1887

Abstract

Purpose. A study was undertaken to determine the risk factors and trends in antimicrobial resistance for enteric fever.

Methodology. Demographic, antimicrobial susceptibility, typing and epidemiological data were examined for 2005–2012 in patients with enteric fever in London. Single and multivariable logistic regression was used to determine the risk factors associated with antibiotic resistance.

Results. 453 cases with Salmonella enterica subsp. enterica serovar Paratyphi A, 17 with S. Paratyphi B and 611 with S. enterica subsp. enterica serovar Typhi were examined. For travellers, 335 (88 %) of S. Paratyphi A isolates were resistant to ciprofloxacin, but resistance to other antimicrobials was low. Almost 80 % (395) of the S. Typhi isolates were resistant to ciprofloxacin, 131 (26 %) to ampicillin, 131 (27 %) to chloramphenicol, 137 (28 %) to trimethoprim and 171 (28 %) to sulphonamide. None of the isolates were resistant to cephalosporins.

A trend analysis for S. Typhi isolates showed no significant change in resistance to ampicillin, chloramphenicol, sulphonamide and trimethoprim or for multidrug resistance (P=0.38). Overall resistance to ciprofloxacin increased for S. Paratyphi A (P=0.018) and for S. Typhi (P<0.001) but fell for S. Typhi in 2011–2012. Resistance profiles were reflected by specific phage types and countries visited by the travellers.

Conclusions. The proportion of S. Typhi strains resistant to ampicillin, chloramphenicol and cotrimoxazole remained steady for the period 2005–2012. There was a significant increase in a trend for resistance to ciprofloxacin which increased until 2010, followed by a fall in 2011–2012. S. Paratyphi resistance to ciprofloxacin increased until 2012. Specific phage types were associated with resistance to specific antimicrobials and travel abroad.

Loading

Article metrics loading...

/content/journal/jmm/10.1099/jmm.0.000484
2017-06-08
2019-10-22
Loading full text...

Full text loading...

/deliver/fulltext/jmm/66/6/698.html?itemId=/content/journal/jmm/10.1099/jmm.0.000484&mimeType=html&fmt=ahah

References

  1. Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. J Glob Health 2012;2:010401 [CrossRef][PubMed]
    [Google Scholar]
  2. Crump JA, Mintz ED. Global trends in typhoid and paratyphoid fever. Clin Infect Dis 2010;50:241–246 [CrossRef][PubMed]
    [Google Scholar]
  3. Dave J, Millar M, Maxeiner H, Freedman J, Meade R et al. East London experience with enteric fever 2007–2012. PLoS One 2015;10:e0120926 [CrossRef][PubMed]
    [Google Scholar]
  4. British Society for Antimicrobial Chemotherapy (BSAC) BSAC methods for antimicrobial susceptibility testing. Version 12 2013http://bsac.org.uk/wp-content/uploads/2012/02/Version-12-Apr-2013_final.pdf [accessed 4 November 2014]
    [Google Scholar]
  5. The European Committee on Antimicrobial Susceptibility Testing (EUCAST) Breakpoint tables for interpretation of MICs and zone diameters. Version 4.0. 2014;www.eucast.org [accessed 4 November 2014]
  6. StataCorp Stata Statistical Software: Release 13 College Station, TX: StataCorp LP; 2013
    [Google Scholar]
  7. Dutta S, Das S, Mitra U, Jain P, Roy I et al. Antimicrobial resistance, virulence profiles and molecular subtypes of Salmonella enterica serovars Typhi and Paratyphi a blood isolates from Kolkata, India during 2009-2013. PLoS One 2014;9:e101347 [CrossRef][PubMed]
    [Google Scholar]
  8. Misra R, Prasad KN, Amrin N, Kapoor P, Singh S et al. Absence of multidrug resistance in Salmonella enterica serotypes Typhi and Paratyphi a isolates with intermediate susceptibility to ciprofloxacin. Trans R Soc Trop Med Hyg 2015;109:538–540 [CrossRef][PubMed]
    [Google Scholar]
  9. Wong VK, Baker S, Pickard DJ, Parkhill J, Page AJ et al. Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter- and intracontinental transmission events. Nat Genet 2015;47:632–639 [CrossRef][PubMed]
    [Google Scholar]
  10. Dave J, Sefton A, de Pinna E, Woodford N, Meade R et al. Trends in antibiotic susceptibility of enteric fever isolates in East London. Travel Med Infect Dis 2015;13:230–234 [CrossRef][PubMed]
    [Google Scholar]
  11. Hassing RJ, Goessens WH, Mevius DJ, van Pelt W, Mouton JW et al. Decreased ciprofloxacin susceptibility in Salmonella Typhi and Paratyphi infections in ill-returned travellers: the impact on clinical outcome and future treatment options. Eur J Clin Microbiol Infect Dis 2013;32:1295–1301 [CrossRef][PubMed]
    [Google Scholar]
  12. WHO background document The diagnosis, treatment and prevention of typhoid fever. Geneva 2003
    [Google Scholar]
  13. Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ. Typhoid fever. N Engl J Med 2002;347:1770–1782 [CrossRef][PubMed]
    [Google Scholar]
  14. Dave J, Sefton A. Enteric fever and its impact on returning travellers. Int Health 2015;7:163–168 [CrossRef][PubMed]
    [Google Scholar]
  15. Baggesen DL, Sørensen G, Nielsen EM, Wegener HC. Phage typing of Salmonella typhimurium - is it still a useful tool for surveillance and outbreak investigation?. Euro Surveill 2010;15:19471[PubMed]
    [Google Scholar]
http://instance.metastore.ingenta.com/content/journal/jmm/10.1099/jmm.0.000484
Loading
/content/journal/jmm/10.1099/jmm.0.000484
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