scholarly journals Ciprofloxacin treatment failure in a case of typhoid fever caused by Salmonella enterica serotype Paratyphi A with reduced susceptibility to ciprofloxacin

2007 ◽  
Vol 56 (2) ◽  
pp. 277-279 ◽  
Author(s):  
Tzonyo Dimitrov ◽  
Edet E. Udo ◽  
Osama Albaksami ◽  
Abdul A. Kilani ◽  
El-Din M. R. Shehab
Keyword(s):  
Typhoid Fever ◽  
Treatment Failure ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Susceptibility Testing ◽  
Laboratory Methods ◽  
New Guidelines ◽  
Oral Ciprofloxacin

This report describes a case of ciprofloxacin treatment failure in a patient with enteric fever caused by Salmonella enterica serotype Paratyphi A. The organism was isolated from a blood culture from a patient who was treated with oral ciprofloxacin (500 mg every 12 h) for 13 days. The organism showed reduced susceptibility to ciprofloxacin (MIC 0.75 μg ml−1) and was resistant to nalidixic acid. The patient was then placed on intravenous ceftriaxone (1 g every 12 h) and responded within 3 days. The patient was discharged after 9 days on ceftriaxone with no relapse on follow-up. This case adds to the increasing incidence of treatment failures with ciprofloxacin in typhoid fever caused by typhoid salmonellae with reduced susceptibility to ciprofloxacin. It also highlights the inadequacy of current laboratory methods for fluoroquinolone susceptibility testing in adequately predicting in vivo activity of ciprofloxacin against typhoid salmonellae and supports calls for new guidelines for fluoroquinolone susceptibility testing of these organisms.

scholarly journals Highly Resistant Salmonella enterica Serovar Typhi with a NovelgyrAMutation Raises Questions about the Long-Term Efficacy of Older Fluoroquinolones for Treating Typhoid Fever

2012 ◽  
Vol 56 (5) ◽  
pp. 2761-2762 ◽  
Author(s):  
Kanika Deshpande Koirala ◽  
Duy Pham Thanh ◽  
Sudeep Dhoj Thapa ◽  
Amit Arjyal ◽  
Abhilasha Karkey ◽  
...  
Keyword(s):  
Multidrug Resistance ◽  
Typhoid Fever ◽  
Treatment Failure ◽  
Salmonella Enterica ◽  
Systemic Infection ◽  
Resistant Isolate ◽  
Content Type ◽  
Salmonella Enterica Serovar Typhi ◽  
Term Efficacy

ABSTRACTAs a consequence of multidrug resistance, clinicians are highly dependent on fluoroquinolones for treating the serious systemic infection typhoid fever. While reduced susceptibility to fluoroquinolones, which lessens clinical efficacy, is becoming ubiquitous, comprehensive resistance is exceptional. Here we report ofloxacin treatment failure in typhoidal patient infected with a novel, highly fluoroquinolone-resistant isolate ofSalmonella entericaserovar Typhi. The isolation of this organism has serious implications for the long-term efficacy of ciprofloxacin and ofloxacin for typhoid treatment.

scholarly journals The Salmonella enterica Serovar Typhi Type IVB Self-Association Pili Are Detached from the Bacterial Cell by the PilV Minor Pilus Proteins

2006 ◽  
Vol 74 (9) ◽  
pp. 5414-5418 ◽  
Author(s):  
Connie K. P. Tam ◽  
Christina Morris ◽  
Jim Hackett
Keyword(s):  
Typhoid Fever ◽  
Bacterial Cell ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Dna Supercoiling ◽  
Bacterial Membrane ◽  
Salmonella Enterica Serovar Typhi ◽  
Protein Molecules ◽  
Dna Fragment ◽  
Self Association

ABSTRACT Salmonella enterica serovar Typhi and some strains (Vi+) of serovar Dublin use type IVB pili to facilitate bacterial self-association, but only when the PilV proteins (potential minor pilus proteins) are not synthesized. Pilus-mediated self-association may be important in the pathogenesis of enteric fever. We have shown previously that the extent of DNA supercoiling controls the rate of Rci-catalyzed inversion of a DNA fragment which includes the C-terminal portions of the PilV proteins. This inversion therefore controls PilV synthesis as a high inversion rate prohibits transcription of pilV-encoding DNA. Here, we describe the manner in which PilV protein expression inhibits bacterial self-association and present data which suggest that incorporation of one or a few PilV protein molecules into a growing pilus, comprised of PilS subunits, causes the pilus to detach at the bacterial membrane. The bacteria are then unable to self-associate. We suggest that this phenomenon may be relevant to the pathogenesis of typhoid fever.

