Multiple-Drug-Resistant Salmonella typhi

Mourad, A S; Metwally, Mohammed; Deen, A. Nour El; Threlfall, E. J.; Rowe, B.; Mapes, T.; Hedstrom, Richard C.; Bourgeois, A. Louis; Murphy, James R.

doi:10.1093/clinids/17.1.135

Cited by 38 publications

(30 citation statements)

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“…Outbreaks of strains of S. enterica serotype Typhi resistant to all first-line drugs have been reported from the Indian subcontinent, Mexico, South Africa, and the Arabian Gulf [7,8,10,[20][21][22]. Similarly, nontyphoidal Salmonella strains resistant to the conventional first-line drugs have also been reported [14].…”

Section: Discussionmentioning

confidence: 99%

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Salmonella isolates’ serotypes and susceptibility to commonly used drugs at a tertiary care hospital in Riyadh, Saudi Arabia

Somily

Sayyed

Habib

et al. 2011

J Infect Dev Ctries

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Introduction: Resistance of Salmonella to therapeutic agents currently being used for treatment of Salmonella infections is emerging as a global problem. This study aimed to assess the prevalence of Salmonella serotypes and their susceptibility patterns to commonly used drugs for treatment of Salmonella infections including quinolones. Correlation between nalidixic acid susceptibility of these isolates and their ciprofloxacin minimum inhibitory concentrations was also sought. Methodology; Salmonella isolates (n=213) were collected between January 2007 and May 2009 at King Khalid University Hospital in Riyadh, Saudi Arabia. The isolates were serotyped and their susceptibilities to commonly used first-line anti-Salmonella drugs (ampicillin, ceftriaxone, trimethoprim/sulfamethoxazole, nalidixic acid and ciprofloxacin) were determined using the automated Microscan system, the Kirby-Bauer disk diffusion method, and E-test. Results: The most frequently detected serotype was D 1 (37%) followed by the serotypes, B (24%) and C 1 (11%). Non-typable Salmonella isolates detected using available conventional Salmonella anti-sera were (11%). Overall resistance rates to nalidixic acid, ampicillin, trimethoprim/sulfamethoxazole and ceftriaxone were 99/213 (46%), 43/213 (20%), 34/213 (16%) and 7/213 (3%), respectively. Of the total isolates, 117 (55%) had a ciprofloxacin MIC of <0.125 µg/ml and among these 105 (90%) were susceptible to nalidixic acid. The remaining 96 (45%) isolates had a ciprofloxacin MIC of ≥0.125 µg/ml and among them, 83 (86.5%) were resistant to nalidixic acid. Conclusions: The majority of Salmonella isolates in this study were non-typhi serotypes. Significantly higher proportions of Salmonellae were resistant to nalidixic acid and ciprofloxacin and a vast majority of nalidixic acid resistant organisms exhibited decreased susceptibility to ciprofloxacin.

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Section: Discussionmentioning

confidence: 99%

“…Resistant typhi strains were mainly found in South America, the Indian subcontinent, and Africa [7][8]. As an alternative ciprofloxacin became the antibiotic of choice for Salmonella infections, i.e., enteric fever [9].…”

Section: Introductionmentioning

confidence: 99%

Salmonella isolates’ serotypes and susceptibility to commonly used drugs at a tertiary care hospital in Riyadh, Saudi Arabia

Somily

Sayyed

Habib

et al. 2011

J Infect Dev Ctries

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“…Another study found similarities in PFGE patterns and plasmid profiles of MDRST isolates from Tajikistan and the Indian subcontinent, suggesting that the ciprofloxacin-resistant strains isolated in Tajikistan originated from the Indian subcontinent (7). Several studies have associated large conjugative plasmids with the presence of the MDR phenotype (2,5,9,13,14,26). Our data and those of others thus support the suggestion that multiple-drug resistance in S. enterica serotype Typhi is largely due to the clonal expansion of a limited number of strains that have acquired (presumably) plasmid-mediated drug resistance genes.…”

