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Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in southern India.
Indian J Med Res. 2013 Apr; 137(4):800-2.IJ

Abstract

BACKGROUND & OBJECTIVES

Salmonella enterica serovars Typhi and Paratyphi are predominantly known to cause enteric fever. Multidrug resistance in S. Tphi and S. Paratyphi has emerged as a cause of concern. This study was done to evaluate status in antimicrobial susceptibility patterns of Salmonella enterica serovar Typhi (S. Typhi) and S. Paratyphi obtained from blood culture in a tertiary care hospital in south India.

METHODS

Blood isolates of Salmonella species over a two year period between May 2009 and June 2011 were studied. A total of 322 isolates of Salmonella species were tested for antimicrobial susceptibility by Kirby-Bauer disc diffusion method. The MIC of ciprofloxacin was obtained by E-test, and azithromycin MIC was confirmed by agar dilution method for a limited number of isolates.

RESULTS

Of the total of 322 isolates studied, 186 (57.8%) were S. Typhi, 134 (41.6%) were S. Paratyphi A, and two were S. Paratyphi B. Of these, 44(13.66%) were resistant to ciprofloxacin (MIC <0.50 μg/ml) and 296 (91.9%) were nalidixic acid resistant. Of these 296 nalidixic acid resistant isolates, 278 (94%) were susceptible to ciprofloxacin by MIC criteria (<0.5 μg/ml). Of the 262 isolates tested for azithromycin sensitivity, only 120 (46%) were susceptible, whereas 81 (31%) were resistant and 55 (21%) showed intermediate susceptibility. Of the isolates, 322 (90%) were susceptible to ampicillin and (95%) were susceptible to co-trimoxazole. However, all the isolates were susceptible to chloramphenicol and ceftriaxone.

INTERPRETATION & CONCLUSIONS

Nalidixic acid resistance screening is not a reliable surrogate indicator of ciprofloxacin resistance. Ciprofloxacin MIC should to be routinely done. Azithromycin resistance appears to be emerging. However, isolates showed a high degree of susceptibility to ampicillin, co-trimoxazole and chloramphenicol. Thus, antibiotics like ampicillin and co-trimoxazole may once again be useful for the management of enteric fever in southern India.

Authors+Show Affiliations

Department of Infectious Diseases, Apollo Hospitals, Chennai, India. drashwini.tayade@gmail.comNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

23703350

Citation

Choudhary, Ashwini, et al. "Antimicrobial Susceptibility of Salmonella Enterica Serovars in a Tertiary Care Hospital in Southern India." The Indian Journal of Medical Research, vol. 137, no. 4, 2013, pp. 800-2.
Choudhary A, Gopalakrishnan R, Nambi PS, et al. Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in southern India. Indian J Med Res. 2013;137(4):800-2.
Choudhary, A., Gopalakrishnan, R., Nambi, P. S., Ramasubramanian, V., Ghafur, K. A., & Thirunarayan, M. A. (2013). Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in southern India. The Indian Journal of Medical Research, 137(4), 800-2.
Choudhary A, et al. Antimicrobial Susceptibility of Salmonella Enterica Serovars in a Tertiary Care Hospital in Southern India. Indian J Med Res. 2013;137(4):800-2. PubMed PMID: 23703350.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in southern India. AU - Choudhary,Ashwini, AU - Gopalakrishnan,Ram, AU - Nambi,P Senthur, AU - Ramasubramanian,V, AU - Ghafur,K Abdul, AU - Thirunarayan,M A, PY - 2013/5/25/entrez PY - 2013/5/25/pubmed PY - 2014/1/1/medline SP - 800 EP - 2 JF - The Indian journal of medical research JO - Indian J Med Res VL - 137 IS - 4 N2 - BACKGROUND & OBJECTIVES: Salmonella enterica serovars Typhi and Paratyphi are predominantly known to cause enteric fever. Multidrug resistance in S. Tphi and S. Paratyphi has emerged as a cause of concern. This study was done to evaluate status in antimicrobial susceptibility patterns of Salmonella enterica serovar Typhi (S. Typhi) and S. Paratyphi obtained from blood culture in a tertiary care hospital in south India. METHODS: Blood isolates of Salmonella species over a two year period between May 2009 and June 2011 were studied. A total of 322 isolates of Salmonella species were tested for antimicrobial susceptibility by Kirby-Bauer disc diffusion method. The MIC of ciprofloxacin was obtained by E-test, and azithromycin MIC was confirmed by agar dilution method for a limited number of isolates. RESULTS: Of the total of 322 isolates studied, 186 (57.8%) were S. Typhi, 134 (41.6%) were S. Paratyphi A, and two were S. Paratyphi B. Of these, 44(13.66%) were resistant to ciprofloxacin (MIC <0.50 μg/ml) and 296 (91.9%) were nalidixic acid resistant. Of these 296 nalidixic acid resistant isolates, 278 (94%) were susceptible to ciprofloxacin by MIC criteria (<0.5 μg/ml). Of the 262 isolates tested for azithromycin sensitivity, only 120 (46%) were susceptible, whereas 81 (31%) were resistant and 55 (21%) showed intermediate susceptibility. Of the isolates, 322 (90%) were susceptible to ampicillin and (95%) were susceptible to co-trimoxazole. However, all the isolates were susceptible to chloramphenicol and ceftriaxone. INTERPRETATION & CONCLUSIONS: Nalidixic acid resistance screening is not a reliable surrogate indicator of ciprofloxacin resistance. Ciprofloxacin MIC should to be routinely done. Azithromycin resistance appears to be emerging. However, isolates showed a high degree of susceptibility to ampicillin, co-trimoxazole and chloramphenicol. Thus, antibiotics like ampicillin and co-trimoxazole may once again be useful for the management of enteric fever in southern India. SN - 0971-5916 UR - https://www.unboundmedicine.com/medline/citation/23703350/Antimicrobial_susceptibility_of_Salmonella_enterica_serovars_in_a_tertiary_care_hospital_in_southern_India_ L2 - http://www.ijmr.org.in/article.asp?issn=0971-5916;year=2013;volume=137;issue=4;spage=800;epage=802;aulast=Choudhary DB - PRIME DP - Unbound Medicine ER -