Indian Journal of Medical Microbiology IAMM  | About us |  Subscription |  e-Alerts  | Feedback |  Login   
  Print this page Email this page   Small font sizeDefault font sizeIncrease font size
 Home | Ahead of Print | Current Issue | Archives | Search | Instructions  
Users Online: 1802 Official Publication of Indian Association of Medical Microbiologists 
  Search
 
 ~ Next article
 ~ Previous article 
 ~ Table of Contents
  
 ~  Similar in PUBMED
 ~  Search Pubmed for
 ~  Search in Google Scholar for
 ~  Article in PDF (193 KB)
 ~  Citation Manager
 ~  Access Statistics
 ~  Reader Comments
 ~  Email Alert *
 ~  Add to My List *
* Registration required (free)  

 
 ~  References
 ~  Article Tables

 Article Access Statistics
    Viewed3122    
    Printed78    
    Emailed0    
    PDF Downloaded351    
    Comments [Add]1    
    Cited by others 6    

Recommend this journal

 


 
CORRESPONDENCE
Year : 2007  |  Volume : 25  |  Issue : 4  |  Page : 436-437
 

Trends of antibiotic resistance in Salmonella enterica serovar typhi isolated from hospitalized patients from 1997 to 2004 in Lagos, Nigeria


1 Department of Microbiology, Lagos State University, Nigeria
2 Department of Medical Microbiology and Parasitology, College of Medicine, University of Lagos, Nigeria

Date of Submission26-Jan-2006
Date of Acceptance04-Mar-2007

Correspondence Address:
K O Akinyemi
Department of Microbiology, Lagos State University
Nigeria
Login to access the Email id

Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.37369

Rights and Permissions



How to cite this article:
Akinyemi K O, Coker A O. Trends of antibiotic resistance in Salmonella enterica serovar typhi isolated from hospitalized patients from 1997 to 2004 in Lagos, Nigeria. Indian J Med Microbiol 2007;25:436-7

How to cite this URL:
Akinyemi K O, Coker A O. Trends of antibiotic resistance in Salmonella enterica serovar typhi isolated from hospitalized patients from 1997 to 2004 in Lagos, Nigeria. Indian J Med Microbiol [serial online] 2007 [cited 2019 Sep 18];25:436-7. Available from: http://www.ijmm.org/text.asp?2007/25/4/436/37369


Dear Editor,

The increasing treatment failure with the empirical therapy in recent times among typhoid fever patients necessitates responsibility of medical microbiologists to assess and report the patterns of antibiotic resistance among  Salmonella More Details enterica serovar Typhi in our environment. A retrospective study of 274 Salmonella enterica serovar Typhi isolates recovered from patients whose blood and/or stool samples were brought to the Central Public Health Laboratory Services (CPHLS), Yaba, from 1997 to 2004 was conducted in order to assess antimicrobial resistance patterns of the isolates. Susceptibility to ampicillin (25 μg) chloramphenicol (30 μg), cotrimoxazole (25 μg), tetracycline (50 μg), nalidixic acid (30 μg), ciprofloxacin (20 μg) and ofloxacin (20 μg) was determined for all isolates by the disk diffusion Kirby Bauer method. [1] After 1999, reference broth micro dilution methods recommended by National Committee for Clinical Laboratory Standard (NCCLS) for susceptibility testing using the established break points was adopted. [2] For ampicillin and chloramphenicol, break points 8.0 and 16.0 μg/mL were used for intermediate and resistant, respectively. Tetracycline and cotrimoxazole ≥4.0 μg/mL for intermediate and ≥8.0 μg/mL for resistant was used, while nalidixic acid ≥4.0 μg/mL for resistant was used. The minimum inhibitory concentration (MIC) of ≤0.03 mg/mL was taken to be fully sensitive for ciprofloxacin and ofloxacin. For analysis in this study, both intermediate and resistant categories were considered to be resistant.  Escherichia More Details coli ATCC 25922 was used as control in susceptibility testing. In all, 221 Salmonella enterica serovar Typhi strains were resistant to at least three antibiotics given a prevalence of 80.7%. In 1997 alone, out of 29 isolates screened, 70.0% were resistant to more than three antimicrobials. This was gradually increased in the subsequent years. For example, 80.0% and 88.6% were recorded in 2000 and 2002, respectively, with a slight decrease in 2004 to 84.6% [Table - 1]. Similar trends were recorded for Salmonella enterica serovar Typhi with single drug resistance. For instance, in aggregates, the highest percentage of resistance was found to chloramphenicol (83.6%) followed closely by ampicillin (81.8%), cotrimoxazole (81.4%) and tetracycline (79.6%), while the least was nalidixic acid (59.0%). A strain of Salmonella enterica serovar Typhi with reduced ciprofloxacin and ofloxacin susceptibility was recorded in 1999 and 2004 [Table - 1].

