1887

Abstract

A prospective study of the prevalent aetiology of enteric fever was undertaken at a tertiary care hospital in North India at intervals of every 3 years. spp. were isolated from 174 (7 %) patients. Amongst these, 140 (80 %) patients were infected by subspecies serovar ( Typhi) and 16 (9 %) by serovar Paratyphi A; the remaining 11 % were infected by other serogroups, Typhimurium, Paratyphi C and Senftenberg, and other group E salmonella. A significantly greater number of . Typhi were isolated in the summer and monsoon months. Multidrug resistance (resistance to chloramphenicol, ampicillin and co-trimoxazole) sequentially increased from 34 % in 1999 to 66 % in 2005. Increasing resistance was also noticed to the other antibiotics, especially to the cephalosporins. Moreover 8 % of the . Typhi isolates were found to be presumptive extended spectrum -lactamase producers. There was a gradual development of resistance to fluoroquinolones over the 7 years. No resistance was observed to fluoroquinolones in 1999, while in 2005 4.4 % resistance was observed to sparfloxacin, 8.8 % resistance to ofloxacin and a high resistance, 13 %, to ciprofloxacin. This is an alarming development and it is of paramount importance to limit unnecessary use of fluoroquinolones and third generation cephalosporins so that their efficacy against salmonella is not jeopardized further.

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2008-10-01
2024-12-07
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References

  1. Ackers M. L., Puhr M. D., Tauxe R. V., Mintz E. D. 2000; Laboratory based surveillance of Salmonella serotype Typhi infections in the United States: antimicrobial resistance on the rise. JAMA 283:2668–2673 [CrossRef]
    [Google Scholar]
  2. Bauer A. W., Kirby W. M. M., Sherris J. C., Truck M. 1966; Antibiotic susceptibility testing by standardized single disc method. Am J Clin Pathol 45:493–496
    [Google Scholar]
  3. Ciraj A. M., Seetha K. S., Gopalkrishna B. K., Shivananda P. G. 1999; Drug resistance pattern and phage types of Salmonella Typhi isolates in Manipal, South Karnataka. Indian J Med Sci 53:486–489
    [Google Scholar]
  4. Edelman R., Levine M. M. 1986; Summary of an international workshop on typhoid fever. Rev Infect Dis 8:329–349 [CrossRef]
    [Google Scholar]
  5. Gaind R., Paglietti B., Murgia M., Dawar R., Uzzau S., Cappuccinelli P., Deb M., Aggarwal P., Rubino S. 2006; Molecular characterization of ciprofloxacin resistant Salmonella enterica serovar Typhi and Paratyphi A causing enteric fever in India. J Antimicrob Chemother 58:1139–1144 [CrossRef]
    [Google Scholar]
  6. Gupta A. 1994; Multi-drug resistant typhoid fever in children: epidemiology and therapeutic approach. Pediatr Infect Dis J 13:134–140 [CrossRef]
    [Google Scholar]
  7. Harish B. N., Madhulika U., Parija S. C. 2004; Isolated high level ciprofloxacin resistance in Salmonella enterica subsp. enterica serotype Paratyphi A. J Med Microbiol 53:819 [CrossRef]
    [Google Scholar]
  8. Ivanoff B. 1994; Typhoid fever: global situation and WHO recommendations. In Proceedings of the 2nd Asia Pacific Symposium on Typhoid Fever and Other Salmonellosis p– 39 Bangkok: Infectious Disease Association of Thailand;
    [Google Scholar]
  9. Jesudasan M. V., John T. J. 1990; Multiresistant Salmonella typhi in India. Lancet 336:252
    [Google Scholar]
  10. Kabra S. K., Madhulika Talati A., Soni N., Patel S., Modi R. R. 2000; Multidrug-resistant typhoid fever. Trop Doct 30:195–197
    [Google Scholar]
  11. Kamili M. A., Ali G., Shah M. Y., Khan R. S., Alladaquab G. Q. 1993; Multiple drug resistance typhoid fever outbreak in Kashmir valley. Indian J Med Sci 47:147–151
    [Google Scholar]
  12. Koneman E. W., Allen S. D., Janada W. M., Schreckenberger P. C., Winn W. C. 1997; Guidelines for the collection, transport, processing, analysis and reporting of cultures from specific specimen sources. In Colour Atlas and Textbook of Diagnostic Microbiology , 5th edn. pp 153–162 New York: Lippincott;
    [Google Scholar]
  13. Madhulika U., Harish B. N., Parija S. C. 2004; Current pattern in antimicrobial susceptibility of Salmonella Typhi isolates in Pondicherry. Indian J Med Res 120:111–114
    [Google Scholar]
  14. Mirza S. H., Beeching N. J., Hart C. A. 1995; The prevalence and clinical features of multi-drug resistant Salmonella Typhi infection in Baluchistan, Pakistan. Ann Trop Med Parasitol 89:515–519
    [Google Scholar]
  15. Ochiai R. L., Wang X. Y., von Seidlein L., Yang J., Bhutta Z. A., Bhattacharya S. K., Agtini M., Deen J. L., Wain J. 2005; Salmonella Paratyphi A rates, Asia. Emerg Infect Dis 11:1764–1766 [CrossRef]
    [Google Scholar]
  16. Paniker C. K. J., Vimla K. N. 1972; Transferable chloramphenicol resistance in Salmonella Typhi. Nature 239:109–110
    [Google Scholar]
  17. Rathish K. C., Chandrashekar M. R., Nagesha C. N. 1995; An outbreak of multi-drug resistant typhoid fever in Bangalore. Indian J Pediatr 62:445–448 [CrossRef]
    [Google Scholar]
  18. Sood S., Kapil A., Dash N., Das B. K., Goel V., Seth P. 1999; Paratyphoid fever in India: an emerging problem. Emerg Infect Dis 5:483–484 [CrossRef]
    [Google Scholar]
  19. Wallace M. R., Yousif A., Mahroos G. 1993; Ciprofloxacin versus ceftriaxone in the treatment of multi-drug resistant typhoid fever. Eur J Clin Microbiol Infect Dis 12:907–910 [CrossRef]
    [Google Scholar]
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