Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management.
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Veeraraghavan Balaji, Pragasam Agila K, Ray Pallab, Kapil Arti, Nagaraj Savitha, Perumal Sulochana Putli Bai, Saigal Karnika, Thomas Maria, Gupta Madhu, Rongsen-Chandola Temsunaro, Jinka Dasaratha Ramaiah, Shastri Jayanthi, Alexander Anna P, Koshy Roshine Mary, De Anuradha, Singh Ashita, Evelyn Ebenezer Sheena, Dutta Shanta, Bavdekar Ashish, More Deepak, Sanghavi Sonali, Nayakanti Raghuprakash Reddy, Jacob Jobin J, Amladi Anushree, Anandan Shalini, Abirami Baby S, Bakthavatchalam Yamuna D, Sethuvel Dhiviya P M, John Jacob, Kang Gagandeep
Аннотация
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.
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.
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.