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CORRESPONDENCE
Year : 2016  |  Volume : 34  |  Issue : 1  |  Page : 115-116
 

Current trend of antibiotic sensitivity of Salmonella typhi and other Salmonellae in Mumbai: A 5 years study


Department of Microbiology, Grant Medical College, Sir J.J. Group of Hospitals, Mumbai, Maharashtra, India

Date of Submission08-Jun-2014
Date of Acceptance28-Apr-2015
Date of Web Publication15-Jan-2016

Correspondence Address:
C A Chande
Department of Microbiology, Grant Medical College, Sir J.J. Group of Hospitals, Mumbai, Maharashtra
India
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Source of Support: None, Conflict of Interest: None


DOI: 10.4103/0255-0857.174100

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How to cite this article:
Chande C A, Chopdekar K A, Pradnya V, Unnati R, Jyoti B, Ritesh S, Shazia C, Joshi S G, Abhay C. Current trend of antibiotic sensitivity of Salmonella typhi and other Salmonellae in Mumbai: A 5 years study. Indian J Med Microbiol 2016;34:115-6

How to cite this URL:
Chande C A, Chopdekar K A, Pradnya V, Unnati R, Jyoti B, Ritesh S, Shazia C, Joshi S G, Abhay C. Current trend of antibiotic sensitivity of Salmonella typhi and other Salmonellae in Mumbai: A 5 years study. Indian J Med Microbiol [serial online] 2016 [cited 2020 Oct 22];34:115-6. Available from: https://www.ijmm.org/text.asp?2016/34/1/115/174100


Dear Editor,

 Salmonella More Details infections are endemic in most parts of India. In past four decades, variations have been observed in the antibiotic susceptibility of the Salmonella isolates. With the emergence of multidrug-resistant Salmonella enterica serovar typhi in 1980s and 1990s, Ciprofloxacin became the drug of choice for the treatment of enteric fever. Widespread use of Ciprofloxacin resulted in the emergence of strains with decreased susceptibility and finally into highly resistant strains.[1],[2] Azithromycin has been used as the preferred drug of choice in paediatric population where fluoroquinolones are contraindicated.

Isolates of Salmonella species recovered from blood of the patients admitted in a tertiary care hospital, Mumbai from 2009 to 2013 were identified and subjected to antibiotic susceptibility testing by modified Kirby–Bauer disc diffusion test referring Clinical and Laboratory Standards Institute guidelines.[3] The antibiotics tested were Ampicillin (10 mcg), Cotrimoxazole (25 mcg), Chloramphenicol (30 mcg), Ceftriaxone (30 mcg), Tetracycline (30 mcg), Ciprofloxacin (5 mcg). The isolates were tested for sensitivity to Azithromycin (15 mcg) employing European Committee on antimicrobial susceptibility testing disc diffusion guidelines for testing and interpretation [4] and were also tested for their minimum inhibitory concentrations (MIC) for Ciprofloxacin and Azithromycin. All Salmonella isolates were also subjected to the test for detection of extended spectrum beta-lactamases (ESBL).

A total of 129 strains of Salmonella species including 108 Salmonella typhi, 10 Salmonella serovar typhimurium, 07 Salmonella serovar enteritidis and 04 Salmonella serovar paratyphi. All were recovered during the 5 years span. All the  Salmonella typhimurium Scientific Name Search isolates were recovered from the paediatric patients. All S. typhi isolates were sensitive to Ampicillin, Cotrimoxazole, Chloramphenicol and Teracycline. Ciprofloxacin MIC in one strain was <0.03 mcg/ml, in 26 strains 0.25 mcg/ml and in 22 strains ≥8 mcg/ml indicating that 45.8% strains are highly Ciprofloxacin resistant. No ESBL were detected in any of S. typhi isolates. All the strains recovered during 2012 and 2013 were sensitive to Azithromycin by disc diffusion test. MIC for Azithromycin in all the strains was ≤4 mcg/ml. No multidrug-resistant strain was recovered in the last 5 years from this region.

All paratyphi A were resistant to Ciprofloxacin. Of the 10 typhimurium isolates, 5 were sensitive AMP, COT, T, CHL, CTR and CP, 3 strains showed resistance to COT, CHL and CP whereas 2 strains were resistant to only CP. All Salmonella enteritidis isolates were sensitive to all the drugs tested except for CP. Emergence of high-level Ciprofloxacin resistance has been reported in S. typhimurium.[5]

The antibiotic susceptibility profile is influenced by various factors including the selective pressure of the antibiotic commonly used. The various epidemiological studies conducted in India have shown that ciproflaxacin no longer be considered as the drug of choice. Azithromycin is viewed as an attractive alternative for the management of enteric infections. In view of the frequent use of Azithromycin and third generation Cephalosporins for the management of enteric fever, continuous monitoring of sensitivity profile of Salmonellae is required for deciding the antibiotic for empirical management.

 
 ~ References Top

1.
Shetty AK, Shetty IN, Furtado ZV, Antony B, Boloor R. Antibiogram of Salmonella isolates from blood with an emphasis on nalidixic Acid and chloramphenicol susceptibility in a tertiary care hospital in coastal Karnataka: A prospective study. J Lab Physicians 2012;4:74-7.  Back to cited text no. 1
[PUBMED]  Medknow Journal  
2.
Renuka K, Sood S, Das BK, Kapil A. High-level ciprofloxacin resistance in Salmonella enterica serotype typhi in India. J Med Microbiol 2005;54:999-1000.  Back to cited text no. 2
    
3.
Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing: 23rd Informational Supplement. CLSI Document M 100 – S23. Wayne, PA: Clinical and Laboratory Standards Institute; 2013.  Back to cited text no. 3
    
4.
European Committee on Antimicrobial Susceptibility Testing. Breakpoint Tables for Interpretation of MICs and Zone Diameters. (EUCAST website). Version 2.0, Valid from; 2012. Available from: http://www.eucast.org/fileadmin/src/media/PDFs/EUCAST_files/Disk_test_documents/EUCAST_breakpoints_v_2.0_111130.pdf. [Last accessed on 2015 Mar 25].  Back to cited text no. 4
    
5.
Giraud E, Cloeckaert A, Baucheron S, Mouline C, Chaslus-Dancla E. Fitness cost of fluoroquinolone resistance in Salmonella enterica serovar Typhimurium. J Med Microbiol 2003;52:697-703.  Back to cited text no. 5
    




 

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