Antibiotic Resistance among Enteric Fever Pathogens in a Tertiary Care Centre
Journal Title: National Journal of Laboratory Medicine - Year 2016, Vol 5, Issue 3
Abstract
Introduction: Enteric fever, a public health problem endemic in India involves multiple systems and is caused by Salmonella enterica, sub-species enterica serovar typhi and serovars paratyphi A, B and C. Fluoroquinolones and third-generation cephalosporins are first-line drugs used in treatment, which has led to increased MIC of Ciprofloxacin causing therapeutic failure. Hence, finding out the isolates with decreased susceptibility to Ciprofloxacin is important for a good treatment response and favourable clinical outcome. Aim: To study the antibiotic resistance pattern of enteric fever pathogens with special reference to quinolones. To study the isolation rate of typhoidal S. typhi and S. paratyphi among different age groups, to determine their antimicrobial susceptibility pattern & note MIC of Ciprofloxacin. Materials and Methods: A retrospective study was done in Microbiology Lab of KMC Hospital, Mangalore during December 2014 to December 2015. Ninety one Blood culture samples with growth of S. typhi & S. paratyphi were processed .The antibiotic susceptibility was done by Modified Kirby Bauer disk diffusion. MIC of ciprofloxacin was tested using Automated Vitek 2 system. Results: Of 1279 positive blood cultures, isolation rate of enteric fever pathogens was 91 (7.11%). Majority of the isolates were S. typhi (69) and S. paratyphi A were 22 in number. 74 (81.31%) isolates were from 13-38 years. Antibiotic resistance pattern: Ampicillin (3.29%), Chloramphenicol (2.19%), Ceftriaxone (0%), Ciprofloxacin (2.19%), Nalidixic acid (85.71%), Cotrimoxazole (3.29%). Isolates with MIC of Ciprofloxacin 0.12 to 1 µg/ml were 81 (89%). Nalidixic acid was resistant in 78 (85.7%). Three isolates (3.29%) were MDR. The most susceptible antibiotic was ceftriaxone while most resistant was nalidixic acid. Conclusion: The increasing numbers of enteric fever pathogens with decreased ciprofloxacin susceptibility is a cause of concern. There is re-emergence of sensitivity to the first line drugs.
Authors and Affiliations
Dr. Ankita Porwal, Dr. Sevitha Bhat
Keywords
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- EP ID EP380798
- DOI 10.7860/NJLM/2016/19872.2144
- Views 97
- Downloads 0
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