Multidrug resistance of Salmonella enterica serovars Typhi and Typhimurium isolated from clinical samples at two rural hospitals in Western Kenya

Abstract

Background: The threat to human health posed by antibiotic resistance is of growing concern. Many commensals and pathogenic organisms have developed resistance to well established and newer antibiotics. This is a cross-sectional study within two hospital settings to determine in vitro antibiotic susceptibilities of Salmonella species isolated in blood, cerebral spinal fluid, pus and stool collected from in-and out-patients. The inclusion criteria was non restrictive to in-and out-patient but preference to severe diarrhea cases with negligible changes to previous treatment regimen was observed. The study was carried out from February 2004 -June 2005. Fifty-three diarrhea patients within the hospital who were chosen by convenient sampling and consented to participate in the study were considered. Methodology: Either blood or pus was collected using vacutainer tubes and syringe, swabs respectively, and cerebral spinal fluid by lumbar puncture from patients who had fever (temp ≥ 38°C) and diarrhea. Stool samples were also colle cted and all specimens analyzed for the presence of Salmonella by routine microbiological procedures. The isolates were subjected to antibiotic susceptibility testing using disc diffusion technique. Results: In St. Elizabeth Mukumu Mission Hospital, Salmonella enterica serovar Typhi was most common (56.6%, n=33), followed by S. typhimurium (34%, n=18), while in Maseno Mission Hospital only S. typhimurium was isolated. Whereas S. typhi was more commonly isolated in male adults and female children (P = 0.9), S. typhimurium was more common in female and male children (P=0.1). All the isolates were sensitive to ciprofloxacin. However, S. typhi was resistant to streptomycin, ampicillin, chloramphenical and cotrimoxazole; S. typhimurium to tetracycline, sulfamethoxazole, cotrimoxazole, ampicillin, chloramphenical and streptomycin. Conclusions: S. typhi displayed a high resistance pattern to most antibiotic screened than S. typhimurium.

Identification of Antibiotic-Resistant Genes in Salmonella Typhi Isolated From Typhoid Patient in Samawa City

“…Our study is the same as shown by shymapada et al, [13] who found that chloramphenicol was the most active and usually used drug for typhoid fever is most broadly used anti-microbial agents. The action by "inhibiting bacterial enzymes DNA gyrase" which is responsible for coiling, division and super coiling of bacteria lDNA during reproduction from present study showed all strain of local S. typhi were resistance for gentamycin as shown by results of aacC2 gene and this results as like mentioned by onyango et al ., [14] who said that Reference to amino glycosides resistance amplification was detected for aacC2 gene, mechanism of antibiotic resistance in S.typhi is refereed by two aspects This first acquisition of foreign genes by plasmids and mutation on chromosome,resistance can be attained by horizontal acquisition of resistance-genes, mobilized by conjugative plasmids, insertion sequences and transposons, by "recombination of foreign-plasmids DNA into the chromosome or by mutations in different chromosomal loci". Consistent with the reported of Randall et al, [15] there was numerous instance in this study when an isolate was resistant to an anti-microbial drug, but the characteristics of the gene conferring resistance was not ascribed with the primers used in the study.…”

Acetalated dextran encapsulated AR-12 as a host-directed therapy to control Salmonella infection

“…Resistant strains have also been observed in Kenya with resistance against cotrimoxazole in 66.7% (22 individuals) of the S . Typhi clinical isolates (Onyango et al, 2008) and in the United States where sulfamethoxazole resistance was observed in 56% of food-borne S . Typhi isolates (Glynn et al, 2004).…”