Treatment of enteric fever in children on the basis of current trends of antimicrobial susceptibility of Salmonella enterica serovar typhi and paratyphi A

Manchanda, V.; Bhalla, P.; Sethi, M.; Sharma, V. K.
April 2006
Indian Journal of Medical Microbiology;Apr2006, Vol. 24 Issue 2, p101
Academic Journal
journal article
Purpose: Recent reports indicate decreased susceptibility of S. typhi to fluoroquinolones, especially ciprofloxacin. Chloramphenicol has been suggested as first line therapy of enteric fever in many studies. This is a prospective study that describes the trends of antimicrobial susceptibility of S. typhi and S. paratyphi A causing bacteraemia in children and reports therapeutic failure to ciprofloxacin and evaluates the possible use of chloramphenicol, ampicillin, ciprofloxacin and third generation cephalosporins as first line therapy in the treatment of enteric fever in children.Methods: The present study was conducted from April 2004 to March 2005 in a superspeciality children hospital at New Delhi. A total of 56 S. typhi and five S. paratyphi A isolates were obtained among the 673 blood cultures performed. Antimicrobial testing was done using disk diffusion technique (NCCLS method) for 13 antimicrobials and MICs were calculated for ampicillin, ciprofloxacin, chloramphenicol and cefotaxime. Analysis of data was done using WHONET software.Results: All 56 isolates of S. typhi were sensitive to amoxycillin+clavulanate, gentamicin, cefixime, cefotaxime and ceftazidime. Multidrug resistance (MDR, resistance to three drugs) was seen in 22 cases (39%) and resistance to five drugs was seen in 12 cases (21%). Only two isolates were resistant to chloramphenicol (3%). MIC 90 for ampicillin, chloramphenicol, ciprofloxacin and cefotaxime were 1.0 microg/ml, 4.0 microg/ml, 64 microg/ml and 0.125 microg/ml respectively. All S. paratyphi A isolates were sensitive to ampicillin and chloramphenicol and resistant to nalidixic acid. MIC distribution data for chloramphenicol revealed elevated MIC but still in susceptible range.Conclusions: There is an urgent need for further clinical studies to evaluate response to chloramphenicol in such cases. Antimicrobial susceptibility data and MIC distribution favour use of ampicillin as a drug of choice for the treatment of enteric fever. Third generation cephalosporins are also useful but their use should be restricted for complicated cases.


Related Articles

  • Antimicrobial susceptibilities of enteric bacterial pathogens isolated in Kathmandu, Nepal, during 2002-2004. Kansakar, Palpasa; Baral, Pankaj; Malla, Sarala; Ghimire, Gokarna Raj // Journal of Infection in Developing Countries;Mar2011, Vol. 5 Issue 3, p163 

    Introduction: The prevalence and antimicrobial susceptibility patterns of the bacterial enteropathogens Vibrio cholerae, Salmonella species and Shigella species were investigated. Methodology: A total of 877 stool samples were received for culture at the National Public Health Laboratory (NPHL),...


    Typhoid is systemic infection and in most developing countries remains a major health problem. Due to an increasing resistance to antibiotics and the limited scope of the vaccine the requirement is to explore the efficacy of formulated drugs in the treatment of this disease. In this study we...

  • Only for substrate antibiotics are a functional AcrAB–TolC efflux pump and RamA required to select multidrug-resistant Salmonella Typhimurium. Ricci, Vito; Piddock, Laura J. V. // Journal of Antimicrobial Chemotherapy (JAC);Sep2009, Vol. 64 Issue 3, p654 

    The article discusses whether the presence of multidrug efflux transporters AcrB and TolC is required for the development of resistant to ciprofloxacin's other substrates from different antibiotic classes. Experiments were performed to select antibiotic-resistant mutants form SL1344, L110 and...