scholarly journals In Vivo Acquisition of Ceftriaxone Resistance in Salmonella enterica Serotype Anatum

2003 ◽  
Vol 47 (2) ◽  
pp. 563-567 ◽  
Author(s):  
Lin-Hui Su ◽  
Cheng-Hsun Chiu ◽  
Chishih Chu ◽  
Mei-Hui Wang ◽  
Ju-Hsin Chia ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Salmonella Enterica ◽  
Antimicrobial Agents ◽  
Nucleotide Sequence Analysis ◽  
Molecular Fingerprinting ◽  
Severe Problem ◽  
E Coli ◽  
Tract Infections ◽  
Emergence Of Resistance

ABSTRACT The emergence of resistance to antimicrobial agents within the salmonellas is a worldwide and severe problem. A case of treatment failure due to the emergence of resistance to ceftriaxone in Salmonella enterica serotype Anatum was studied. S. enterica serotype Anatum and Escherichia coli, both of which are susceptible to ceftriaxone, were initially isolated from a diabetic patient hospitalized for the treatment of wound and urinary tract infections. Resistant S. enterica serotype Anatum and E. coli strains were isolated concomitantly 2 weeks after the initiation of ceftriaxone therapy. The patient eventually died of a sepsis caused by the ceftriaxone-resistant salmonella. PCR, nucleotide sequence analysis, and DNA-DNA hybridization identified a bla CTX-M-3 gene located on a 95.1-kb plasmid from the ceftriaxone-resistant isolates of S. enterica serotype Anatum and E. coli. The plasmid was proved to be conjugative. Molecular fingerprinting showed that the susceptible and resistant strains were genetically indistinguishable. The emergence of resistance to ceftriaxone in S. enterica serotype Anatum was due to the in vivo acquisition of a plasmid containing the bla CTX-M-3 gene and was the cause for treatment failure in this patient.

Treatment failure in typhoid fever with ciprofloxacin susceptible Salmonella enterica Serotype Typhi

2004 ◽  
Vol 49 (1) ◽  
pp. 1-3 ◽  
Author(s):  
Priscilla Rupali ◽  
O.C. Abraham ◽  
Mary V. Jesudason ◽  
T.Jacob John ◽  
Anand Zachariah ◽  
...  
Keyword(s):  
Typhoid Fever ◽  
Treatment Failure ◽  
Salmonella Enterica

scholarly journals Salmonella Extracellular Matrix Components Influence Biofilm Formation and Gallbladder Colonization

2016 ◽  
Vol 84 (11) ◽  
pp. 3243-3251 ◽  
Author(s):  
Haley E. Adcox ◽  
Erin M. Vasicek ◽  
Varun Dwivedi ◽  
Ky V. Hoang ◽  
Joanne Turner ◽  
...  
Keyword(s):  
Extracellular Matrix ◽  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Biofilm Formation ◽  
Bacterial Survival ◽  
Content Type ◽  
Extracellular Matrix Components ◽  
Matrix Components

Salmonella enterica serovar Typhi, the causative agent of typhoid fever in humans, forms biofilms encapsulated by an extracellular matrix (ECM). Biofilms facilitate colonization and persistent infection in gallbladders of humans and mouse models of chronic carriage. Individual roles of matrix components have not been completely elucidated in vitro or in vivo . To examine individual functions, strains of Salmonella enterica serovar Typhimurium, the murine model of S . Typhi, in which various ECM genes were deleted or added, were created to examine biofilm formation, colonization, and persistence in the gallbladder. Studies show that curli contributes most significantly to biofilm formation. Expression of Vi antigen decreased biofilm formation in vitro and virulence and bacterial survival in vivo without altering the examined gallbladder pro- or anti-inflammatory cytokines. Oppositely, loss of all ECM components (Δ wcaM Δ csgA Δ yihO Δ bcsE ) increased virulence and bacterial survival in vivo and reduced gallbladder interleukin-10 (IL-10) levels. Colanic acid and curli mutants had the largest defects in biofilm-forming ability and contributed most significantly to the virulence increase of the Δ wcaM Δ csgA Δ yihO Δ bcsE mutant strain. While the Δ wcaM Δ csgA Δ yihO Δ bcsE mutant was not altered in resistance to complement or growth in macrophages, it attached and invaded macrophages better than the wild-type (WT) strain. These data suggest that ECM components have various levels of importance in biofilm formation and gallbladder colonization and that the ECM diminishes disseminated disease in our model, perhaps by reducing cell attachment/invasion and dampening inflammation by maintaining/inducing IL-10 production. Understanding how ECM components aid acute disease and persistence could lead to improvements in therapeutic treatment of typhoid fever patients.

