L Singhal1, P K Gupta, P Kale, V Gautam, P Ray. 1. Department of Medical Microbiology, Post Graduate Institute of Medical Education and Research, Chandigarh, India.
Abstract
PURPOSE: Enteric fever is endemic in India with Salmonella Typhi being the major causative agent. Antibiotic therapy constitutes the mainstay of management. The present study was undertaken to find the susceptibility profile of Salmonella enterica var Typhi (S. Typhi) blood isolates in a tertiary care hospital between January 2001 and December 2012. MATERIALS AND METHODS: A retrospective analysis of laboratory records was carried out. Conventional blood culture method was used until 2009; from January 2010 onwards BACTEC 9240 system has been in use. Salmonella were confirmed by serotyping using group and type specific antisera. Antibiotic susceptibility was performed using the disk diffusion method. In addition 116 isolates were subjected to minimum inhibitory concentration testing for chloramphenicol, ciprofloxacin, amoxicillin and nalidixic acid (NA) using agar dilution and for ceftriaxone and azithromycin using E-strips (Biomerieux). RESULT: A total of 1016 typhoidal salmonellae were obtained. The predominant serotype obtained was S. Typhi (852, 83.8%) followed by Salmonella enterica var Paratyphi A (164, 16.2%). We observed a re-emergence of susceptibility to first line antibiotics and a notable decline in multidrug resistant (MDR) strains. We also found all recent isolates resistant to NA and susceptible to third generation cephalosporins and 84.5% of isolates having decreasing ciprofloxacin susceptibility using revised criteria as per Clinical and Laboratory Standards Institute 2012 guidelines. CONCLUSION: There has been re-emergence of susceptibility to first line antibiotics and a notable decline in MDR strains of S. Typhi. We have a very high resistance to NA and decreasing susceptibility to ciprofloxacin. Third generation cephalosporins and azithromycin seem to be effective therapeutic options. Judicious use of these antibiotics is mandatory to prevent emergence of resistant strains.
PURPOSE: Enteric fever is endemic in India with Salmonella Typhi being the major causative agent. Antibiotic therapy constitutes the mainstay of management. The present study was undertaken to find the susceptibility profile of Salmonella enterica varTyphi (S. Typhi) blood isolates in a tertiary care hospital between January 2001 and December 2012. MATERIALS AND METHODS: A retrospective analysis of laboratory records was carried out. Conventional blood culture method was used until 2009; from January 2010 onwards BACTEC 9240 system has been in use. Salmonella were confirmed by serotyping using group and type specific antisera. Antibiotic susceptibility was performed using the disk diffusion method. In addition 116 isolates were subjected to minimum inhibitory concentration testing for chloramphenicol, ciprofloxacin, amoxicillin and nalidixic acid (NA) using agar dilution and for ceftriaxone and azithromycin using E-strips (Biomerieux). RESULT: A total of 1016 typhoidal salmonellae were obtained. The predominant serotype obtained was S. Typhi (852, 83.8%) followed by Salmonella enterica var Paratyphi A (164, 16.2%). We observed a re-emergence of susceptibility to first line antibiotics and a notable decline in multidrug resistant (MDR) strains. We also found all recent isolates resistant to NA and susceptible to third generation cephalosporins and 84.5% of isolates having decreasing ciprofloxacin susceptibility using revised criteria as per Clinical and Laboratory Standards Institute 2012 guidelines. CONCLUSION: There has been re-emergence of susceptibility to first line antibiotics and a notable decline in MDR strains of S. Typhi. We have a very high resistance to NA and decreasing susceptibility to ciprofloxacin. Third generation cephalosporins and azithromycin seem to be effective therapeutic options. Judicious use of these antibiotics is mandatory to prevent emergence of resistant strains.
