Khan Sadia, Kurup Parvathy, Vinod Vivek, Biswas Raja, Pillai Gopala Krishna, Kumar Anil
Department of Microbiology, Amrita Institute of Medical Sciences, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
Amrita Centre for Nanosciences and Molecular Medicine, Amrita Vishwa Vidyapeetham, Kochi, Kerala, India.
J Lab Physicians. 2019 Jan-Mar;11(1):39-44. doi: 10.4103/JLP.JLP_99_18.
Enteric fever continues to be an important public health challenge for the developing world. With the emergence of fluoroquinolone resistance in spp. azithromycin is increasingly being used for oral treatment of enteric fever. We investigated the antibiotic susceptibility pattern of azithromycin in spp. isolates from a tertiary care hospital to detect emerging resistance.
The study assessed the reliability of disc diffusion as a screening test to detect azithromycin resistance by comparing it with the minimum inhibitory concentrations (MICs) of the drug in 100 spp. strains. The strains of spp. showing resistance to azithromycin were further investigated for resistance markers - , , and genes.
This study was conducted on 100 strains recovered from blood culture samples between 2013 and 2017. Among these isolates, 18 showed resistance to azithromycin by disc diffusion methodology with zones of inhibition <13 mm. MIC of 6 of these isolates were ≥32 mg/L. The mean MIC of azithromycin increased from 5 mg/L in 2013 to 24 mg/L in 2017. Azithromycin consumption as defined daily doses per 1000 patient days also showed an increase over the past 4 years.
Azithromycin disc diffusion diameter interpretations as recommended by Clinical and Laboratory Standards Institute can mislabel a few sensitive strains as resistant. Azithromycin resistance is emerging in typhoidal and nontyphoidal . gene is associated with high MICs in nontyphoidal spp.
伤寒热仍然是发展中世界面临的一项重要公共卫生挑战。随着 种中氟喹诺酮耐药性的出现，阿奇霉素越来越多地用于伤寒热的口服治疗。我们调查了阿奇霉素在一家三级护理医院分离出的 种中的抗生素敏感性模式，以检测新出现的耐药性。
该研究通过将纸片扩散法与100株 种菌株中该药物的最低抑菌浓度（MIC）进行比较，评估了纸片扩散法作为检测阿奇霉素耐药性筛选试验的可靠性。对显示对阿奇霉素耐药的 种菌株进一步研究耐药标志物—— 、 和 基因。
本研究对2013年至2017年从血培养样本中分离出的100株 菌株进行。在这些分离株中，18株通过纸片扩散法显示对阿奇霉素耐药，抑菌圈<13毫米。其中6株的MIC≥32毫克/升。阿奇霉素的平均MIC从2013年的5毫克/升增加到2017年的24毫克/升。以每1000患者日规定日剂量定义的阿奇霉素消耗量在过去4年中也有所增加。
临床和实验室标准协会推荐的阿奇霉素纸片扩散直径解释可能会将一些敏感菌株误标记为耐药菌株。伤寒和非伤寒 中正在出现阿奇霉素耐药性。 基因与非伤寒 种中的高MIC相关。