scholarly journals Salmonella enterica Serovar Paratyphi C Carries an Inactive Shufflon

2004 ◽  
Vol 72 (1) ◽  
pp. 22-28 ◽  
Author(s):  
Connie K. P. Tam ◽  
Jim Hackett ◽  
Christina Morris
Keyword(s):  
Typhoid Fever ◽  
Base Pair ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Terminal Region ◽  
Inverted Repeats ◽  
Single Base ◽  
Single Base Pair ◽  
Self Association ◽  
Base Pair Insertion

ABSTRACT Salmonella enterica serovar Typhi uses type IVB pili to facilitate bacterial self-association, but only when the PilV proteins (potential minor pilus proteins) are not synthesized. This pilus-mediated event may be important in typhoid fever pathogenesis. We initially show that S. enterica serovar Paratyphi C strains harbor a pil operon very similar to that of serovar Typhi. An important difference, however, is located in the shufflon which concludes the pil operon. In serovar Typhi, the Rci recombinase acts upon two 19-bp inverted repeats to invert the terminal region of the pilV gene, thereby disrupting PilV synthesis and permitting bacterial self-association. In serovar Paratyphi C, however, the shufflon is essentially inactive because each of the Rci 19-bp substrates has acquired a single base pair insertion. A PilV protein is thus synthesized whenever the pil operon is active, and bacterial self-association therefore does not occur in serovar Paratyphi C. The data thus suggest that serovar Typhi bacterial self-association using type IVB pili may be important in the pathogenesis of epidemic enteric fever.

scholarly journals Azithromycin susceptibility testing of Salmonella enterica serovar Typhi: impact on management of enteric fever

2021 ◽  
pp. 100069
Author(s):  
Jordan P. Skittrall ◽  
David Levy ◽  
Christian Obichukwu ◽  
Amy Gentle ◽  
Marie A. Chattaway ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Susceptibility Testing ◽  
Salmonella Enterica Serovar Typhi

Azithromycin susceptibility testing for Salmonella enterica isolates: discordances in results using MIC gradient strips

2020 ◽  
Vol 75 (7) ◽  
pp. 1820-1823
Author(s):  
Jennifer Goldblatt ◽  
Andrew Ward ◽  
Mohammed Yusuf ◽  
Martin Day ◽  
Gauri Godbole ◽  
...  
Keyword(s):  
Salmonella Enterica ◽  
Antibiotic Susceptibility ◽  
Enteric Fever ◽  
Susceptibility Testing ◽  
Reference Laboratory ◽  
Diagnostic Laboratory ◽  
Gastrointestinal Bacteria ◽  
Point Of Intersection ◽  
Azithromycin Resistance ◽  
Reader System

Abstract Background Azithromycin resistance is emerging in typhoidal Salmonella. Confirmation of azithromycin MIC is the most frequent antibiotic susceptibility request made to the Gastrointestinal Bacteria Reference Unit (GBRU) laboratory in England by local diagnostic laboratories. Objectives (i) Determine concordance between local diagnostic and reference laboratory estimations of azithromycin MIC by gradient strip in Salmonella enterica serovars Typhi and Paratyphi. (ii) Consider causes of variation. Methods Isolates from patients with enteric fever attending a central London hospital between May 2011 and April 2019 were tested for azithromycin susceptibility using gradient strips, according to EUCAST methodology. Matched local diagnostic and reference laboratory estimations of azithromycin and ciprofloxacin (as a comparator) MICs were included; concordance in estimations was examined. Results Local diagnostic laboratory readings overestimated azithromycin MIC values compared with the reference laboratory, resulting in poor concordance in susceptibility/resistance attribution (concordant susceptibility interpretation in 8/19, κ = 0). In contrast, ciprofloxacin MIC estimation demonstrated superior concordance (concordant susceptibility interpretation in 16/17, κ = 0.85). None of the isolates was resistant to azithromycin at the reference laboratory and no known genes associated with azithromycin resistance were detected in any isolate using WGS. Conclusions Overestimation of azithromycin resistance is likely to be due to difficulty in interpreting the point of intersection of the ‘trailing edge’ with the gradient strip, used to determine MIC. We advise local diagnostic laboratories to review their experience and consider adopting a ‘second reader’ system to mitigate this.

