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Enteric fever in Karachi: current antibiotic susceptibility of Salmonellae isolates.
J Coll Physicians Surg Pak. 2012 Mar; 22(3):147-50.JC

Abstract

OBJECTIVE

To determine the current sensitivity and resistance profile of Salmonellae (S.) isolates in a laboratory setting.

STUDY DESIGN

An observational study.

PLACE AND DURATION OF STUDY

Dr. Essa`s Laboratory and Diagnostic Centre, Karachi, Pakistan, from November 2008 - October 2010.

METHODOLOGY

Isolates from blood culture specimens of 481 bacteraemic patients were identified using conventional biochemical tests. Salmonellae was confirmed with specific antisera and their antibiograms determined by Kirby-Bauer Disc Diffusion method using 12 relevant antibiotics. Inclusions of the study were bacteraemia documented in all blood samples positive for S. typhi, S. paratyphi-A and B. Exclusions were all samples other than blood and blood samples negative for S. typhi and S. paratyphi-A and B during the same period. Multidrug resistance (MDR) of isolates was defined as the isolates showing resistance to all conventional anti-typhoid medicines i.e., Chloramphenicol, Ampicillin and Co-trimoxazole.

RESULTS

Specimens (n=217) yielded 131 Salmonellae typhi (60.36%), 71 S. paratyphi-A (32.71%), and 15 S. paratyphi-B (6.9%); these were sensitive to the Quinolones [Enoxacin: 94.96% (n=91), Ciprofloxacin, 96.47% (n=182), Ofloxacin: 95.74% (n=203)], and Cephalosporins [Cefixime: 96.62% (n=202), Cefotaxime: 99.17% (n=206), Ceftriaxone: 98.79% (n=208)]. Resistance to Amoxicillin was 96.48% (n=128) and 29.91% (n=78) to Co-trimoxazole. About 62.64% (n=136) of the isolates were MDR strains.

CONCLUSION

Ciprofloxacin is currently a suitable empirical choice in presumed enteric fever cases, but culture and sensitivity analysis should be encouraged and results incorporated in prescription strategy. Increasing frequency of S. paratyphi-A isolates possibly suggests incomplete coverage employing monovalent vaccine.

Authors+Show Affiliations

Department of Pathology, Dow Medical College, DUHS, North Nazimabad, Karachi. farhanessa@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Comparative Study
Journal Article

Language

eng

PubMed ID

22414353

Citation

Abdullah, Farhan Essa, et al. "Enteric Fever in Karachi: Current Antibiotic Susceptibility of Salmonellae Isolates." Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, vol. 22, no. 3, 2012, pp. 147-50.
Abdullah FE, Haider F, Fatima K, et al. Enteric fever in Karachi: current antibiotic susceptibility of Salmonellae isolates. J Coll Physicians Surg Pak. 2012;22(3):147-50.
Abdullah, F. E., Haider, F., Fatima, K., Irfan, S., & Iqbal, M. S. (2012). Enteric fever in Karachi: current antibiotic susceptibility of Salmonellae isolates. Journal of the College of Physicians and Surgeons--Pakistan : JCPSP, 22(3), 147-50. https://doi.org/02.2012/JCPSP.147150
Abdullah FE, et al. Enteric Fever in Karachi: Current Antibiotic Susceptibility of Salmonellae Isolates. J Coll Physicians Surg Pak. 2012;22(3):147-50. PubMed PMID: 22414353.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enteric fever in Karachi: current antibiotic susceptibility of Salmonellae isolates. AU - Abdullah,Farhan Essa, AU - Haider,Faryal, AU - Fatima,Kanwal, AU - Irfan,Saboohi, AU - Iqbal,Mir Saud, PY - 2011/01/03/received PY - 2012/01/28/accepted PY - 2012/3/15/entrez PY - 2012/3/15/pubmed PY - 2012/10/24/medline SP - 147 EP - 50 JF - Journal of the College of Physicians and Surgeons--Pakistan : JCPSP JO - J Coll Physicians Surg Pak VL - 22 IS - 3 N2 - OBJECTIVE: To determine the current sensitivity and resistance profile of Salmonellae (S.) isolates in a laboratory setting. STUDY DESIGN: An observational study. PLACE AND DURATION OF STUDY: Dr. Essa`s Laboratory and Diagnostic Centre, Karachi, Pakistan, from November 2008 - October 2010. METHODOLOGY: Isolates from blood culture specimens of 481 bacteraemic patients were identified using conventional biochemical tests. Salmonellae was confirmed with specific antisera and their antibiograms determined by Kirby-Bauer Disc Diffusion method using 12 relevant antibiotics. Inclusions of the study were bacteraemia documented in all blood samples positive for S. typhi, S. paratyphi-A and B. Exclusions were all samples other than blood and blood samples negative for S. typhi and S. paratyphi-A and B during the same period. Multidrug resistance (MDR) of isolates was defined as the isolates showing resistance to all conventional anti-typhoid medicines i.e., Chloramphenicol, Ampicillin and Co-trimoxazole. RESULTS: Specimens (n=217) yielded 131 Salmonellae typhi (60.36%), 71 S. paratyphi-A (32.71%), and 15 S. paratyphi-B (6.9%); these were sensitive to the Quinolones [Enoxacin: 94.96% (n=91), Ciprofloxacin, 96.47% (n=182), Ofloxacin: 95.74% (n=203)], and Cephalosporins [Cefixime: 96.62% (n=202), Cefotaxime: 99.17% (n=206), Ceftriaxone: 98.79% (n=208)]. Resistance to Amoxicillin was 96.48% (n=128) and 29.91% (n=78) to Co-trimoxazole. About 62.64% (n=136) of the isolates were MDR strains. CONCLUSION: Ciprofloxacin is currently a suitable empirical choice in presumed enteric fever cases, but culture and sensitivity analysis should be encouraged and results incorporated in prescription strategy. Increasing frequency of S. paratyphi-A isolates possibly suggests incomplete coverage employing monovalent vaccine. SN - 1681-7168 UR - https://www.unboundmedicine.com/medline/citation/22414353/Enteric_fever_in_Karachi:_current_antibiotic_susceptibility_of_Salmonellae_isolates_ L2 - https://medlineplus.gov/antibiotics.html DB - PRIME DP - Unbound Medicine ER -