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Multidrug resistant Salmonella typhi in Delhi

L Dar1, B L Gupta, A Rattan

  • 1Department of Microbiology, All India Institute of Medical Sciences, New Delhi.

Insights

In 1990, 50% of Salmonella typhi strains showed multidrug resistance (MDR) to common antibiotics like chloramphenicol. However, these strains remained sensitive to newer drugs such as ciprofloxacin, indicating potential treatment options.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Antimicrobial Resistance

Background:

  • Typhoid fever, caused by Salmonella typhi, remains a significant global health concern.
  • The emergence of multidrug-resistant (MDR) Salmonella typhi strains poses a substantial challenge to effective treatment.
  • Understanding resistance patterns is crucial for guiding antimicrobial therapy and public health strategies.

Purpose of the Study:

  • To investigate the prevalence of multidrug resistance in Salmonella typhi isolates from typhoid fever patients.
  • To determine the susceptibility profiles of resistant strains to a range of commonly used and newer antibiotics.

Main Methods:

  • Isolation and identification of Salmonella typhi from blood cultures of patients diagnosed with typhoid fever.
  • Antimicrobial susceptibility testing using standard microbiological methods.
  • Determination of minimum inhibitory concentrations (MICs) for key antibiotics.

Main Results:

  • Out of 158 Salmonella typhi isolates, 79 (50%) exhibited simultaneous resistance to chloramphenicol, ampicillin, and cotrimoxazole.
  • These MDR strains were also resistant to streptomycin and tetracycline but remained sensitive to gentamicin, amikacin, and cephalexin.
  • High minimum inhibitory concentrations (MICs) were observed for chloramphenicol (>1024 µg/ml) and trimethoprim (>128 µg/ml).
  • A majority of MDR strains showed sensitivity to cefotaxime, ciprofloxacin, and amoxicillin-clavulanic acid.

Conclusions:

  • A significant proportion of Salmonella typhi isolates in 1990 displayed multidrug resistance, highlighting a growing public health threat.
  • While resistance to older antibiotics is prevalent, newer agents like ciprofloxacin and cefotaxime show promise for treating MDR typhoid fever.
  • Continued surveillance of antimicrobial resistance patterns is essential for effective management of typhoid fever.

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