Authors: Swathi Purighalla; Saritha Esakimuthu; Mallika Reddy; Tara Seth; Sunita D Patil; George K Varghese; Raghunath Dasarathy; Vijay S Richard; Vasan K Sambandamurthy Journal: Indian J Med Res Date: 2017-07 Impact factor: 2.375
Authors: Ayman A Elshayeb; Abdelazim A Ahmed; Marmar A El Siddig; Adil A El Hussien Journal: Ann Clin Microbiol Antimicrob Date: 2017-11-14 Impact factor: 3.944
Authors: Massimo Sartelli; Dieter G Weber; Etienne Ruppé; Matteo Bassetti; Brian J Wright; Luca Ansaloni; Fausto Catena; Federico Coccolini; Fikri M Abu-Zidan; Raul Coimbra; Ernest E Moore; Frederick A Moore; Ronald V Maier; Jan J De Waele; Andrew W Kirkpatrick; Ewen A Griffiths; Christian Eckmann; Adrian J Brink; John E Mazuski; Addison K May; Rob G Sawyer; Dominik Mertz; Philippe Montravers; Anand Kumar; Jason A Roberts; Jean-Louis Vincent; Richard R Watkins; Warren Lowman; Brad Spellberg; Iain J Abbott; Abdulrashid Kayode Adesunkanmi; Sara Al-Dahir; Majdi N Al-Hasan; Ferdinando Agresta; Asma A Althani; Shamshul Ansari; Rashid Ansumana; Goran Augustin; Miklosh Bala; Zsolt J Balogh; Oussama Baraket; Aneel Bhangu; Marcelo A Beltrán; Michael Bernhard; Walter L Biffl; Marja A Boermeester; Stephen M Brecher; Jill R Cherry-Bukowiec; Otmar R Buyne; Miguel A Cainzos; Kelly A Cairns; Adrian Camacho-Ortiz; Sujith J Chandy; Asri Che Jusoh; Alain Chichom-Mefire; Caroline Colijn; Francesco Corcione; Yunfeng Cui; Daniel Curcio; Samir Delibegovic; Zaza Demetrashvili; Belinda De Simone; Sameer Dhingra; José J Diaz; Isidoro Di Carlo; Angel Dillip; Salomone Di Saverio; Michael P Doyle; Gereltuya Dorj; Agron Dogjani; Hervé Dupont; Soumitra R Eachempati; Mushira Abdulaziz Enani; Valery N Egiev; Mutasim M Elmangory; Paula Ferrada; Joseph R Fitchett; Gustavo P Fraga; Nathalie Guessennd; Helen Giamarellou; Wagih Ghnnam; George Gkiokas; Staphanie R Goldberg; Carlos Augusto Gomes; Harumi Gomi; Manuel Guzmán-Blanco; Mainul Haque; Sonja Hansen; Andreas Hecker; Wolfgang R Heizmann; Torsten Herzog; Adrien Montcho Hodonou; Suk-Kyung Hong; Reinhold Kafka-Ritsch; Lewis J Kaplan; Garima Kapoor; Aleksandar Karamarkovic; Martin G Kees; Jakub Kenig; Ronald Kiguba; Peter K Kim; Yoram Kluger; Vladimir Khokha; Kaoru Koike; Kenneth Y Y Kok; Victory Kong; Matthew C Knox; Kenji Inaba; Arda Isik; Katia Iskandar; Rao R Ivatury; Maurizio Labbate; Francesco M Labricciosa; Pierre-François Laterre; Rifat Latifi; Jae Gil Lee; Young Ran Lee; Marc Leone; Ari Leppaniemi; Yousheng Li; Stephen Y Liang; Tonny Loho; Marc Maegele; Sydney Malama; Hany E Marei; Ignacio Martin-Loeches; Sanjay Marwah; Amos Massele; Michael McFarlane; Renato Bessa Melo; Ionut Negoi; David P Nicolau; Carl Erik Nord; Richard Ofori-Asenso; AbdelKarim H Omari; Carlos A Ordonez; Mouaqit Ouadii; Gerson Alves Pereira Júnior; Diego Piazza; Guntars Pupelis; Timothy Miles Rawson; Miran Rems; Sandro Rizoli; Claudio Rocha; Boris Sakakushev; Miguel Sanchez-Garcia; Norio Sato; Helmut A Segovia Lohse; Gabriele Sganga; Boonying Siribumrungwong; Vishal G Shelat; Kjetil Soreide; Rodolfo Soto; Peep Talving; Jonathan V Tilsed; Jean-Francois Timsit; Gabriel Trueba; Ngo Tat Trung; Jan Ulrych; Harry van Goor; Andras Vereczkei; Ravinder S Vohra; Imtiaz Wani; Waldemar Uhl; Yonghong Xiao; Kuo-Ching Yuan; Sanoop K Zachariah; Jean-Ralph Zahar; Tanya L Zakrison; Antonio Corcione; Rita M Melotti; Claudio Viscoli; Perluigi Viale Journal: World J Emerg Surg Date: 2016-07-15 Impact factor: 5.469