scholarly journals In Vivo and In Vitro Efficacy of Amodiaquine Monotherapy for Treatment of Infection by Chloroquine-Resistant Plasmodium vivax

2008 ◽  
Vol 53 (3) ◽  
pp. 1094-1099 ◽  
Author(s):  
A. R. Hasugian ◽  
E. Tjitra ◽  
A. Ratcliff ◽  
H. Siswantoro ◽  
E. Kenangalem ◽  
...  
Keyword(s):  
Treatment Failure ◽  
Plasmodium Vivax ◽  
Inhibitory Concentration ◽  
Rank Correlation ◽  
Early Treatment Failure ◽  
Rural Clinic ◽  
Treatment Of Infection

ABSTRACT Amodiaquine retains efficacy against infection by chloroquine-resistant Plasmodium falciparum; however, little information is available on its efficacy against infection by chloroquine-resistant Plasmodium vivax. Patients presenting to a rural clinic with a pure P. vivax infection that recurred after recent antimalarial treatment were retreated, this time with amodiaquine monotherapy, and the risk of further recurrence within 4 weeks was assessed. Of the 87 patients with pure P. vivax infection, 15 patients did not complete a full course of treatment, 4 of whom were intolerant to treatment. In the 72 patients completing treatment, 91% (63 of 69) had cleared their parasitemia within 48 h with no early treatment failure. Follow-up to day 28 or recurrent parasitemia was achieved for 56 patients (78%). The cumulative incidence of treatment failure by day 28 was 22.8% (95% confidence interval, 7.3 to 38%). The in vitro sensitivity profile was determined for a separate set of isolates from outpatients with pure P. vivax infection. The median 50% inhibitory concentration of amodiaquine was 11.3 nM (range, 0.37 to 95.8) and was correlated significantly with that of chloroquine (Spearman rank correlation coefficient, 0.602; P < 0.001) Although amodiaquine results in a rapid clinical response, the risk of recurrence by day 28 is unacceptably high, reducing its suitability as an alternative treatment of infection by chloroquine-resistant P. vivax in this region.

scholarly journals Clinical Profile of Enteric Fever in Children of a Tertiary Care Centre in Kathmandu, Nepal

2020 ◽  
Vol 3 (2) ◽  
pp. 122-127
Author(s):  
Sunil Budhathoki ◽  
Satyam Rimal ◽  
Lopsang Lama ◽  
Sabina Shrestha ◽  
Seshananda Sanjel ◽  
...  
Keyword(s):  
Abdominal Pain ◽  
Typhoid Fever ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
College Teaching ◽  
Common Finding ◽  
Female Ratio ◽  
Laboratory Parameters ◽  
Common Features ◽  
Loose Motion

Background: Enteric fever, commonly known as typhoid fever is a global public health problem. It is one of the common infectious diseases of humans, fever lasting for more than 7 days. It is transmitted by faecooral route and common in the areas with poor sanitation. Globally, majority of the Typhoid fever is caused by Salmonella enterica var typhi, one fifth of the infection is caused by Salmonella enterica var paratyphi. This study was conducted to describe clinical and laboratory parameters among children with enteric fever. Methods: It was a descriptive cross-sectional study conducted in the Pediatric ward and Pediatric Intensive Care Unit (PICU) of Nepal Medical College Teaching Hospital (NMCTH), Atterkhel, Kathmandu, Nepal from 2015 January to 2015 December. Inclusion criteria: clinical details and laboratory parameters of children aged 13 months to 15 years old with diagnosis of enteric fever was obtained in the proforma and descriptive statistics were calculated. Result: A total of 1,020 children with the sign and symptom suggestive of enteric fever were admitted in the inpatient department (Pediatrics) during the study period. All the enteric fever suspected children were tested for blood culture, Widal test and complete blood count, out of them 80 children were diagnosed as enteric fever. Male female ratio is 1.6:1. Fever was the most common clinical feature observed in 95% cases and other common features were loose motion (37.5%), vomiting (33.8%) and abdominal pain (27.5%). Hepato-splenomegaly is common finding of Enteric fever reported in 85.0% and 43.7%. Majority of the patients had normal leucocyte count (71.0%) and leucopenia reported in 20.0%. Conclusion: Fever and hepato-splenomegaly were the major clinical presentation of typhoid fever in our study. Other less common features were loose motion, vomiting and abdominal pain. This finding may be useful for the pediatrician and other health professionals for the early diagnosis of enteric fever.  

Sign in / Sign up

Export Citation Format

Share Document