Evaluation of minimum inhibitory concentration of quinolones and third generation cephalosporins to Salmonella typhi isolates.

A total of 323 Salmonella typhi isolates (261 isolates obtained during 1995-99 from Ludhiana and 62 randomly selected isolates obtained between 1980-99 from Chandigarh) were analyzed for drug resistant pattern. S. typhi isolates prior to 1986 were sensitive to all the antimicrobials tested by disc diffusion method. Most common multidrug resistance pattern noticed was ACCo T i.e. resistance to ampicillin, Chloramphenicol, cotrimoxazole and tetracycline. This study has revealed that withdrawal of chloramphenicol due to high level of resistance during 1990-94, has led to re-emergence of 43-93 percent chloramphenicol sensitive mutants during 1995-99. Two S. typhi isolates in 1995 and one in 1999 from Ludhiana depicted resistance to ciprofloxacin. Susceptibility of S. typhi isolates to third generation cephalosporins ranged between 87 to 100 per cent. There was a gradual increase with time period in mean minimum inhibitory concentration (MIC) of ciprofloxacin as it increased from 0.066 ug/ml for 1980-83 S. typhi isolates to 0.13 ug/ml for the 1996-99 isolates. Similarly, cefotaxime mean MIC for 1980-83 isolate was 0.172 ug/ml which further increased up to 0.32 ug/ml for S. typhi isolates encountered between 1996-99. In contrast, mean MIC value of 0.62 ug/ml of Ceftriaxone remained unchanged irrespective of the year of isolation of S. typhi isolates.

Changing pattern of biotypes, phage types & drug resistance of Salmonella typhi in Ludhiana during 1980-1999.

BACKGROUND & OBJECTIVES: Ludhiana, an industrial city of Punjab, has a large floating population where typhoid has become endemic. A retrospective study was carried out over a period of 20 years (1980-1999) at Ludhiana on the biotyping, phage typing and drug resistance pattern of Salmonella typhi. METHODS: Of a total of 1697 S. typhi isolates obtained, phage typing and biotyping were done of only 1243 isolates. Antimicrobial susceptibility pattern of these isolates was also studied. RESULTS: Of the 1243 S. typhi isolates, 963 (77.5%) and 280 (22.5%) were of biotype I and biotype II respectively. Twenty four different S. typhi phage types were prevalent in Ludhiana in the past two decades. Between 1980 and 1989, more prevalent phage types were phage type A (35%), O (17.6%) and E1 (15.1%). During 1990-1999, there was a considerable increase in the incidence of phage type E1 (48.1%). The cumulative analysis of past two decades revealed that the incidence of phage type E1 (38.8%) was most predominant. In the past one decade (1990-1999), 412 S. typhi isolates of 13 different phage types exhibited multidrug resistance (MDR) pattern ACCoT (resistant to ampicillin, chloramphenicol, co-trimoxazole and tetracycline). High chloramphenicol resistance (74.7%) and MDR pattern ACCoT (68.2%) was shown by phage type E1 of S. typhi. INTERPRETATION & CONCLUSION: An association was observed between drug resistance and phage type pattern of S. typhi as 70 per cent isolates of S. typhi phage types E1 and O exhibited ACCoT multidrug resistant pattern. Reemergence of chloramphenicol susceptibility in the last decade emphasizes the need for regular antimicrobial surveillance to minimize the misuse of these drugs.