Spurious sulfamethoxazole-trimethoprim resistance of Salmonella typhi.

Several studies have identified thymidine excess in susceptibility test media as the cause of spurious resistance of various bacteria to sulfamethoxazole-trimethoprim. We document the phenomenon in Salmonella typhi and Salmonella paratyphi-A and demonstrate its occurrence in 3 of 17 (18%) lots of Mueller-Hinton agars now in use in major medical laboratories in Lima, Peru. The findings are particularly significant because sulfamethoxazole-trimethoprim is an important alternative to chloramphenicol or ampicillin for the treatment of typhoid and paratyphoid fevers.