Drug Resistance Pattern in the Recent Isolates of Salmonella Typhi with Special Reference to Cephalosporins and Azithromycin in the Gangetic Plain
Introduction: Typhoid fever is an endemic disease in India against which many antibiotics are available. In the recent times, emerging resistance to traditional antibiotics, such as Ampicillin, Chloramphenicol and Trimethoprim/sulfamethoxazole, Azithromycin and third generation Cephalosporins are...
| Main Authors: | , , , |
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| Format: | Article |
| Language: | English |
| Published: |
JCDR Research and Publications Private Limited
2017-06-01
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| Series: | Journal of Clinical and Diagnostic Research |
| Subjects: | |
| Online Access: | https://jcdr.net/articles/PDF/9973/23330_CE(RA1)_F(T)_PF1(GU_SRI)_PFA(AK)_PF2(P_RK)_PF3%20(Sh%20NE%20VT).pdf |
| Summary: | Introduction: Typhoid fever is an endemic disease in India
against which many antibiotics are available. In the recent times,
emerging resistance to traditional antibiotics, such as Ampicillin,
Chloramphenicol and Trimethoprim/sulfamethoxazole, Azithromycin and third generation Cephalosporins are being reported
and increasingly being used in the treatment of invasive
Salmonella infections. However, the latter two drugs have been
reported with occasional clinical failures. Currently, we do not
have data regarding their drug resistance levels in the recent
isolates of Salmonella enterica subspecies enterica serotype
Typhi.
Aim: To determine the current levels of drug resistance of the
two drugs (i.e., cephalosporins and azithromycin) against S.
Typhi isolates.
Materials and Methods: It is a prospective case study. A total
of 47 recent strains of S. Typhi were isolated from blood and
stool specimens. These isolates were subjected to identification
and confirmation by biochemical, serological tests followed
by genotypic methods. The antimicrobial testing was done
by disc diffusion and Minimum Inhibitory Concentration (MIC)
methods for various in use antibiotics including ceftriaxone
and azithromycin from February 2011 to March 2013 in the
Department of Microbiology, Institute of Medical Sciences,
Banaras Hindu University, Varanasi, India.
Results: It was intriguing to see the return of conventional drugs
such as chloramphenicol, amoxicillin and co-trimoxazole. The
drugs like quinolones, ceftriaxone and azithromycin were found
to be ineffective against >20% of the isolates. However, nalidixic
acid was found to have maximum resistance (36/47,76.6%) while
highest sensitivity was observed for chloramphenicol (1/47,2.1%).
Moreover, co-trimoxazole (9/47,19.1%) has displayed with
significant come back.
Conclusion: It could be concluded that combination of
amoxicillin and co-trimoxazole would prove as good as
azithromycin or ceftriaxone alone for empirical therapy of S.
Typhi infection. However, detection of an isolate (1/47, 2.1%),
sensitive only to chloramphenicol, a drug known for causing
bone marrow suppression, is an alarming sign. |
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| ISSN: | 2249-782X 0973-709X |