scholarly journals Is Antimicrobial Resistance Pattern of Enteric Fever Changing in Kathmandu Valley?

2013 ◽  
Vol 32 (3) ◽  
pp. 221-228
Author(s):  
Ganesh Kumar Rai ◽  
Subhana Karki ◽  
Bina Prajapati
Keyword(s):  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Resistance Pattern ◽  
Kathmandu Valley ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern

Introduction: Enteric fever is a public health problem in developing countries including Nepal. Antimicrobial sensitivity pattern of Salmonella sp causing enteric fever is changing over time and also differs according to geographical location. Periodic surveillance of antimicrobial resistance of Salmonella sp is mandatory for management of enteric fever rationally. The objective of this study was to analyze the resistance pattern of Salmonella sp to commonly used antimicrobials. Materials and Methods: This was a retrospective study undertaken reviewing the records of blood isolates of Salmonella sp over one year period at Kanti Children’s Hospital, Nepal. Antimicrobial sensitivity testing was done following Kirby Bauer’s disk diffusion technique using Muller Hinton agar. Results: Salmonella typhi was found to be 100% resistance to ampicillin and resistance to nalidixic acid and ciprofloxacin was also high. The resistance to chloramphenicol and ofloxacin was low. No resistance was found to amoxicillin, ceftriaxone, cefotaxime and amikacin. However, among the sensitive isolates of Salmonella typhi intermediate sensitivity to ceftriaxone and ceftazidime was reported to be high. Among the isolates of S paratyphi A, the resistance to nalidixic acid was 100% followed by 75% to ciprofloxacin. No resistance was found to chloramphenicol, ceftriaxone, cefixime, amikacin and low resistance to amoxicillin and ofloxacin. Among the sensitive isolates of S paratyphi A, majority of them were only moderately sensitive to cefotaxime and ceftazidime and about 1/3 of the organisms had only intermediate sensitivity to ceftriaxone. Conclusiion: Commonly used parenteral third generation cephalosporins, first line drugs like chloramphenicol and amoxicillin and ofloxacin among fluoroquinolones were found to be effective in vitro in treating enteric fever. However, Salmonella typhi was found to be highly resistant to the most frequently used drugs like ciprofloxacin and cefixime and Salmonella paratyphi A to ciprofloxacin. A comparative chart of antimicrobial sensitivity of enteric fever in children over 10 year period from different hospitals of Kathmandu valley is also presented in the study. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6625 J. Nepal Paediatr. SocVol.32(3) 2012 221-228

scholarly journals Antimicrobial sensitivity patterns of salmonella typhi in children

2016 ◽  
Vol 15 (3) ◽  
pp. 416-418
Author(s):  
Md Khoyber Ali ◽  
Shahin Sultana
Keyword(s):  
Blood Culture ◽  
Nalidixic Acid ◽  
Medical Science ◽  
Antibiotic Sensitivity ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Diffusion Method ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern

Background: Enteric fever is an important public health problem in developing countries including Bangladesh. A changing antibiotic sensitivity pattern of Salmonella typhi and emergence of resistance has increased to a great concern. Objective: Aim of the study was to investigate the antibiotic sensitivity pattern of Salmonella typhi. Methods: A total of 181 Salmonella typhi samples from 5 to 15 years age group were collected from blood culture during the period of October to December 2014 from IBN SINA Hospital, Dhaka, Bangladesh. Specimens from the blood culture were identified by standard procedures as needed. Antimicrobial susceptibility testing was performed by disk diffusion method according to ‘The Clinical Laboratory Standard Institute’ guidelines. Results: Among the tested antibiotics, S. typhi was susceptible to ceftriaxone 100%, followed by cefixime and gentamicin 99.4%, ciprofloxacin 98.6%, cotrimoxazole 88.9%, azithromycin 88.4 % and least susceptible antibiotic was Ampicillin 62.5% and nalidixic acid 5%. Conclusion: The antimicrobial sensitivity testing showed that the Salmonella typhi were highly sensitive (>88%) to most of the drugs used in this study, whereas nalidixic acid showed only 5% sensitivity. So this study indicates that ceftriaxone, cefixime, gentamicin and ciprofloxacin can be used as a first line therapy and nalidixic acid should be avoided for treatment.Bangladesh Journal of Medical Science Vol.15(3) 2016 p.416-418

scholarly journals Antimicrobial Sensitivity Pattern of Salmonella spp. Clinical Isolates in Blood Culture: A Tertiary Center Study

