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A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.
06:55

A High-throughput Platform for the Screening of Salmonella spp./Shigella spp.

Published on: November 7, 2018

Emergence of multidrug-resistant Salmonella typhi in rural southern India

P S Rao1, V Rajashekar, G K Varghese

  • 1Department of Microbiology, Kasturba Hospital, Manipal, Karnataka, India.

The American Journal of Tropical Medicine and Hygiene
|January 1, 1993
PubMed

Insights

Multidrug-resistant Salmonella typhi poses treatment challenges in India. Fluoroquinolones like ciprofloxacin show promise for treating drug-resistant typhoid fever, though severe cases may still be fatal.

Area of Science:

  • Infectious Diseases
  • Microbiology
  • Pharmacology

Background:

  • Multidrug-resistant Salmonella typhi (MDRST) is a growing public health concern in India.
  • Enteric fever, primarily caused by Salmonella typhi, presents significant therapeutic difficulties due to antimicrobial resistance.

Purpose of the Study:

  • To investigate the prevalence of multidrug-resistant Salmonella typhi in suspected enteric fever cases.
  • To evaluate the in vitro susceptibility of Salmonella typhi isolates to various antibiotics, including fluoroquinolones.
  • To assess the clinical outcomes of treating MDRST infections with fluoroquinolones.

Main Methods:

  • Retrospective analysis of clinically suspected enteric fever cases at Kasturba Hospital, Manipal, India (January 1990 - June 1991).
  • Isolation and antimicrobial susceptibility testing of Salmonella typhi from blood cultures.
  • Clinical data review for complications and treatment responses.

Main Results:

  • Out of 134 Salmonella bacteremia cases, 102 were Salmonella typhi.
  • 78.4% of S. typhi isolates were resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole.
  • No in vitro resistance was observed for ciprofloxacin, norfloxacin, and gentamicin.
  • Three of four patients with major complications from MDRST responded well to ciprofloxacin; one patient died.
  • Hepatitis and jaundice were observed in 12 other patients.

Conclusions:

  • The emergence of MDRST necessitates the use of fluoroquinolones in treating drug-resistant typhoid fever.
  • Ciprofloxacin demonstrated in vitro efficacy and clinical benefit in most MDRST cases.
  • Continued surveillance and development of effective treatment strategies for MDRST are crucial.

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