Related Experiment Videos
An outbreak of multidrug resistant typhoid fever in Bangalore
K C Rathish1, M R Chandrashekar, C N Nagesha
1Department of Microbiology, Dr. B.R. Ambedkar Medical College, Bangalore.
Abstract:
Six hundred and eighty five blood cultures from children clinically diagnosed as enteric fever yielded 176 salmonella strains showing isolation success rate of 25.7%, S. typhi were 164 (93.2%), S. paratyphi A 5 (2.8%), S. choleraesuis 4 (2.3%) and S. typhimurium 3 (1.7%). Antibiogram of 164 isolates of S. typhi showed triple drug resistance (TDR) in 156 strains (95.1%) to chloramphenicol, ampicillin and cotrimoxazole, and sensitivity of 90.2% and 95.1% to norfloxacin and ciprofloxacin respectively. Minimum inhibitory concentrations (MIC) of chloramphenicol were between 360 mcg and 640 mcg per ml. Phage types of 38 strains of TDR S. typhi were predominantly E1 and 0 with prevalences of 47.4% and 36.8% respectively in this region. All children with S. typhi isolates sensitive to quinolones in Vitro responded well to these drugs with almost no relapse and hence, the newer generation of quinolones could be considered as the first choice in the primary treatment of enteric fever.
Insights
Salmonella strains causing enteric fever in children show high resistance to common antibiotics. Newer generation quinolones are effective treatments for Salmonella typhi infections, offering a promising alternative for enteric fever management.
Area of Science:
- Microbiology
- Infectious Diseases
- Clinical Medicine
Background:
- Enteric fever, primarily caused by Salmonella species, poses a significant public health challenge, particularly in pediatric populations.
- Increasing antimicrobial resistance in Salmonella strains necessitates ongoing surveillance and evaluation of treatment options.
Purpose of the Study:
- To determine the prevalence of Salmonella species in pediatric enteric fever cases.
- To analyze the antimicrobial resistance patterns of isolated Salmonella strains, focusing on triple drug resistance (TDR).
- To evaluate the efficacy of newer generation quinolones in treating Salmonella typhi infections.
Main Methods:
- Blood cultures from children diagnosed with enteric fever were analyzed for Salmonella isolation.
- Antibiogram testing was performed on isolated Salmonella typhi strains to assess resistance and sensitivity patterns.
- Minimum inhibitory concentrations (MIC) for chloramphenicol and in vitro sensitivity to quinolones were determined.
- Phage typing was conducted on TDR S. typhi isolates.
Main Results:
- A 25.7% isolation success rate yielded 176 Salmonella strains, predominantly Salmonella typhi (93.2%).
- A high prevalence of triple drug resistance (TDR) was observed in 95.1% of S. typhi isolates to chloramphenicol, ampicillin, and cotrimoxazole.
- Salmonella typhi isolates demonstrated high sensitivity (90.2% and 95.1%) to norfloxacin and ciprofloxacin, respectively.
- Children treated with quinolone-sensitive S. typhi isolates showed excellent clinical response with minimal relapse.
Conclusions:
- The study highlights a significant challenge posed by TDR Salmonella typhi in pediatric enteric fever.
- Newer generation quinolones exhibit high in vitro efficacy against susceptible S. typhi strains.
- Quinolones represent a viable first-line treatment option for pediatric enteric fever caused by susceptible Salmonella typhi.