2020 ◽  
Vol 11 (2) ◽  
pp. 134-137
Author(s):  
ABM Shakil Gani ◽  
Ayman Wadud ◽  
Mizanur Rahman ◽  
Sushmita Roy ◽  
Selin Aktari
Keyword(s):  
Blood Culture ◽  
Enteric Fever ◽  
Salmonella Typhi ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Local Resistance ◽  
Salmonella Spp ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern ◽  
Tertiary Center

Objective: Bangladesh is an endemic area for enteric fever. Adequate and timely antimicrobial treatment invariably cures this disease. But resistant strains of Salmonella spp. have made it difficult to treat nowadays. This study will help clinicians in understanding the local resistance pattern of enteric fever and identifying recent changes in the trends of the sensitivity pattern of commonly used antibiotics in Bangladesh. Materials and Methods: This cross-sectional study was conducted during the period from January 2016 to June 2019 in Sheikh Hasina Medical College, Tangail, to determine the antimicrobial sensitivity patterns of Salmonella typhi and paratyphi isolated by blood culture from clinically suspected typhoid fever patients. The blood sample was processed on BACTEC 9050 and isolates obtained from subculture were serotyped. Then antibiotic susceptibility testing was carried out using the disk diffusion method. Results and Discussion: A total of 137 cases were recorded in four years. All cephalosporins were found sensitive in more than 90% of cases. We did not find any resistance to Ceftriaxone in our patients’ group. Moxifloxacin and Levofloxacin showed higher sensitivity than Ciprofloxacin (100% and 96% Vs 90%). Nalidixic acid demonstrated lower sensitivity than previously reported (less than 5%), while Gentamicin showed the highest sensitivity around 100%. Conclusion: Multidrug-resistant (MDR) Salmonella typhi and paratyphi are emerging rapidly. To overcome this global issue, rational use of antibiotics has to be ensured. Physicians should also be aware of the local resistance pattern so that they can treat their patients effectively. J Shaheed Suhrawardy Med Coll, December 2019, Vol.11(2); 134-137

scholarly journals A study on Nalidixic Acid Resistant Salmonella among the patients attending Shree Birendra Hospital

2012 ◽  
Vol 10 (2) ◽  
pp. 1-3 ◽  
Author(s):  
Raina Chaudhary ◽  
Khagendra Sijapati ◽  
Sunil Kumar Singh
Keyword(s):  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Brain Heart Infusion ◽  
Public Health Problem ◽  
Diffusion Method ◽  
Disc Diffusion ◽  
Diffusion Test ◽  
Sensitivity Pattern

Introduction: Enteric fever is the commonest public health problem in developing countries like Nepal. Multi Drug Resistant Salmonella isolates are in vitro susceptible to Quinolone but exhibited a higher Minimum Inhibitory Concentration in vivo. Such phenomenon can be demonstrated by simple disc diffusion test of Nalidixic Acid which shows resistance. This study is conducted to determine prevalence of Nalidixic Acid Resistant Salmonella with their anti biotic sensitivity pattern at Shree Birendra Hospital, Chauni, kathmandu. Method: Of total 3945 blood samples from the patients suspected to have enteric fever were collected during the period of January 2011 to August 2011. Then it was mixed with Brain Heart Infusion , further processed according to standard methodology and their anti microbial susceptibility was performed by Kirby-Bauer disc diffusion method. Results: From 3945 samples, 280 (7.09%) showed positi ve growth, 114 (40.7%) Salmonella enterica serotype Typhi and 166 (59.2%) Salmonella enterica serotype Paratyphi A. a total of 221 (78.92%) were Nalidixic Acid Resistant Salmonella, all these strains were sensitive to Ciprofloxcin and Ofloxacin in disc diffusion test. Conclusion: Study showed a higher frequency of Nalidixic Acid Resistant Salmonella among the patients. screening of Nalidixic Acid disc diffusion test must be done as routine work for determination of low level resistance of Quinolone so as to decide the drug for the treatment of enteric fever. DOI: http://dx.doi.org/10.3126/mjsbh.v10i2.6453 Medical Journal of Shree Birendra Hospital July-Dec 2011 10(2) 1-3

scholarly journals Prevalent Bacteria and Their Sensitivity and Resistance Pattern to Antibiotics: A Study in Dhaka Medical College Hospital

