Emergence of Quinolone Resistance and Re-Emergence of Susceptibility to First Line Antibiotics in Salmonella Spp. Isolated in a Tertiary Care Hospital
Journal Title: Scholars Journal of Applied Medical Sciences - Year 2016, Vol 4, Issue 7
Abstract
Typhoid fever (enteric fever) is a global health problem causing high morbidity and mortality, especially in endemic areas such as India. It afflicts local inhabitants as well as travellers to endemic areas. It has a mortality rate of 30% if not treated properly though appropriate treatment reduces the mortality rate to as low as 0.5%. Multi drug resistant Salmonella are still common in many areas, although in some regions highly sensitive strains have re-emerged. Isolation of Salmonella spp. from blood samples was done over a period of 1 year. The isolates were confirmed as Salmonella by using a battery of biochemical reactions. Specific antisera were used for serologic characterization of Salmonella strains. Antimicrobial susceptibility testing was performed as per CLSI guidelines. Minimum inhibitory concentrations were also evaluated for ciprofloxacin by E test. Total number of Salmonella isolates from clinical samples was 78. Six isolates (7.6%) were found to be multidrug resistant. Eight isolates were sensitive to all the antimicrobials tested. Among the antibiotics used for susceptibility testing of the isolates, all the isolates were found to be susceptible to cefixime, ceftriaxone, cefotaxime and azithromycin. 92.3 % of the Salmonella spp. were susceptible to chloramphenicol, 91 % to co-trimoxazole and 88.4 % of the isolates were susceptible to ampicillin. Only 12.9% of the isolates were found to be susceptible to ciprofloxacin and 10.3% to nalidixic acid. The present study revealed the increased rate of nalidixic acid resistant Salmonella spp. associated with reduced susceptibility to fluoroquinolones in contrast to increased susceptibility of the strains to conventional first-line drugs ampicillin, chloramphenicol, and cotrimoxazole. So, the conventional first-line drugs along with the third generation cephalosporins and azithromycin can be used as empiric therapy for treatment of enteric fever in our setting. Keywords:Salmonella typhi, Typhoid, Multidrug resistance, Re-emergence susceptibility, Quinolone resistance, Decreased ciprofloxacin susceptibility, Nalidixic acid resistance.
Authors and Affiliations
Dr. V Ramadevi, Dr. Vijendra Kawle, Dr. Girisha Pindi
Keywords
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