1887

Abstract

In recent years, increase in occurrence of fluoroquinolone (FQ)-resistant Typhi isolates has caused considerable inconvenience in selecting appropriate antimicrobials for treatment of typhoid. The World Health Organization (WHO) recommends azithromycin for the empirical treatment option of uncomplicated typhoid. The CLSI updated the breakpoints of disc diffusion (DD) and MIC results of FQs and azithromycin for Typhi in 2015, but DD breakpoints of ofloxacin and levofloxacin were not included. In this study, the inhibition zone diameters and MICs of nalidixic acid, ciprofloxacin, ofloxacin, levofloxacin and azithromycin were determined in Typhi Kolkata isolates ( =146) over a 16-year period (1998 to 2013) and the data were compared with the available CLSI breakpoints. Very major error and major error (ME) of FQs were not observed in the study isolates, but the minor error of ciprofloxacin (15.8 %) and ME of azithromycin (3.5 %) exceeded the acceptable limit. A positive correlation between MICs of FQ and mutations in the quinolone-resistance-determining region (QRDR) showed the reliability of MIC results to determine FQ susceptibility of Typhi ( =74). Isolates showing decreased ciprofloxacin susceptibility (MIC 0.125–0.5 µg  ml) were likely to have at least one mutation in the QRDR region. The results on DD breakpoints of ofloxacin (resistant, ≤15 mm; intermediate, 16–24 mm, and susceptible, ≥25 mm) and levofloxacin (resistant, ≤18 mm; intermediate, 19–27 mm, and susceptible, ≥28 mm) corroborated those of earlier studies. In view of the emerging FQ- and azithromycin-resistant Typhi isolates, DD and MIC breakpoints of those antimicrobials should be revisited routinely.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000288
2016-07-01
2024-03-29
Loading full text...

Full text loading...

/deliver/fulltext/jmm/65/7/632.html?itemId=/content/journal/jmm/10.1099/jmm.0.000288&mimeType=html&fmt=ahah