2017 ◽  
Vol 26 (1) ◽  
pp. 52-64
Author(s):  
Mohammad Zaid Hossain ◽  
Akhtarun Naher ◽  
Pratyay Hasan ◽  
Kazi Tuba E Mozazfia ◽  
Homyra Tasnim ◽  
...  
Keyword(s):  
Nalidixic Acid ◽  
Antibiotic Sensitivity ◽  
Sampling Technique ◽  
Salmonella Typhi ◽  
Medical College Hospital ◽  
Resistance Pattern ◽  
College Hospital ◽  
Medical College ◽  
Sensitivity Pattern ◽  
Changes Over Time

Background and rationale: Antibiotic resistance is a global problem. Many factors are complexly related to the issue in multiple dimensions. Bangladesh is right in the middle of this great calamity, and is seeing the rise in resistant strains of several bacteria. Very sadly, the prevalent malpractice of abusing antibiotics in Bangladesh contributes to add complexity to the danger which may prove to be possibly the greatest threat humans have ever faced. There is much scarcity of medical literature in Bangladesh, on the antibiotic sensitivity pattern and prevalent microorganisms. Moreover, antibiotic sensitivity pattern changes over time and place. Again, most of the studies done in Bangladesh, concentrate on a single disease, pathogen, or specimen. This study attempts to see the prevalent microorganisms and the antibiotic sensitivity pattern in multiple types of specimens collected from Dhaka Medical College Hospital. This study also attempts to establish a way of presentation of the relevant findings which can be used in future to ensure easy comparability and contrasting of findings.Methods: The specimens were collected from the adult patients (age >12 years) admitted in the Internal Medicine ward of Dhaka Medical College Hospital, Dhaka, over a period of 6 months. The sampling technique was consecutive sampling method. Specimens which were culture positive, were only included in the study for analysis. Multiple specimens were taken.Results: S. aureus was 100% sensitive to amikacin, moxifloxacin, imipenem, meropenem, piperacillin+tazobactum combination, vancomycin, doxycycline, tetracycline, tigecycline, nitrofurantoin, azactum, linezolid and 100% resistant to cefixime. Enterobacter was 100% sensitive to penicillin, amikacin, gentamicin, netilmicin, doxycycline, tetracycline, tigecycline and 100% resistant to cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, levofloxacin, vancomycin. E. coli was 100% sensitive to imipenem, meropenem, vancomycin, tigecycline and 100% resistant to mecillinam, aztreonam. Klebsiella was 100% sensitive to flucloxacillin, colistin, vancomycin, tigecycline, linezolid and 100% resistant to nalidixic acid. Proteus was 100% sensitive to cephradine, cefoxitin, cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, amikacin, ciprofloxacin, imipenem, meropenem, netilmicin, piperacillin+tazobactum combination, tetracycline, tigecycline, azithromycin, azactum and 100% resistant to doxycycline, tetracycline, chloramphenicol and cefuroxime. Pseudomonas was 100% sensitive only to amikacin, netilmicin, and 100% resistant to cefixime, ceftazidime, ceftriaxone, cefepime, cotrimoxazole, gentamicin, ciprofloxacin, levofloxacin, imipenem, meropenem, doxycline, tetracycline, chloramphenicol. Salmonella typhi was 100% sensitive to amoxicillin, cefoxitin, cefixime, ceftriaxone, cefepime, cotrimoxazole, amikacin, netilmicin, azithromycin, chloramphenicol, azactum and 100% resistant to cephradine, doxycycline, tetracycline, nalidixic acid. MRSA was 100% sensitive to imipenem, vancomycin, teicoplanin, nitrofurantoin, linezolid and 100% resistant to cefpirome, cefoxitin, ceftazidime, cotrimoxazole, clindamycin, gentamicin, ciprofloxacin, netilmicin, tetracycline, clarithromycin. Acinetobacter was 100% sensitive to penicillin, cefuroxime, colistin, piperacillin+tazobactum combination, tigecycline, chloramphenicol and 100% resistant to cefixime, nalidixic acid. Citrobacter freundii was 100% sensitive to ceftazidime, ceftriaxone, cotrimoxazole, amikacin, gentamicin, ciprofloxacin, levofloxacin, imipenem, meropenem, netilmicin, nalidixic acid and 100% resistant to ampicillin, cefixime, nitrofurantoin.Conclusion: More and more antibiotics are becoming ineffective due to emergence of resistance. Serious actions should be taken. Awareness should be raised from the policy maker level to the physicians and patients.J Dhaka Medical College, Vol. 26, No.1, April, 2017, Page 52-64

scholarly journals Antimicrobial resistance in non-typhoidal salmonellas from humans in Northern Ireland, 2001–2003: standardization needed for better epidemiological monitoring

