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Increased quinolone resistance among typhoid Salmonella isolated from Egyptian patients.
J Infect Dev Ctries. 2014 May 14; 8(5):661-5.JI

Abstract

INTRODUCTION

Typhoid fever is endemic in Egypt; and quinolones are the empirical treatment of choice. There are very limited data reporting quinolone resistance among Egyptian typhoidal Salmonella isolates. We previously reported that all typhoidal Salmonella were sensitive to quinolones. This study aimed to isolate and identify typhoidal Salmonella from cases suffering from enteric fever at Minia Governorate, Egypt, determine their quinolone resistance patterns, compare them to those reported 20 years ago, and test gyrA mutation as a possible mechanism for quinolone resistance.

METHODOLOGY

Stool samples from Widal-positive subjects were screened by culture on suitable media and were identified biochemically. The identified isolates were tested for resistance against three representatives of the first three quinolone generations, namely nalidixic acid (NAL), levofloxacin (LEV), and norfloxacin (NOR). The gyrA gene was amplified and sequenced to detect point mutation(s) conferring quinolone resistance.

RESULTS

Out of 230 stool samples (from patients with Widal anti-O titers of ≥ 1/160), 40 isolates were S. enterica serovar Typhi (97.5%) and Paratyphi A (2.5%). Six (15%) isolates were resistant to at least one of the quinolones, compared to 0% in 1993. In this regard, 15%, 7.5%, and 2.5% of the isolates were resistant to NAL, both NAL and LEV, and all three quinolones tested, respectively. Sequencing of the gyrA gene revealed point mutations at position 83 and/or 87 of the gyrA gene only among the resistant isolates.

CONCLUSION

There has been an increase in quinolone-resistant typhoidal Salmonella in Egypt over time.

Authors+Show Affiliations

Faculty of Medicine, Minia University, Egypt. zahraa200784@yahoo.com.No affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

24820472

Citation

Saleh, Fatma O I., et al. "Increased Quinolone Resistance Among Typhoid Salmonella Isolated From Egyptian Patients." Journal of Infection in Developing Countries, vol. 8, no. 5, 2014, pp. 661-5.
Saleh FO, Ahmed HA, Khairy RM, et al. Increased quinolone resistance among typhoid Salmonella isolated from Egyptian patients. J Infect Dev Ctries. 2014;8(5):661-5.
Saleh, F. O., Ahmed, H. A., Khairy, R. M., & Abdelwahab, S. F. (2014). Increased quinolone resistance among typhoid Salmonella isolated from Egyptian patients. Journal of Infection in Developing Countries, 8(5), 661-5. https://doi.org/10.3855/jidc.4111
Saleh FO, et al. Increased Quinolone Resistance Among Typhoid Salmonella Isolated From Egyptian Patients. J Infect Dev Ctries. 2014 May 14;8(5):661-5. PubMed PMID: 24820472.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increased quinolone resistance among typhoid Salmonella isolated from Egyptian patients. AU - Saleh,Fatma O I, AU - Ahmed,Hazem A, AU - Khairy,Rasha M M, AU - Abdelwahab,Sayed F, Y1 - 2014/05/14/ PY - 2013/08/09/received PY - 2013/11/22/accepted PY - 2013/11/22/revised PY - 2014/5/14/entrez PY - 2014/5/14/pubmed PY - 2015/1/6/medline SP - 661 EP - 5 JF - Journal of infection in developing countries JO - J Infect Dev Ctries VL - 8 IS - 5 N2 - INTRODUCTION: Typhoid fever is endemic in Egypt; and quinolones are the empirical treatment of choice. There are very limited data reporting quinolone resistance among Egyptian typhoidal Salmonella isolates. We previously reported that all typhoidal Salmonella were sensitive to quinolones. This study aimed to isolate and identify typhoidal Salmonella from cases suffering from enteric fever at Minia Governorate, Egypt, determine their quinolone resistance patterns, compare them to those reported 20 years ago, and test gyrA mutation as a possible mechanism for quinolone resistance. METHODOLOGY: Stool samples from Widal-positive subjects were screened by culture on suitable media and were identified biochemically. The identified isolates were tested for resistance against three representatives of the first three quinolone generations, namely nalidixic acid (NAL), levofloxacin (LEV), and norfloxacin (NOR). The gyrA gene was amplified and sequenced to detect point mutation(s) conferring quinolone resistance. RESULTS: Out of 230 stool samples (from patients with Widal anti-O titers of ≥ 1/160), 40 isolates were S. enterica serovar Typhi (97.5%) and Paratyphi A (2.5%). Six (15%) isolates were resistant to at least one of the quinolones, compared to 0% in 1993. In this regard, 15%, 7.5%, and 2.5% of the isolates were resistant to NAL, both NAL and LEV, and all three quinolones tested, respectively. Sequencing of the gyrA gene revealed point mutations at position 83 and/or 87 of the gyrA gene only among the resistant isolates. CONCLUSION: There has been an increase in quinolone-resistant typhoidal Salmonella in Egypt over time. SN - 1972-2680 UR - https://www.unboundmedicine.com/medline/citation/24820472/Increased_quinolone_resistance_among_typhoid_Salmonella_isolated_from_Egyptian_patients_ L2 - http://www.jidc.org/index.php/journal/article/view/24820472 DB - PRIME DP - Unbound Medicine ER -