  • Rapid result. Johnston, Nicole // New Scientist;06/26/99, Vol. 162 Issue 2192, p11 

    Highlights the development of a ten-minute testing device for the presence of Salmonella typhimurium. Dangers of S. typhimurium; Design of the testing device; How, when the bacteria are present, they interfere with a laser beam pattern and indicate their presence; This rapid test as a...

  • Periplasmic adaptor protein AcrA has a distinct role in the antibiotic resistance and virulence of Salmonella enterica serovar Typhimurium. Blair, Jessica M. A.; La Ragione, Roberto M.; Woodward, Martin J.; Piddock, Laura J. V. // Journal of Antimicrobial Chemotherapy (JAC);Nov2009, Vol. 64 Issue 5, p965 

    Objectives: AcrA can function as the periplasmic adaptor protein (PAP) in several RND tripartite efflux pumps, of which AcrAB-TolC is considered the most important. This system confers innate multiple antibiotic resistance. Disruption of acrB or tolC impairs the ability of Salmonella Typhimurium...

  • Enteric fever in Cambodian children is dominated by multidrug-resistant H58 Salmonella enterica serovar Typhi with intermediate susceptibility to ciprofloxacin Emary, Kate; Moore, Catrin E.; Chanpheaktra, Ngoun; An, Khun Peng; Chheng, Kheng; Sona, Soeng; Duy, Pham Thanh; Nga, Tran Vu Thieu; Wuthiekanun, Vanaporn; Amornchai, Premjit; Kumar, Varun; Wijedoru, Lalith; Stoesser, Nicole E.; Carter, Michael J.; Baker, Stephen; Day, Nicholas P.J.; Parry, Christopher M. // Transactions of the Royal Society of Tropical Medicine & Hygiene;Dec2012, Vol. 106 Issue 12, p718 

    Abstract: Infections with Salmonella enterica serovar Typhi isolates that are multidrug resistant (MDR: resistant to chloramphenicol, ampicillin, trimethoprim–sulphamethoxazole) with intermediate ciprofloxacin susceptibility are widespread in Asia but there is little information from...

  • Ciprofloxacin selects for multidrug resistance in Salmonella enterica serovar Typhimurium mediated by at least two different pathways. Ricci, Vito; Piddock, Laura J. V. // Journal of Antimicrobial Chemotherapy (JAC);May2009, Vol. 63 Issue 5, p909 

    : Objectives The aim of this study was to understand the role of ramA in conferring multidrug resistance (MDR) in Salmonella enterica serovar Typhimurium. : Methods Two phenotypically distinct isogenic MDR laboratory mutants derived from Salmonella Typhimurium SL1344 and three human clinical...

  • Korean Beechwood Creosote as a Substitute to an Antibiotic for Post Weaning Diarrhea in Piglets. Sodhi, Simrinder Singh; Jeong Hyun Kim; Sharma, Neelesh; Kwang Keun Cho; Jae Young Kim; Ki Beom Kim; Chul-Yon Jeong; Yong Min Yoon; Sung Jong Oh; Dong Kee Jeong // Pakistan Veterinary Journal;2014, Vol. 34 Issue 3, p341 

    Post weaning diarrhea (PWD) effects the economy of pig industry and extensive use of antibiotics to treat PWD led to the development of antibiotic resistance. To counter the issue of antibiotic resistance, role of Korean Beechwood creosote has been studied. Six weeks old, 12 piglets were divided...

  • Chlorine Inactivation of Nonresistant and Antibiotic-Resistant Strains of Salmonella Typhimurium Isolated from Chicken Carcasses. OSCAR, T. P.; TASMIN, R.; PARVEEN, S. // Journal of Food Protection;Jun2013, Vol. 76 Issue 6, p1031 

    A study was conducted to test the hypothesis that strains of Salmonella Typhimurium that are resistant to antibiotics are more resistant to chlorine in chilled water than strains of Salmonella Typhimurium that are not resistant to antibiotics. To test this hypothesis, strains (n = 16) of...


Read the Article


Sorry, but this item is not currently available from your library.

Try another library?
Sign out of this library

Other Topics