2006 ◽  
Vol 135 (4) ◽  
pp. 675-680 ◽  
Author(s):  
G. ONG ◽  
I. WILSON ◽  
B. SMYTH ◽  
P. ROONEY
Keyword(s):  
Northern Ireland ◽  
Antimicrobial Resistance ◽  
Susceptibility Testing ◽  
Treatment Options ◽  
Resistance Pattern ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Epidemiological Monitoring ◽  
Testing Practices ◽  
Third Generation Cephalosporins

SUMMARYThis study investigated the identification and antimicrobial susceptibility testing of Salmonella isolates in Northern Ireland during 2001–2003. All six participating hospital laboratories used similar methods. Identification and antimicrobial resistance of human enteric (n=897) Salmonella isolates were analysed by retrospective collation of laboratory records. Resistance of human Salmonella isolates to nalidixic acid was 16% but resistance to ciprofloxacin or cefotaxime was rare (<1%). Minor inter-laboratory variations in sensitivity testing practices make it difficult to compare antimicrobial sensitivity results reliably and also to monitor for epidemic clones such as S. Typhimurium DT104 with the ACSSuT resistance pattern. The outcome of this study was the adoption of a standardized regional approach to the isolation of salmonella antimicrobial resistance. This should improve epidemiological monitoring of epidemic clones and assure optimum treatment options are available. In cases of treatment failure, MICs to third-generation cephalosporins and ciprofloxacin should be determined.

scholarly journals Antimicrobial Resistance ofSalmonella entericaSerovars Typhi and Paratyphi Isolates from a General Hospital in Karawaci, Tangerang, Indonesia: A Five-Year Review

2017 ◽  
Vol 2017 ◽  
pp. 1-7 ◽  
Author(s):  
Nata Pratama Hardjo Lugito ◽  
Cucunawangsih
Keyword(s):  
Antimicrobial Resistance ◽  
General Hospital ◽  
Enteric Fever ◽  
Adult Population ◽  
Public Health Problem ◽  
Resistance Pattern ◽  
Global Public Health ◽  
Prevalent Disease ◽  
Paratyphoid Fever ◽  
Resistance Rates

Typhoid and paratyphoid fever known as enteric fever pose important global public health problem, with 21.6 million cases and approximately 250,000 deaths annually. It is a prevalent disease in Indonesia, but data on the antimicrobial resistance pattern is limited. This study aim was to provide data on the antimicrobial resistance pattern ofS.Typhi andS.Paratyphi bloodstream isolates in a general hospital in Karawaci, Tangerang, Banten, Indonesia, during the period of January 2011 to December 2015. Susceptibility against antimicrobials was detected according to the guidelines of the Clinical and Laboratory Standards Institute (CLSI). Out of a total of 168 isolates 55.4% wereS.Typhi and 44.6%S.Paratyphi A. Most of the isolates, 92.9%, were from children aged 6–18 years and adult population. There was low resistance ofS.Typhi against ampicillin, trimethoprim-sulfamethoxazole, ceftriaxone, ciprofloxacin, and levofloxacin, similar to previous studies in Indonesia. In the 2011–2015 period, resistance rates against most antimicrobials and MDR rate ofS.Typhi andS.Paratyphi were low, emphasizing that there is a distinct epidemiological dynamic of the enteric fever in Indonesia.

scholarly journals Epidemiology of Typhoid and Paratyphoid Fever in Kathmandu : Two Years Study and Trends of Antimicrobial Resistance

2005 ◽  
Vol 44 (157) ◽  
Author(s):  
S Malla ◽  
P Kansakar ◽  
Serichantalergs Serichantalergs ◽  
M Rahman ◽  
S Basnet
Keyword(s):  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Tetracycline Resistance ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Resistance Pattern ◽  
Drug Resistant ◽  
Diffusion Technique ◽  
Plasmid Analysis ◽  
Paratyphoid Fever

Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major healthproblem. Appropriate antibiotics are essential for the treatment of typhoid and paratyphoid fever. Aprospective study was carried out to characterize the epidemiological features of enteric fever in Kathmandu,Nepal and to analyse the recent trend of antimicrobial resistance pattern of the Salmonella isolated from thecases of enteric fever from different hospitals in Kathmandu during June, 2002 to June, 2004. A total of 1469Salmonella typhi and Salmonella paratyphi ‘A’ isolates collected during this period from five different hospitallaboratories situated in Kathmandu were studied. The antimicrobial susceptibilities of the isolates towardsAmpicillin (10mcg), Chloramphenicol (30mcg), Cotrimoxazole (25mcg), Ciprofloxacin (5mcg) and Ceftriaxone(5mcg) were determined by standard disc diffusion technique and Agar dilution technique were used todetermine the minimum inhibitory concentration (MIC) for Ampicillin, Ciprofloxacin, Chloramphenicoland Ceftriaxone. All the isolates tested were found to be sensitive to Ceftriaxone and Ciprofloxacin, the mostcommonly used antibiotic for treatment of enteric fever in Nepal. Of the total isolates studied, 15.5% from2002, 8% from 2003 and 3.45% from 2004 were found to be multidrug resistant (exhibiting resistance towardsAmpicillin, Chloramphenicol and Cotrimoxazole). Of the total multi drug resistant Salmonella isolates, 92%were Salmonella typhi. All the multidrug resistant isolates were also further tested for susceptibilities towardsTetracycline (30mcg), Nalidixic acid (30 mcg), Streptomycin (10units), Gentamycin (25mcg), Azithromycin(15mcg), Kanamycin (30mcg), Neomycin (30mcg). 50% of the multi drug resistant Salmonella typhi werealso resistant to Tetracycline. Plasmid analysis revealed that all of the Mutidrug resistant Salmonella typhiisolates with Tetracycline resistance harbored a large molecular weight (147 Kb) plasmid.Key Words: Enteric fever, Salmonella, Antibiotic, Plasmid, Multidrugresistant

scholarly journals Salmonella Typhi Infections and Effect of Fluroquinolones and Third Generation Cephalosporins in Clinical Outcome

1970 ◽  
Vol 31 (3) ◽  
pp. 216-221 ◽  
Author(s):  
UK Singh ◽  
AK Neopane ◽  
M Thapa ◽  
N Aryal ◽  
K Agrawal
Keyword(s):  
Public Health ◽  
Nalidixic Acid ◽  
Health Problem ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Third Generation ◽  
Third Generation Cephalosporins ◽  
Culture Positive

Background: Enteric fever is a common public health problem in Nepal. The emerging fluoroquinolone resistance to Salmonella typhi is a major concern in every hospital and is a public health problem these days. Continuous antibiotic susceptibility patterns surveillance and standard treatment policies need to be established to control MDR typhoid. Objective: To detect the increasing pattern of fluoroquinolone resistant Salmonella typhi and to correlate its clinical response to third generation cephalosporins. Materials and Method: This is a cross- sectional prospective study conducted in the pediatric ward of Birendra Hospital, Kathmandu, from September 2009 to August 2010. Forty seven children aged between 3-14 years with the diagnosis of suspected, probable and confirmed cases of Enteric fever were enrolled in the study. Data was collected and statistical analysis was done using SPSS program. Result: Culture positive enteric fever was found in 21 cases (44.68%) and positive Widal test in 18 (38.29%). Among the culture positive cases, antibiotic sensitivity was highest for Ofloxacin (95.23%), followed by third generation Cephalosporins (Ceftriaxone, Cefixime) (90.47%). A significant number of isolates were resistant to Nalidixic acid (71.42%). All cases were successfully treated with parenteral antibiotics followed by oral third generation cephalosporins without any complications and/or mortality. Conclusion: There is an increasing trend to fluoroquinolone resistant Salmonella typhi. Third generation cephalosporin can be the appropriate antibiotic for treatment.of clinically suspected cases of Enteric fever and to minimize the risk of increasing emergence of MDR enteric fever including Nalidixic acid resistant Typhoid.(NARST). Key words: Cephalosporin; drug resistance; Enteric fever; Fluoroquinolone; Salmonella typhi. DOI: http://dx.doi.org/10.3126/jnps.v31i3.5361 J Nep Paedtr Soc 2011;31(3): 216-221

scholarly journals Methicillin-Resistant Staphylococcus aureus (MRSA): Prevalence and Antimicrobial Sensitivity Pattern among Patients—A Multicenter Study in Asmara, Eritrea

