Trends in antibiotic susceptibility of enteric fever isolates from South India, 2002–2013

Joshi, Sangeeta; Adhikary, Ranjeeta; Beena, Hosdurg Bhaskar; Bhavana, Malavalli Venkatesh; Bhalwar, Rajvir

doi:10.1016/j.mjafi.2018.08.002

Cited by 3 publications

(3 citation statements)

References 25 publications

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“…The first azithromycin resistance isolate was detected in 2014; resistance to azithromycin is caused by spontaneous point mutations in the acrb gene [26,39]. This is concordant with reports from other countries in the regions [40][41][42][43][44].…”

Section: Discussionsupporting

confidence: 77%

23-year trends indicate low rates of antimicrobial resistance inSalmonellaParatyphi A

Sajib

Tanmoy

Hooda

et al. 2023

Preprint

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Background: Typhoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid. Hence, with rising drug resistance in Salmonella Typhi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. Here, we report 23-year AMR trends of Salmonella Paratyphi A in Bangladesh. Methods: From 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines. Results: Over 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but current average MIC is 32-fold lower than the resistance cut-off. Over 99%, of the isolates exhibited decreased susceptibility to ciprofloxacin. Conclusions: Salmonella Paratyphi A has remained susceptible to most antibiotics, unlike Salmonella Typhi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever.

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Section: Discussionsupporting

confidence: 77%

23-year trends indicate low rates of antimicrobial resistance inSalmonellaParatyphi A

Sajib

Tanmoy

Hooda

et al. 2023

Preprint

View full text Add to dashboard Cite

show abstract

“…The first azithromycin resistant isolate was detected in 2014; resistance to azithromycin is caused by spontaneous point mutations in the acrB gene [27,41]. This is concordant with reports from other countries in the region [42][43][44][45][46].…”

Section: Plos Neglected Tropical Diseasessupporting

confidence: 79%

Trends in antimicrobial resistance amongst Salmonella Paratyphi A isolates in Bangladesh: 1999–2021

Sajib,

Tanmoy,

Hooda

et al. 2023

PLoS Negl Trop Dis

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Background Typhoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid. Hence, with rising drug resistance in Salmonella Typhi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. However, unlike for typhoid, there is no vaccine to prevent paratyphoid. Here, we report 23-year AMR trends of Salmonella Paratyphi A in Bangladesh. Methods From 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines. Results Over 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but the current average MIC is 32-fold lower than the resistance cut-off. Over 99% of the isolates exhibited decreased susceptibility to ciprofloxacin. Conclusions Salmonella Paratyphi A has remained susceptible to most antibiotics, unlike Salmonella Typhi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever, especially in the post typhoid vaccine era, and with the availability of new paratyphoid diagnostics.

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“…In the same context, Joshi et al. 5 studied the trends in antibiotic resistance in Salmonella typhi and Salmonella paratyphi -A isolates over the past 12 years from South India. They show that multidrug resistance (to chloramphenicol, ampicillin and cotrimoxazole) was relatively stable throughout the study period, whereas nalidixic acid resistance increased in both typhi and paratyphi ; complete susceptibility to ceftriaxone and azithromycin was observed in this study.…”

mentioning

confidence: 99%

Man and Microbe: Fraternizing with the frenemy

Subapriya

2019

Medical Journal Armed Forces India

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Trends in antibiotic susceptibility of enteric fever isolates from South India, 2002–2013

Cited by 3 publications

References 25 publications

23-year trends indicate low rates of antimicrobial resistance inSalmonellaParatyphi A

23-year trends indicate low rates of antimicrobial resistance inSalmonellaParatyphi A

Trends in antimicrobial resistance amongst Salmonella Paratyphi A isolates in Bangladesh: 1999–2021

Man and Microbe: Fraternizing with the frenemy

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