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Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study.
Antimicrob Agents Chemother. 2008 Apr; 52(4):1278-84.AA

Abstract

Patients with typhoid fever due to Salmonella enterica serotype Typhi strains for which fluoroquinolones MICs are elevated yet that are classified as susceptible by the current interpretive criteria of the Clinical and Laboratory Standards Institute may not respond adequately to fluoroquinolone therapy. Patients from seven U.S. states with invasive Salmonella serotype Typhi infection between 1999 and 2002 were enrolled in a multicenter retrospective cohort study. Patients infected with Salmonella serotype Typhi isolates with ciprofloxacin MICs of 0.12 to 1 microg/ml (decreased ciprofloxacin susceptibility but not resistant to ciprofloxacin [DCS]) were compared with patients infected with isolates with ciprofloxacin MICs <0.12 microg/ml for fever clearance time and treatment failure. Of 71 patients, 30 (43%) were female and 24 (34%) were infected with Salmonella serotype Typhi with DCS; the median age was 14 years (range, 1 to 51 years). Twenty-one (88%) of 24 isolates with DCS were resistant to nalidixic acid. The median antimicrobial-related fever clearance times in the DCS and non-DCS groups were 92 h (range, 21 to 373 h) and 72 h (range, 19 to 264 h) (P = 0.010), respectively, and the fluoroquinolone-related fever clearance times in the DCS and non-DCS groups were 90 h (range, 9 to 373 h) and 64 h (range, 34 to 204 h) (P = 0.153), respectively. Four (17%) of 24 patients in the DCS group and 2 (4%) of 46 patients in the non-DCS group (relative risk, 2.5; 95% confidence interval, 1.2 to 5.1) experienced treatment failure. Associations persisted after adjustment for potential confounders. We demonstrate that patients infected with Salmonella serotype Typhi isolates with DCS show evidence of a longer time to fever clearance and more frequent treatment failure. Nalidixic acid screening does not detect all isolates with DCS.

Authors+Show Affiliations

Enteric Diseases Epidemiology Branch, National Center for Zoonotic, Vectorborne, and Enteric Diseases, MS A-38, Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, GA 30333, USA. jcrump@cdc.govNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Research Support, U.S. Gov't, P.H.S.

Language

eng

PubMed ID

18212096

Citation

Crump, John A., et al. "Clinical Response and Outcome of Infection With Salmonella Enterica Serotype Typhi With Decreased Susceptibility to Fluoroquinolones: a United States Foodnet Multicenter Retrospective Cohort Study." Antimicrobial Agents and Chemotherapy, vol. 52, no. 4, 2008, pp. 1278-84.
Crump JA, Kretsinger K, Gay K, et al. Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study. Antimicrob Agents Chemother. 2008;52(4):1278-84.
Crump, J. A., Kretsinger, K., Gay, K., Hoekstra, R. M., Vugia, D. J., Hurd, S., Segler, S. D., Megginson, M., Luedeman, L. J., Shiferaw, B., Hanna, S. S., Joyce, K. W., Mintz, E. D., & Angulo, F. J. (2008). Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study. Antimicrobial Agents and Chemotherapy, 52(4), 1278-84. https://doi.org/10.1128/AAC.01509-07
Crump JA, et al. Clinical Response and Outcome of Infection With Salmonella Enterica Serotype Typhi With Decreased Susceptibility to Fluoroquinolones: a United States Foodnet Multicenter Retrospective Cohort Study. Antimicrob Agents Chemother. 2008;52(4):1278-84. PubMed PMID: 18212096.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study. AU - Crump,John A, AU - Kretsinger,Katrina, AU - Gay,Kathryn, AU - Hoekstra,R Michael, AU - Vugia,Duc J, AU - Hurd,Sharon, AU - Segler,Susan D, AU - Megginson,Melanie, AU - Luedeman,L Jeffrey, AU - Shiferaw,Beletshachew, AU - Hanna,Samir S, AU - Joyce,Kevin W, AU - Mintz,Eric D, AU - Angulo,Frederick J, AU - ,, Y1 - 2008/01/22/ PY - 2008/1/24/pubmed PY - 2008/7/4/medline PY - 2008/1/24/entrez SP - 1278 EP - 84 JF - Antimicrobial agents and chemotherapy JO - Antimicrob Agents Chemother VL - 52 IS - 4 N2 - Patients with typhoid fever due to Salmonella enterica serotype Typhi strains for which fluoroquinolones MICs are elevated yet that are classified as susceptible by the current interpretive criteria of the Clinical and Laboratory Standards Institute may not respond adequately to fluoroquinolone therapy. Patients from seven U.S. states with invasive Salmonella serotype Typhi infection between 1999 and 2002 were enrolled in a multicenter retrospective cohort study. Patients infected with Salmonella serotype Typhi isolates with ciprofloxacin MICs of 0.12 to 1 microg/ml (decreased ciprofloxacin susceptibility but not resistant to ciprofloxacin [DCS]) were compared with patients infected with isolates with ciprofloxacin MICs <0.12 microg/ml for fever clearance time and treatment failure. Of 71 patients, 30 (43%) were female and 24 (34%) were infected with Salmonella serotype Typhi with DCS; the median age was 14 years (range, 1 to 51 years). Twenty-one (88%) of 24 isolates with DCS were resistant to nalidixic acid. The median antimicrobial-related fever clearance times in the DCS and non-DCS groups were 92 h (range, 21 to 373 h) and 72 h (range, 19 to 264 h) (P = 0.010), respectively, and the fluoroquinolone-related fever clearance times in the DCS and non-DCS groups were 90 h (range, 9 to 373 h) and 64 h (range, 34 to 204 h) (P = 0.153), respectively. Four (17%) of 24 patients in the DCS group and 2 (4%) of 46 patients in the non-DCS group (relative risk, 2.5; 95% confidence interval, 1.2 to 5.1) experienced treatment failure. Associations persisted after adjustment for potential confounders. We demonstrate that patients infected with Salmonella serotype Typhi isolates with DCS show evidence of a longer time to fever clearance and more frequent treatment failure. Nalidixic acid screening does not detect all isolates with DCS. SN - 0066-4804 UR - https://www.unboundmedicine.com/medline/citation/18212096/Clinical_response_and_outcome_of_infection_with_Salmonella_enterica_serotype_Typhi_with_decreased_susceptibility_to_fluoroquinolones:_a_United_States_foodnet_multicenter_retrospective_cohort_study_ L2 - http://aac.asm.org/cgi/pmidlookup?view=long&amp;pmid=18212096 DB - PRIME DP - Unbound Medicine ER -