Therefore, the high prevalence of MDR (multidrug resistant) - Salmonella enterica serovar Typhi recorded may be attributed to two main reasons. Firstly drug abuse, which is because of therapeutic intervention in suspected cases of typhoid fever due to attitude of self-medication. This prevents early reporting of patients to the hospitals at the onset of disease symptoms, except where complications had occurred, as observed in this study, where only untreated cases of typhoid fever by self-medication were brought to the hospitals. It should be noted that severe, refractory or complicated infections have been attributed to increase chloramphenicol and other antibiotic resistance in strains of Salmonella enterica serovar Typhi in some parts of the world, [3] a situation that seems to have come to stay in our environment. Secondly, either clonal spread and/or extrachromosomal genes may be potential mechanisms for increase in the level of reduced susceptibility as noticed in this study, an observation that has been well documented in literature. [4],[5] The implication of high prevalence of multiple antibiotic resistance recorded in our study is that efficacy of the relatively cheap empirical therapy for typhoid fever patients in Nigeria is now doubtful and thus calls for urgent attention. More importantly, the increasing trends of MDR - Salmonella enterica serovar Typhi may spread to neighbouring countries of Africa and other parts of the world particularly among the travelers returning from this region, if the unprecedented upsurge remains unchecked. This study revealed increased circulation of MDR - Salmonella enterica serovar Typhi isolates over relatively short period. We suggest restriction and/or immediate stoppage, for a while, of the use of chloramphenicol and other first line antibiotics for the treatment for typhoid fever, to prevent possible emergence of resistance strains to relatively safe antimicrobials such as ciprofloxacin and ofloxacin in Nigeria.

 
 ~ References Top

1.Bauer AW, Kirby WM, Sherris JC, Turck M. Antibiotic susceptibility testing by a standardized single disk method. Am J Clin Pathol 1966; 45 :493-6.  Back to cited text no. 1  [PUBMED]  
2.National Committee for Clinical laboratory Standards, Performance standards for antimicrobial susceptibility testing. Ninth informational Supplement. NCCLS document No. 19-100-59. NCCLS: Wayne; 1999.  Back to cited text no. 2    
3.Saha SK, Saha S, Ruhulamin M, Hanif M, Islam M. Decreasing trend of multiresistant Salmonella typhi in Bangladesh. J Antimicrob Chemother 1997; 39 :554-6.  Back to cited text no. 3  [PUBMED]  [FULLTEXT]
4.Hakanem A, Kotilainen P, Huovinen P, Helenius H, Siitonens A. Reduced fluoroquinolene susceptibility in Salmonella enterica serotypes in travelers returning from southeast Asia. Emerg Infect Dis 2001; 7 :996-1003.  Back to cited text no. 4    
5.Akinyemi KO, Smith SI, Oyefolu AO, Coker AO. Multidrug resistance in Salmonella enterica serovar typhi isolated from patients with typhoid fever complications in Lagos, Nigeria. Public Health 2005; 119 :321-7.  Back to cited text no. 5  [PUBMED]  [FULLTEXT]



 
 
    Tables

  [Table - 1]

This article has been cited by
1 Multidrug-ResistantSalmonella entericaSerotype Typhi, Gulf of Guinea Region, Africa
Murielle Baltazar,Antoinette Ngandjio,Kathryn Elizabeth Holt,Elodie Lepillet,Maria Pardos de la Gandara,Jean-Marc Collard,Raymond Bercion,Ariane Nzouankeu,Simon Le Hello,Gordon Dougan,Marie-Christine Fonkoua,François-Xavier Weill
Emerging Infectious Diseases. 2015; 21(4)
[Pubmed] | [DOI]
2 Quinolone-resistant Salmonella Typhi in South Africa, 2003–2007
Smith, A.M., Govender, N., Keddy, K.H.
Epidemiology and Infection. 2010; 138(1): 86-90
[Pubmed] | [PDF]
3 Quinolone-resistant Salmonella Typhi in South Africa, 2003–2007
A. M. SMITH,N. GOVENDER,K. H. KEDDY
Epidemiology and Infection. 2010; 138(01): 86
[Pubmed] | [DOI]
4 Antimicrobial resistance in typhoidal and nontyphoidal salmonellae
Christopher M Parry,EJ Threlfall
Current Opinion in Infectious Diseases. 2008; 21(5): 531
[Pubmed] | [DOI]
5 Antimicrobial resistance in typhoidal and nontyphoidal salmonellae
Parry, C.M., Threlfall, E.J.
Current Opinion in Infectious Diseases. 2008; 21(5): 531-538
[Pubmed]
6 Foodborne Disease Trends and Reports
Peter Gerner-Smidt, Jean M. Whichard
Foodborne Pathogens and Disease. 2008; 5(4): 365
[VIEW] | [DOI]



 

Top
Print this article  Email this article
Previous article Next article

    

© 2004 - Indian Journal of Medical Microbiology
Published by Wolters Kluwer - Medknow

Online since April 2001, new site since 1st August '04