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An outbreak of multidrug resistant Salmonella typhimurium in Delhi (India)

C Wattal1, V Kaul, T D Chugh

  • 1Department of Medical Microbiology, Sir Ganga Ram Hospital, New Delhi.

Insights

Multidrug-resistant Salmonella typhimurium outbreaks require effective control. Oral rehydration therapy alone treated most enteritis cases, while barrier nursing and disinfection limited spread.

Area of Science:

  • Microbiology
  • Infectious Diseases
  • Epidemiology

Background:

  • Multidrug-resistant Salmonella typhimurium (S. typhimurium) poses a significant public health threat.
  • Antibiotic resistance in bacterial pathogens is a growing global concern.

Purpose of the Study:

  • To investigate an outbreak of multidrug-resistant S. typhimurium.
  • To identify effective treatment and control strategies for S. typhimurium infections.

Main Methods:

  • Retrospective analysis of patient data from May to September 1991.
  • Antimicrobial susceptibility testing of S. typhimurium isolates.
  • Plasmid profiling and phage typing of S. typhimurium strains.

Main Results:

  • Eighty-five patients with multidrug-resistant S. typhimurium were identified.
  • Of 80 stool culture positives, 58 patients (72.5%) had enteritis, with 23 (39.6%) successfully treated with oral rehydration therapy alone.
  • All isolates were sensitive to ofloxacin, but five were resistant to cefotaxime. 88-96% were resistant to other antibiotics.
  • Antibiotic use prolonged convalescent carrier rates.
  • The predominant phage type was 178, and resistant strains harbored seven plasmids.
  • Barrier nursing and sodium hypochlorite disinfection were effective in limiting the outbreak.

Conclusions:

  • Oral rehydration therapy is effective for S. typhimurium enteritis.
  • Multidrug-resistant S. typhimurium outbreaks can be controlled using barrier nursing and disinfection.
  • Prudent antibiotic use is crucial to prevent prolonged carrier states.

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