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CORRESPONDENCE
Year : 2003  |  Volume : 21  |  Issue : 4  |  Page : 292
 

A preliminary report on current antibiogram of salmonella enterica serotype typhi in Nagpur


Department of Microbiology, Indira Gandhi Medical College, Nagpur - 440 018, Maharashtra, India

Correspondence Address:
Department of Microbiology, Indira Gandhi Medical College, Nagpur - 440 018, Maharashtra, India



How to cite this article:
Tankhiwale S S, Agrawal G, Jalgaonkar S V. A preliminary report on current antibiogram of salmonella enterica serotype typhi in Nagpur. Indian J Med Microbiol 2003;21:292


How to cite this URL:
Tankhiwale S S, Agrawal G, Jalgaonkar S V. A preliminary report on current antibiogram of salmonella enterica serotype typhi in Nagpur. Indian J Med Microbiol [serial online] 2003 [cited 2019 Sep 18];21:292. Available from: http://www.ijmm.org/text.asp?2003/21/4/292/8050


Dear Editor
 Salmonella More Details typhi is the commonest species responsible for enteric fever in India.[1] Chloramphenicol has been the preferred treatment since 1948.[2] With the emergence of multi-drug resistant strains (MDR) from different parts of the country, fluoroquinolones emerged as the first drug of choice in the treatment of enteric fever.
Recent reports of chloramphenicol sensitivity are variable. While 100% resistance was observed from Hubli in 1997[3] and more than 95% from Hyderabad in 1999,[4] 91.6% strains from New Delhi were found to be sensitive in 1998.[5] Twenty three isolates of S.typhi were isolated from our laboratory in the year 2002 from blood cultures in suspected cases of enteric fever. Thirteen isolates (56.52%) were chloramphenicol sensitive with minimum inhibitory concentration (MIC) < 8g/mL while 8 had MIC of > 32 g/mL indicating resistance; 2 isolates were intermediate sensitive with MIC value between 8 and 32 g/mL. Similar variability was observed with ampicillin sensitivity. As many as 85 to 100% isolates were reported as resistant in recent reports,[3],[4] 47.82% of the isolates in our study were ampicillin sensitive. Co-trimoxazole sensitivity was similar to other reports with less than 30% isolates being sensitive to this drug.
Decreasing efficacy to ciprofloxacin, which lately is the drug of choice for the treatment of enteric fever, has been reported.[3],[4] Four isolates (13.05%) out of 23 were found to be resistant to ciprofloxacin. All the 23 isolates were found to be sensitive to cephotaxime, a third generation cephalosporin. Seven of the 23 isolates (30.43%) were simultaneously resistant to ampicillin, chloramphenicol and co-trimoxazole (ACCo) indicating multi-drug resistance. Very high multi-drug resistance of 64.2% has been reported recently[3] with ACCoT (including tetracycline) pattern.
Even though the recent reports of sensitivity to chloramphenicol are variable from different regions, our experience in the last one year indicates that more than 50% isolates are sensitive. With increasing resistance to fluoroquinolones and the possibility of re-emergence of sensitivity to chloramphenicol, the policy of empirical treatment of enteric fever needs to be rationalized. However, continued surveillance on antimicrobial susceptibility pattern and study of multi-drug resistance is necessary. 

 ~ References Top

1.Pillai PK, Prakash K. Current status of drug resistance and phage types of Salmonella typhi in India. Indian J Med Res 1993;97:154-158.  Back to cited text no. 1    
2.Woodward TE, Smadel JE, Ley HL. Preliminary Report on the beneficial effects of chloramycetin in the treatment of typhoid fever. Ann Intern Med 1948;29:131-134.  Back to cited text no. 2    
3.Nadgir S, Krishna BVS, Halesh LH, Tallur SS. Multidrug resistant Salmonella typhi in Hubli. Indian J Med Microbiol 1998;16(4):185.  Back to cited text no. 3    
4.Hemlatha R, Vijaylakshmi P, Gyaneshwari, Rao MVR, Ramani A. Multidrug resistant Salmonella typhi in Hyderabad. Indian J Med Micrbiol 1999;17(1):39-41.  Back to cited text no. 4    
5.Sood S, Kapil A, Das B, Jain Y, Kabra SK. Remergence of chloramphenicol sensitive Salmonella typhi. Lancet 1999;353(9160):1241-1242.  Back to cited text no. 5    
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2004 - Indian Journal of Medical Microbiology
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