Menezes G A, Harish B N, Khan M A, Goessens W, Hays J P
Department of Clinical Laboratory Sciences, College of Applied Medical Sciences, Molecular Diagnostics and Personalised Therapeutics Unit, Ha'il University, Hail, Kingdom of Saudi Arabia; Department of Microbiology, Institute of National Importance, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India, .
Indian J Med Microbiol. 2016 Apr-Jun;34(2):222-7. doi: 10.4103/0255-0857.180352.
Enteric fever is a public health problem with the upsurge in the occurrence of Salmonella isolates that are resistant to ciprofloxacin. In this study, a total of 284 blood culture isolates of S. Paratyphi A were investigated. Of these isolates, 281 (98.9%) were nalidixic acid resistant. A high rate (6.3%) of high-level resistance (≥ 4 μg/mL) was found to ciprofloxacin. The isolates with ciprofloxacin minimum inhibitory concentrations (MICs) of ≥ 12 μg/mL had 4 mutations, 2 mutations within the quinolone resistance-determining region of gyrA and 2 mutations also in parC. According to the Clinical Laboratory Standards Institute 2012 MIC breakpoints, 75.0% of isolates were resistant to ciprofloxacin. Finally, 3 major pulsed-field gel electrophoresis patterns were observed among the S. Paratyphi A isolates. The spread of fluoroquinolone resistant S. Paratyphi A necessitates a change toward 'evidence-based' treatment for enteric fever. The research provides a perspective on the increasing prevalence of antimicrobial resistant S. Paratyphi A isolates in this region of India.
由于对环丙沙星耐药的沙门氏菌分离株的出现有所增加，肠热症成为一个公共卫生问题。在本研究中，共调查了284株甲型副伤寒沙门氏菌的血培养分离株。在这些分离株中，281株（98.9%）对萘啶酸耐药。发现对环丙沙星的高水平耐药率（≥4μg/mL）较高（6.3%）。环丙沙星最低抑菌浓度（MIC）≥12μg/mL的分离株有4个突变，gyrA喹诺酮耐药决定区有2个突变，parC中也有2个突变。根据临床实验室标准协会2012年的MIC断点，75.0%的分离株对环丙沙星耐药。最后，在甲型副伤寒沙门氏菌分离株中观察到3种主要的脉冲场凝胶电泳模式。耐氟喹诺酮甲型副伤寒沙门氏菌的传播使得肠热症的治疗需要转向“循证”治疗。该研究提供了关于印度该地区耐抗菌药物甲型副伤寒沙门氏菌分离株患病率上升的一个视角。