Section: Discussionmentioning

confidence: 99%

Analysis of Salmonella enterica Serotype Typhi Pulsed-Field Gel Electrophoresis Patterns Associated with International Travel

et al. 2005

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Typhoid fever is a significant cause of morbidity and mortality worldwide, causing an estimated 16 million cases and 600,000 deaths annually. Although overall rates of the disease have dramatically decreased in the United States, the number of travel-related infections has increased in recent decades. Drug resistance among Salmonella enterica serotype Typhi strains has emerged worldwide, making antimicrobial susceptibility testing an important function in public health laboratories. Pulsed-field gel electrophoresis (PFGE) subtyping of food-borne and waterborne pathogens has proven to be a valuable tool for the detection of outbreaks and laboratory-based surveillance. This retrospective study examined the distribution of PFGE patterns of S. enterica serotype Typhi isolates from patients with a history of international travel. Isolates were collected as part of a passive laboratory-based antimicrobial susceptibility surveillance study. Isolates were PFGE subtyped by using the restriction enzyme XbaI to restrict the total genomic DNA. Isolates indistinguishable with XbaI were further characterized using the restriction enzyme BlnI. A total of 139 isolates were typed, representing travel to 31 countries. Restriction fragment patterns consisted of 14 to 18 fragments ranging in size from 580 to 40 kbp. Seventy-nine unique PFGE patterns were generated using XbaI. Isolates from the same geographic region did not necessarily have similar PFGE patterns. Of the 139 isolates, 46 (33%) were resistant to more than one antimicrobial agent (multidrug resistant [MDR]). Twenty-seven (59%) of 46 MDR isolates had indistinguishable PFGE patterns with both XbaI and BlnI. It appears that MDR S. enterica serotype Typhi has emerged as a predominant clone in Southeast Asia and the Indian subcontinent.

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“…However, in a phageVi surveillance-based study conducted in the same year at Alexandria Fever Hospital (Alexandria, Egypt), 43% of the isolated S. Typhi strains were MDR. Moreover, the identified phage types were E2 or D1-N [62] which are different from the phage type E1 that dominates in the Indian subcontinent [63,64]. It is not known whether S. Typhi E2 and D1-N are also the dominant types in the other North African countries.…”

Section: Antimicrobial Resistance and Treatmentmentioning

confidence: 99%

Enteric Fever in Mediterranean North Africa

Ghenghesh

Franka

Tawil

et al. 2009

J Infect Dev Ctries

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Typhoid fever is endemic in the Mediterranean North African countries (Morocco, Algeria, Tunisia, Libya, and Egypt) with an estimated incidence of 10-100 cases per 100,000 persons. Outbreaks caused by Salmonella enterica serovar Typhi are common and mainly due to the consumption of untreated or sewage-contaminated water. Salmonella enterica Paratyphi B is more commonly involved in nosocomial cases of enteric fever in North Africa than expected and leads to high mortality rates among infants with congenital anomalies. Prevalence among travellers returning from this region is low, with an estimate of less than one per 100,000. Although multidrug resistant strains of Salmonella Typhi and Paratyphi are prevalent in this region, the re-emergence of chloramphenicol-and ampicillin-susceptible strains has been observed. In order to better understand the epidemiology of enteric fever in the Mediterranean North African region, population-based studies are needed. These will assist the health authorities in the region in preventing and controlling this important disease.

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Multiple-Drug-Resistant Salmonella typhi

Cited by 38 publications

References 0 publications

Salmonella isolates’ serotypes and susceptibility to commonly used drugs at a tertiary care hospital in Riyadh, Saudi Arabia

Salmonella isolates’ serotypes and susceptibility to commonly used drugs at a tertiary care hospital in Riyadh, Saudi Arabia

Analysis of Salmonella enterica Serotype Typhi Pulsed-Field Gel Electrophoresis Patterns Associated with International Travel

Enteric Fever in Mediterranean North Africa

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