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Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management.
- Source :
-
The Journal of infectious diseases [J Infect Dis] 2021 Nov 23; Vol. 224 (Supple 5), pp. S502-S516. - Publication Year :
- 2021
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Abstract
- Background: Systematic studies to estimate the disease burden of typhoid and paratyphoid in India are limited. Therefore, a multicenter study on the Surveillance of Enteric Fever in India was carried out to estimate the incidence, clinical presentation, and antimicrobial resistance (AMR) trend. The data presented here represent the national burden of AMR in Salmonella Typhi and Salmonella Paratyphi A.<br />Methods: Antimicrobial susceptibility testing was performed for S. Typhi and S. Paratyphi A (n = 2373) isolates collected prospectively during a 2-year period from November 2017 to January 2020.<br />Results: Of 2373 Salmonella isolates, 2032 (85.6%) were identified as S. Typhi and 341 (14.4%) were S. Paratyphi A. Approximately 2% of S. Typhi were multidrug-resistant (MDR), whereas all 341 (100%) of S. Paratyphi A isolates were sensitive to the first-line antimicrobials. Among 98% of ciprofloxacin nonsusceptible isolates, resistance (minimum inhibitory concentration [MIC] >0.5 µg/mL) was higher in S. Typhi (37%) compared with S. Paratyphi A (20%). Azithromycin susceptibility was 99.9% and 100% with a mean MIC of 4.98 μg/mL for S. Typhi and 7.39 μg/mL for S. Paratyphi A respectively. Ceftriaxone was the only agent that retained 100% susceptibility. Moreover, beta-lactam/beta-lactamase inhibitors showed potent in vitro activity against the study isolates.<br />Conclusions: Data obtained from this systematic surveillance study confirms the declining trend of MDR Salmonella isolates from India. The higher prevalence of ciprofloxacin nonsusceptibility enforces to limit its use and adhere to the judicious usage of azithromycin and ceftriaxone for enteric fever management.<br /> (© The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America.)
- Subjects :
- Anti-Bacterial Agents pharmacology
Anti-Bacterial Agents therapeutic use
Azithromycin pharmacology
Azithromycin therapeutic use
Ceftriaxone pharmacology
Ceftriaxone therapeutic use
Ciprofloxacin pharmacology
Ciprofloxacin therapeutic use
Drug Resistance, Bacterial
Humans
India epidemiology
Microbial Sensitivity Tests
Salmonella typhi
Salmonella paratyphi A
Typhoid Fever drug therapy
Typhoid Fever epidemiology
Subjects
Details
- Language :
- English
- ISSN :
- 1537-6613
- Volume :
- 224
- Issue :
- Supple 5
- Database :
- MEDLINE
- Journal :
- The Journal of infectious diseases
- Publication Type :
- Academic Journal
- Accession number :
- 35238369
- Full Text :
- https://doi.org/10.1093/infdis/jiab144