印度南部一家三级医院肠沙门氏菌血清型的抗菌药敏性。
Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in southern India.
机构信息
Department of Infectious Diseases, Apollo Hospitals, Chennai, India.
出版信息
Indian J Med Res. 2013 Apr;137(4):800-2.
BACKGROUND & OBJECTIVES: Salmonella enterica serovars Typhi and Paratyphi are predominantly known to cause enteric fever. Multidrug resistance in S. Tphi and S. Paratyphi has emerged as a cause of concern. This study was done to evaluate status in antimicrobial susceptibility patterns of Salmonella enterica serovar Typhi (S. Typhi) and S. Paratyphi obtained from blood culture in a tertiary care hospital in south India.
METHODS
Blood isolates of Salmonella species over a two year period between May 2009 and June 2011 were studied. A total of 322 isolates of Salmonella species were tested for antimicrobial susceptibility by Kirby-Bauer disc diffusion method. The MIC of ciprofloxacin was obtained by E-test, and azithromycin MIC was confirmed by agar dilution method for a limited number of isolates.
RESULTS
Of the total of 322 isolates studied, 186 (57.8%) were S. Typhi, 134 (41.6%) were S. Paratyphi A, and two were S. Paratyphi B. Of these, 44(13.66%) were resistant to ciprofloxacin (MIC <0.50 μg/ml) and 296 (91.9%) were nalidixic acid resistant. Of these 296 nalidixic acid resistant isolates, 278 (94%) were susceptible to ciprofloxacin by MIC criteria (<0.5 μg/ml). Of the 262 isolates tested for azithromycin sensitivity, only 120 (46%) were susceptible, whereas 81 (31%) were resistant and 55 (21%) showed intermediate susceptibility. Of the isolates, 322 (90%) were susceptible to ampicillin and (95%) were susceptible to co-trimoxazole. However, all the isolates were susceptible to chloramphenicol and ceftriaxone.
INTERPRETATION & CONCLUSIONS: Nalidixic acid resistance screening is not a reliable surrogate indicator of ciprofloxacin resistance. Ciprofloxacin MIC should to be routinely done. Azithromycin resistance appears to be emerging. However, isolates showed a high degree of susceptibility to ampicillin, co-trimoxazole and chloramphenicol. Thus, antibiotics like ampicillin and co-trimoxazole may once again be useful for the management of enteric fever in southern India.
背景与目的
肠伤寒沙门氏菌血清型 Typhi 和 Paratyphi 主要引起肠热病。肠伤寒沙门氏菌和 Paratyphi 沙门氏菌的多药耐药性已成为令人关注的问题。本研究旨在评估印度南部一家三级护理医院从血液培养中获得的肠伤寒沙门氏菌血清型 Typhi（S. Typhi）和 S. Paratyphi 的抗菌药物敏感性模式现状。
方法
在 2009 年 5 月至 2011 年 6 月的两年期间，研究了沙门氏菌属的血液分离株。采用 Kirby-Bauer 圆盘扩散法对 322 株沙门氏菌属进行了抗菌药物敏感性测试。采用 E 试验法测定环丙沙星的 MIC，对有限数量的分离株采用琼脂稀释法确证阿奇霉素 MIC。
结果
在总共 322 株研究的分离株中，186 株（57.8%）为 S. Typhi，134 株（41.6%）为 S. Paratyphi A，2 株为 S. Paratyphi B。其中，44 株（13.66%）对环丙沙星（MIC <0.50 μg/ml）耐药，296 株（91.9%）对萘啶酸耐药。在这 296 株耐萘啶酸的分离株中，278 株（94%）按 MIC 标准（<0.5 μg/ml）对环丙沙星敏感。在 262 株检测阿奇霉素敏感性的分离株中，只有 120 株（46%）敏感，81 株（31%）耐药，55 株（21%）中介。所有分离株均对氨苄西林敏感（90%），对复方新诺明敏感（95%）。然而，所有分离株均对氯霉素和头孢曲松敏感。
结论
萘啶酸耐药筛查不是环丙沙星耐药的可靠替代指标。应常规进行环丙沙星 MIC 检测。阿奇霉素耐药性似乎正在出现。然而，分离株对氨苄西林、复方新诺明和氯霉素表现出高度敏感性。因此，氨苄西林和复方新诺明等抗生素可能再次对印度南部肠热病的治疗有用。
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