Title: Changing Trends in Antibiotic Resistance Profile of Salmonella enteritica species in a Tertiary Care Hospital in Central Kerala
Authors: Dr Reena John, Dr Anupama Sethumadhavan, Dr Prithi Nair.K
DOI: https://dx.doi.org/10.18535/jmscr/v5i10.06
Abstract
Background: Infections due to salmonella is an important cause of significant morbidity and mortality in many developing countries. Salmonella Typhi being the major causative agent and affects roughly 21.6 million people each year.
Objective: A retrospective study was conducted to analyze the antibiotic sensitivity pattern of Salmonella enterica species isolated from clinical specimen from a tertiary care hospital.
Materials and Methods: A total of 39 Salmonella enterica species isolated from the blood and stool samples were analyzed from the period of 2011 January to 2017 June. Patients were in the age group of 2-63 years. Salmonella Typhi was the predominant isolate 74% (29). These isolates were tested for antimicrobial susceptibility according to the CLSI guidelines.
Results: No Multidrug resistant (MDR) strains were isolated where as sensitivity to Ciprofloxacin and Azithromycin decreased gradually since 2012.
Conclusion: Since 1987, when ciprofloxacin was approved for clinical use, fluoroquinolones (FQs) have been widely prescribed for a diverse range of infections, including bacterial enteritis and typhoid fever. A broad antibacterial spectrum, favorable safety profile, and excellent oral absorption have contributed to the popularity of these agents. However, marked increases in FQ resistance were observed within a decade of the introduction of these agents, and Salmonella infections have typified this trend. A careful consideration should be given before deciding the antibiotic for treatment in order to prevent the emergence of antibiotic resistance.
Keywords: Salmonella enterica, Flouroquinalone, Azithromycin , Multidrug resistance.
References
- WHO Estimate 2016
- Nath etal. Drug resistance patterns in Salmonella enterica subspecies enterica serotype Typhi strains isolated over a period of two decades, with special reference to ciprofloxacin and ceftriaxone. Int J Antimicrob Agents. 2010;35(5):482-85
- Clinical and Laboratory Standards Institute (CLSI).
- Choudhary A, Gopalakrishnan R, Nambi PS, Ramasubramanian V, Ghafur KA, Thirunarayan MA. Antimicrobial suscepti-bility of Salmonella enterica serovars in a tertiary care hospital in southern India. Indian J Med Res. 2013;137(4):800–802.
- Verma S, Thakur S, Kanga A, Singh G, Gupta P. Emerging Salmonella paratyphi A enteric fever and changing trends in antimicrobial Antimicrobial susceptibility profile,resistance pattern of Salmonella in Shimla. Indian J Med Microbiol. 2010;28(1):51–53.
- Manchanda V, Bhalla P, Sethi M, Sharma VK. Treatment of enteric fever in children on the basis of current trends of antimicrobial susceptibility of Salmonella enterica serovar typhi and paratyphi A. Indian J Med Microbiol. 2006;24(2):101–106.
- Mohanty S, Renuka K, Sood S, Das BK, Kapil A. Antibiogram pattern and seasonality of Salmonella serotypes in a North Indian tertiary care hospital. Epidemiol Infect. 2006;134(5):961–966. Epub 2006 Feb 14.. [PMC free article]
- Singhal L, Gupta PK, Kale P, Gautam V, Ray P. Trends in antimicrobial susceptibility of Salmonella Typhi from North India (2001–2012)Indian J Med Microbiol. 2014;32(2):149–152. [PubMed]
- Tankhiwale SS, Agrawal G, Jalgaonkar SV. An unusually high occurrence of Salmonella enterica serotype paratyphi A in patients with enteric fever. Indian J Med Res 2003;117:10-2.
- Rudresh SM, Nagarathnamma T. Antibiotic susceptibility pattern of Salmonella enterica serovar typhi and Salmonella enterica serovar paratyphi A with special reference to quinolone resistance. Drug Dev Ther. 2015;6:70–73.
- Rai S, Jain S, Prasad KN, Ghoshal U, Dhole TN. Rationale of azithromycin prescribing practices for enteric fever in India. Indian J Med Microbiol. 2012;30(1):30–33.
- Yashavanth R, Vidyalakshmi K.The re-emergence of chloramphenicol sensitivity among enteric fever pathogens in Manga-lore. J Clin Diagn Res 2010;(4); 3106-8.
- GuptaV, Kaur J, Chander J. An increase in enteric fever cases due to Salmonella Paratyphi Ain &around Chandigarh. Indian J Med Res 2009;129(1) 95-8.
- Prajapati B, Rai GK, Rai SK, Upreti HC, Thapa M, Singh G,et al. Prevalence of Salmonella typhi and paratyphi infection in children: a hospital based study. Nepal Med Coll J 2008; 10(4): 238-41.