References

  1. Accou-Demartin M., Gaborieau V., Song Y., Roumagnac P., Marchou B., Achtman M., Weill F. X. 2011; Salmonella enterica serotype Typhi with nonclassical quinolone resistance phenotype. Emerg Infect Dis 17:1091–1094 [View Article][PubMed]
    [Google Scholar]
  2. Andrews J. M. 2001; Determination of minimum inhibitory concentrations. J Antimicrob Chemother 48:5–16 [View Article][PubMed]
    [Google Scholar]
  3. CLSI 2012 Methods for Dilution Antimicrobial Susceptibility Tests for Bacteria That Grow Aerobically ; Approved Standard , 9th edn. , CLSI document M07-A9. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  4. CLSI 2015 Performance Standards for Antimicrobial Susceptibility Testing ; 25th Informational Supplement . CLSI document M100-S25. Wayne, PA: Clinical and Laboratory Standards Institute;
    [Google Scholar]
  5. Chau T. T., Campbell J. I., Galindo C. M., Van Minh Hoang N., Diep T. S., Nga T. T., Van Vinh Chau N., Tuan P. Q., Page A. L. et al. 2007; Antimicrobial drug resistance of Salmonella enterica serovar Typhi in Asia and molecular mechanism of reduced susceptibility to the fluoroquinolones. Antimicrob Agents Chemother 51:4315–4323 [View Article][PubMed]
    [Google Scholar]
  6. Chiou C. S., Lauderdale T. L., Phung D. C., Watanabe H., Kuo J. C., Wang P. J., Liu Y. Y., Liang S. Y., Chen P. C. 2014; Antimicrobial resistance in Salmonella enterica serovar Typhi isolates from Bangladesh, Indonesia, Taiwan, and Vietnam. Antimicrob Agents Chemother 58:6501–6507 [View Article][PubMed]
    [Google Scholar]
  7. Clark R. B. L., Lewinski M. A., Loeffelholz M. J., Thibbetts R. J. 2009 Cumitech 31A, Verification and Validation of Procedures in the Clinical Microbiology Laboratory Edited by Sharp S. E. Washington, DC: ASM Press;
    [Google Scholar]
  8. Cooke F. J., Wain J. 2004; The emergence of antibiotic resistance in typhoid fever. Travel Med Infect Dis 2:67–74 [View Article][PubMed]
    [Google Scholar]
  9. Deak E., Hindler J. A., Skov R., Sjölund-Karlsson M., Sokovic A., Humphries R. M. 2015; Performance of Etest and disk diffusion for detection of ciprofloxacin and levofloxacin resistance in Salmonella enterica . J Clin Microbiol 53:298–301 [View Article][PubMed]
    [Google Scholar]
  10. Effa E. E., Bukirwa H. 2008; Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever). Cochrane Database Syst Rev 4:CD006083 [View Article][PubMed]
    [Google Scholar]
  11. Geetha V. K., Yugendran T., Srinivasan R., Harish B. N. 2014; Plasmid-mediated quinolone resistance in typhoidal Salmonella : a preliminary report from South India. Ind J Med Microbiol 32:31–34 [Crossref]
    [Google Scholar]
  12. Gunell M., Kotilainen P., Jalava J., Huovinen P., Siitonen A., Hakanen A. J. 2010; In vitro activity of azithromycin against nontyphoidal Salmonella enterica . Antimicrob Agents Chemother 54:3498–3501 [View Article][PubMed]
    [Google Scholar]
  13. Gupta R., Gaind R., Wain J., Deb M., Singh L. C., Basir S. F. 2014; Characterization of non-classical quinolone resistance in Salmonella enterica serovar Typhi: report of a novel mutation in gyrB gene and diagnostic challenges. Biomol Det Quant 2:30–34 [View Article]
    [Google Scholar]
  14. Hassing R. J., Goessens W. H., van Pelt W., Mevius D. J., Stricker B. H., Molhoek N., Verbon A., van Genderen P. J., Pelt W. 2014; Salmonella subtypes with increased MICs for azithromycin in travelers returned to The Netherlands. Emerg Infect Dis 20:705–710 [View Article][PubMed]
    [Google Scholar]
  15. Humphries R. M., Fang F. C., Aarestrup F. M., Hindler J. A. 2012; In vitro susceptibility testing of fluoroquinolone activity against Salmonella : recent changes to CLSI standards. Clin Infect Dis 55:1107–1113 [View Article][PubMed]
    [Google Scholar]
  16. Menezes G. A., Harish B. N., Khan M. A., Goessens W. H., Hays J. P. 2012; Antimicrobial resistance trends in blood culture positive Salmonella Typhi isolates from Pondicherry, India, 20052009. Clin Microbiol Infect 18:239–245 [View Article][PubMed]
    [Google Scholar]
  17. Parry C. M., Thuy C. T., Dongol S., Karkey A., Vinh H., Chinh N. T., Duy P. T., Thieu Nga T. V., Campbell J. I. et al. 2010; Suitable disk antimicrobial susceptibility breakpoints defining Salmonella enterica serovar Typhi isolates with reduced susceptibility to fluoroquinolones. Antimicrob Agents Chemother 54:5201–5208 [View Article][PubMed]
    [Google Scholar]
  18. Parry C. M., Thieu N. T., Dolecek C., Karkey A., Gupta R., Turner P., Dance D., Maude R. R., Ha V. et al. 2015; Clinically and microbiologically derived azithromycin susceptibility breakpoints for Salmonella enterica serovars Typhi and Paratyphi A. Antimicrob Agents Chemother 59:2756–2764 [View Article][PubMed]
    [Google Scholar]
  19. Rahman B. A., Wasfy M. O., Maksoud M. A., Hanna N., Dueger E., House B. 2014; Multi-drug resistance and reduced susceptibility to ciprofloxacin among Salmonella enterica serovar Typhi isolates from the Middle East and Central Asia. New Microbe New Infect 2:88–92 [View Article]
    [Google Scholar]
  20. Rai S., Jain S., Prasad K. N., Ghosal U., Dhole T. N. 2012; Rationale of azithromycin prescribing practices for enteric fever in India. Ind J Med Res 30:30–33
    [Google Scholar]
  21. Rowe B., Ward L. R., Threlfall E. J. 1997; Multidrug-resistant Salmonella Typhi: a worldwide epidemic. Clin Infect Dis 24:106–109 [Crossref]
    [Google Scholar]
  22. Sjölund-Karlsson M., Howie R. L., Crump J. A., Whichard J. M. 2014; Fluoroquinolone susceptibility testing of Salmonella enterica : detection of acquired resistance and selection of zone diameter breakpoints for levofloxacin and ofloxacin. J Clin Microbiol 52:877–884 [View Article][PubMed]
    [Google Scholar]
  23. Sjölund-Karlsson M., Howie R., Rickert R., Newton A., Gonzalez-Aviles G., Crump J. A. 2015; Plasmid-mediated quinolone resistance in isolates of Salmonella enterica serotype Typhi, USA. Int J Antimicrob Agents 45:88–90 [View Article][PubMed]
    [Google Scholar]
  24. Vlieghe E. R., Phe T., De Smet B., Veng C. H., Kham C., Bertrand S., Vanhoof R., Lynen L., Peetermans W. E. et al. 2012; Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. PLoS Negl Trop Dis 6:e1933 [View Article][PubMed]
    [Google Scholar]
  25. WHO 1983; Manual of Laboratory Investigation of Acute Enteric Infections. Geneva: World Health Organization; (WHO/CDD/63.3 rev)
  26. WHO 2003; Background Document: The Diagnosis, Treatment and Prevention of Typhoid fever. WHO Documents, WHO/V and B/03.07 Geneva: World Health Organization;
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000288
Loading
/content/journal/jmm/10.1099/jmm.0.000288
Loading

Data & Media loading...

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error