2008

J Infect Dev Ctries

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“…Other mechanisms, such as multi-antibiotic resistance associated efflux pumps (MAR locus), bacterial permeability, qnr plasmid and up/down regulation of operon genes, have been demonstrated recently [3][4][5]. There have been isolated reports of ciprofloxacin resistance in S. Typhi, from India [6][7][8] and elsewhere [9]. Nonetheless, high-level fluoroquinolone resistance in non-enteric fever salmonellae is frequent, with MICs ranging from 16-64 μg/mL [10][11][12].…”

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confidence: 99%

“…Nonetheless, high-level fluoroquinolone resistance in non-enteric fever salmonellae is frequent, with MICs ranging from 16-64 μg/mL [10][11][12]. Molecular analysis studies of fluoroquinolone resistance or decreased susceptibility in clinical isolates of S. Typhi are relatively scarce from India [6,13]. We examined the incidence of NARST, decreased susceptibility to ciprofloxacin and made molecular analyses of these strains.…”

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confidence: 99%

Salmonella enterica serovar typhi: molecular analysis of strains with decreased susceptibility and resistant to ciprofloxacin in india from 2001-2003

Capoor¹,

Nair²,

Aggarwal³

et al. 2007

Braz J Infect Dis

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Chromosomally-mediated reduced susceptibility to ciprofloxacin narrows the therapeutic options in enteric fever. We made a molecular comparison of clinical isolates of fluoroquinolone-resistant strains of Salmonella enterica serotype Typhi from January 2001 to May 2003; 178 isolates were subjected to antimicrobial susceptibility testing by the Kirby-Bauer method of disk diffusion, and agar dilution was used to determine the minimum inhibitory concentration (MIC) to ciprofloxacin. Nalidixic-acid resistant strains (NARST) were observed in 51% of the isolates, of which 98.9% had decreased susceptibility (MIC≥ ≥ ≥ ≥ ≥0.125-1μ μ μ μ μg/mL) to ciprofloxacin. A single strain (4 μ μ μ μ μg/mL) was resistant to ciprofloxacin and double mutations were found in the gyrA gene (76 Asp→ → → → →Asn, 44 leu→ → → → →Ileu). Among seven NARST strains with reduced susceptibility, a single mutation was found in five strains, one of which had 76 Asp→ → → → →Asn and two each had mutations at 87 Asp→ → → → →Asn and 72 Phe→ → → → →Tyr, respectively); no mutations could be detected in two isolates. Routine antimicrobial surveillance, coupled with molecular analysis of fluoroquinolone resistance, is crucial for revision of enteric fever therapeutics.

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“…Decreased susceptibility of S. Typhi isolates to fluoroquinolones is emerging as an important problem in South Asian countries such as India, Vietnam, and elsewhere (Parry, 2004;Rahman et al, 2006;Renuka et al, 2005). Nalidixic acid resistance is useful as a surrogate marker of decreased susceptibility to fluoroquinolones (Hakanen et al, 1999).…”

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confidence: 99%

Is nalidixic acid resistance linked to clinical virulence in Salmonella enterica serovar Typhi infections?

Kadhiravan

Wig

Renuka

et al. 2008

Journal of Medical Microbiology

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High-level ciprofloxacin resistance in Salmonella enterica serotype Typhi in India

Cited by 62 publications

References 11 publications

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Typhoid fever in sub-Saharan Africa: Challenges of diagnosis and management of infections

Salmonella enterica serovar typhi: molecular analysis of strains with decreased susceptibility and resistant to ciprofloxacin in india from 2001-2003

Is nalidixic acid resistance linked to clinical virulence in Salmonella enterica serovar Typhi infections?

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