Public Health Laboratory London, Public Health England, Barts Health NHS Trust, The Royal London Hospital, Department of Infection, 3rd Floor Pathology & Pharmacy Building, 80 Newark Street, London E1 2ES, UK.
Centre of Immunology and Infectious Disease, Blizard Institute, Barts and The London School of Medicine & Dentistry, Queen Mary University of London, UK.
Travel Med Infect Dis. 2015 May-Jun;13(3):230-4. doi: 10.1016/j.tmaid.2015.04.001. Epub 2015 Apr 23.
The study sought evidence for changes in the proportions of antibiotic resistant strains among isolates of Salmonella enterica serovar Typhi (S. typhi) and Salmonella enterica serovar Paratyphi (S. paratyphi) between 2005 and 2012.
Blood culture isolates of S. typhi and S. paratyphi from patients attending Newham and The Royal London Hospitals were included in the study. The organisms were cultured on selective media and identified by Maldi-ToF, API 20E and serology. Minimum inhibitory concentrations (MICs) of augmentin, chloramphenicol, co-trimoxazole, ceftriaxone, ciprofloxacin and azithromycin were determined by E tests for 194 isolates.
Median MICs of ciprofloxacin and ceftriaxone were stable at 0.5 mg/L and 0.125 mg/L, respectively. Chloramphenicol, azithromycin, co-trimoxazole and augmentin median MICs were 4 mg/L, 8 mg/L, 0.064 mg/L and 0.5 mg/L, respectively. MIC90 values were lower than the resistant breakpoint for ceftriaxone, azithromycin and augmentin, but were >256 mg/L for chloramphenicol, 32 mg/L for co-trimoxazole and 1 mg/L for ciprofloxacin.
Antibiotic resistance remained stable for enteric fever isolates between 2005 and 2012. The isolates remained susceptible to augmentin, ceftriaxone and azithromycin over this period, but the MIC90 was greater than the resistant breakpoint for chloramphenicol, cotrimoxazole and ciprofloxacin. The implications for clinical practice are that isolates of S. typhi and S. paratyphi from East London remain sensitive to ceftriaxone and azithromycin.
本研究旨在寻找 2005 年至 2012 年间，肠炎沙门氏菌血清型 Typhi（S. typhi）和肠炎沙门氏菌血清型 Paratyphi（S. paratyphi）分离株中抗生素耐药株比例的变化证据。
本研究纳入了在纽汉和伦敦皇家医院就诊的患者的血培养 S. typhi 和 S. paratyphi 分离株。这些细菌在选择性培养基上培养，并用基质辅助激光解吸电离飞行时间质谱法（Maldi-ToF）、API 20E 和血清学进行鉴定。对 194 株分离株进行了氨苄西林、氯霉素、复方磺胺甲噁唑、头孢曲松、环丙沙星和阿奇霉素的最低抑菌浓度（MIC）E 试验。
环丙沙星和头孢曲松的中位 MIC 分别稳定在 0.5mg/L 和 0.125mg/L。氯霉素、阿奇霉素、复方磺胺甲噁唑和氨苄西林的中位 MIC 分别为 4mg/L、8mg/L、0.064mg/L 和 0.5mg/L。MIC90 值低于头孢曲松、阿奇霉素和氨苄西林的耐药折点，但>256mg/L 氯霉素、32mg/L 复方磺胺甲噁唑和 1mg/L 环丙沙星。
2005 年至 2012 年间，肠热病分离株的抗生素耐药性保持稳定。在此期间，分离株对氨苄西林、头孢曲松和阿奇霉素仍敏感，但 MIC90 大于氯霉素、复方磺胺甲噁唑和环丙沙星的耐药折点。这对临床实践的影响是，来自东伦敦的 S. typhi 和 S. paratyphi 分离株对头孢曲松和阿奇霉素仍然敏感。