2019 ◽  
Vol 2019 ◽  
pp. 1-9 ◽  
Author(s):  
Eyob Yohaness Garoy ◽  
Yacob Berhane Gebreab ◽  
Oliver Okoth Achila ◽  
Daniel Goitom Tekeste ◽  
Robel Kesete ◽  
...  
Keyword(s):  
Staphylococcus Aureus ◽  
Public Health Problem ◽  
Cross Sectional Study ◽  
Resistance Pattern ◽  
Multiple Drug ◽  
Cross Sectional ◽  
Methicillin Resistant ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern ◽  
Referral Hospitals

Background. Methicillin-resistant Staphylococcus aureus (MRSA) is a well-recognized public health problem throughout the world. The evolution of new genetically distinct community-acquired and livestock-acquired MRSA and extended resistance to other non-β-lactams including vancomycin has only amplified the crisis. This paper presents data on the prevalence of MRSA and resistance pattern to other antibiotics on the selected specimen from two referral hospitals in Asmara, Eritrea. Method. A cross-sectional study was conducted among 130 participants recruited from two referral hospitals in Asmara, Eritrea. Isolation of S. aureus was based on culture and biochemical profiles. Standard antimicrobial disks representing multiple drug classes were subsequently set for oxacillin, gentamicin, erythromycin, and vancomycin. Data were analyzed using SPSS version 20 software. Results. S. aureus isolation rate from the 130 samples was 82 (63.1%). Patients <18 years of age were more likely to be colonized by S. aureus compared to patients above 61 years. The proportion of MRSA among the isolates was 59 (72%), methicillin-intermediate S. aureus (MISA) was 7 (8.5%), and methicillin-sensitive S. aureus (MSSA) was 15 (19.5%). The isolates were mostly from the pus specimen in burn, diabetic, and surgical wound patients. Antimicrobial susceptibility test showed that 13 (15.9%) of the isolates were resistant to vancomycin, 9 (11.0%) to erythromycin, and 1 (1.2%) to gentamicin. Coresistance of MRSA isolates to some commonly used antibiotics was also noted: oxacillin/erythromycin 5 (6.1%) and oxacillin/vancomycin 9 (11%). A few isolates were resistant to oxacillin/vancomycin/erythromycin 2 (2.4%) and oxacillin/gentamicin and erythromycin 1 (1.2%). Conclusion. This study reports a relatively high prevalence of MRSA. Isolates that are resistant to other tested antibiotics including vancomycin are also reported. The data have important implication for quality of patients care in the two settings: antibiotic selection and infection control practices, and the need for additional studies.

scholarly journals Phylogenomics and antimicrobial resistance of Salmonella Typhi and Paratyphi A, B and C in England, 2016–2019

2021 ◽  
Vol 7 (8) ◽  
Author(s):  
Marie Anne Chattaway ◽  
Amy Gentle ◽  
Satheesh Nair ◽  
Laura Tingley ◽  
Martin Day ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Health Management ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Content Type ◽  
Recent Emergence

The emergence of antimicrobial resistance (AMR) to first- and second-line treatment regimens of enteric fever is a global public-health problem, and routine genomic surveillance to inform clinical and public-health management guidance is essential. Here, we present the prospective analysis of genomic data to monitor trends in incidence, AMR and travel, and assess hierarchical clustering (HierCC) methodology of 1742 isolates of typhoidal salmonellae. Trend analysis of Salmonella Typhi and S. Paratyphi A cases per year increased 48 and 17.3%, respectively, between 2016 and 2019 in England, mainly associated with travel to South Asia. S. Paratyphi B cases have remained stable and are mainly associated with travel to the Middle East and South America. There has been an increase in the number of S. Typhi exhibiting a multidrug-resistant (MDR) profile and the emergence of extensively drug resistant (XDR) profiles. HierCC was a robust method to categorize clonal groups into clades and clusters associated with travel and AMR profiles. The majority of cases that had XDR S. Typhi reported recent travel to Pakistan (94 %) and belonged to a subpopulation of the 4.3.1 (H58) clone (HC5_1452). The phenotypic and genotypic AMR results showed high concordance for S. Typhi and S. Paratyphi A, B and C, with 99.99 % concordance and only three (0.01 %) discordant results out of a possible 23 178 isolate/antibiotic combinations. Genomic surveillance of enteric fever has shown the recent emergence and increase of MDR and XDR S. Typhi strains, resulting in a review of clinical guidelines to improve management of imported infections.

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