Re-emergence of susceptibility to conventionally used drugs among strains of Salmonella Typhi in central west India

Abstract

Introduction: Typhoid fever (enteric fever) is a global health problem causing high morbidity and mortality, especially in endemic areas such as India. The problem is exacerbated as the causative agent, Salmonella enterica subspecies enterica serovar Typhi (S. Typhi), rapidly develops resistance to drugs used in treatment. However, non-responsiveness of S. Typhi to quinolones has been reported simultaneously with the re-emergence of susceptibility to chloramphenicol. The present study investigates the re-emergence of sensitivity to conventionally used drugs among strains of S. Typhi in the central west part of India. Methodology: We evaluated 128 S. Typhi isolates received at the National Salmonella and Escherichia Centre for chloramphenicol, ampicillin and trimethoprim susceptibility using standard methods. Minimum inhibitory concentrations were also evaluated. Results: The proportion of S. Typhi isolates showing susceptibility to chloramphenicol, ampicillin, and trimethoprim was 95.3%, 94.5%, and 94.5%, respectively. These findings may help the health authorities in reconsidering the addition of these antimicrobial drugs into the treatment regime of typhoid fever and therefore may help combat the problem of increasing resistance to quinolones and cephalosporins. Conclusion: The changing trends of S. Typhi resistance patterns necessitate reconsideration of conventionally used drugs in typhoid fever treatment in India. In the present study, S. Typhi strains exhibited increased susceptibility toward chloramphenicol, ampicillin and trimethoprim, therefore suggesting the possibility of their use for treatment of typhoid fever.

Re-emergence of susceptibility to conventional first line drugs in Salmonella isolates from enteric fever patients in Nepal

“…Similarly, a study conducted in eastern Nepal between 2000 and 2004 showed a decreasing trend of MDR Salmonella Typhi [25]. Consistent with our findings, high susceptibility to chloramphenicol, cotrimoxazole, and ampicillin were also reported from different parts of India such as Bangalore, Chennai, Chandigarh, central west, and northern India [3,4,[26][27][28][29]. Re-emergence of chloramphenicol sensitivity was reported in northern India, with 96% sensitivity in Salmonella enterica serovar Typhi and 100% sensitivity in Salmonella enterica serovar Paratyphi A [19].…”

Pattern of Anti-Microbial Sensitivity and Resistance against Salmonella Species in a Tertiary Hospital in Dhaka

“…High susceptibility to chloramphenicol, cotrimoxazole, and ampicillin were also reported from several parts of India such as Bangaluru, Chennai, Chandigarh, central west, and northern India. 13 A study done by Chand et al 14 revealed reemergence of susceptibility to ampicillin, chloramphenicol and cotrimoxazole in great proportion.…”

Typhoidal Salmonaelle in Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh

“…19 High susceptibility to chloramphenicol, cotrimoxazole and ampicillin were also reported from several parts of India such as Bangaluru, Chennai, Chandigarh, Central west and northern India. 20 In Bangladesh, study done by Begum et al 13 revealed increased sensitivity to chloramphenicol, ampicillin and cotrimoxazole over the 2 year study periods. Probably, clinicians are not using amoxicillin, cotrimoxazole and chloramphenicol very frequently in this region and drug resistance strains have been eliminated.…”