Reemergence of Chloramphenicol Sensitivity among Salmonella enterica serovars Typhi and Paratyphi : a six year experience in a tertiary care hospital in Nepal.

  • Niranjan Nayak Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
  • Rajani Shrestha Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
  • Dharm Raj Bhatta Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
  • Deependra Hamal Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
  • Supram Hosuru Subramanya Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal
  • Shishir Gokhale Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal

Abstract

Emerging drug resistance among Salmonella Typhi and Paratyphi has become challenging in the treatment of enteric fever. The objective of this study was to determine the antibiotic susceptibility pattern of Salmonella serotypes isolated from patients with enteric fever admitted to Manipal Teaching Hospital, Pokhara,Nepal. A total of 30 Salmonella enterica serovar Typhi, Paratyphi A, and Paratyphi B isolated from cases of typhoid and paratyphoid fever admitted to Manipal Teaching Hospital over a period from January 2012 to March 2018 were investigated. All strains were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility testing,using Kirby-Bauer disc diffusion method following the criteria designed by the Clinical and Laboratory Standards Institute (CLSI 2013). S Typhi was the most predominant amongst all the isolates (18 of 30 i.e. 60%), followed by S Paratyphi A (33.3%, 10 out of 30) and S Paratyphi B (6.6%; 2 out of 30). Overall, 91.3% of the isolates were susceptible to chloramphenicol. The percentage sensitivities towards ceftriaxone, ciprofloxacin, cotrimoxazole and ampicillin were 82.6%, 75.8%, 63% and 37% respectively. All the isolates were sensitive to imipenem and amikacin. These findings suggested that there were changing patterns of antibiotic resistance in enteric fever with reemergence of chloramphenicol sensitive Salmonellae. This necessitates continuous surveillance of cases and re-evaluation of chloramphenicol therapy in Salmonella infections in Nepal.

Keywords: Enteric fever, Salmonella, Chloramphenicol, Re-emergence of chloramphenicol sensitivity

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References

Arora, D., Singh, R., Kaur, M., Ahi, R.S. (2010). A changing pattern in antimicrobial susceptibility of Salmonella enterica serotype isolated in north India. African Journal of Microbiology Research.4, 197-203
Bauer, A.W., Kirby, W.M.M., Sherris, J.C.,Turck, M. (1966) Antibotic susceptibility testing by standardized single disc method. American Journal of Clinical Pathology. 45,493-6.
Bhatia, J.K., Mathur, A.D., Arora, M. M (2007) Re-emergence of chloramphenicol sensitivity in enteric fever. Medical Journal Armed Forces India. 63(3), 212-4.
Capoor, M.R. & Nair, D. (2010) Quinolone and cephalosporin resistance in enteric fever .Journal of Global Infectious disease.2 (3), 258-62.
Chau, T.T., Campbell, J.I., Galindo, C.M., Van Minh Hoang, N., Diep, T.S., Nga, T.T. et al. (2007) Antimicrobial drug resistance of Salmonella enterica serovar Typhi in Asia and molecular mechanism of reduced susceptibility to the fluoroquinolones. Antimicrobial Agents and Chemotherapy. 51(12), 4315-23.
Crump, J.A., Luby, S.P., Mintz, E.D. (2004). The global burden of typhoid fever. Bulletin World Health Organization. 82(5), 346-53.
Daga, M.K., Sarin, K., Sarkar, R. (1994). A study of culture positive multidrug resistant enteric fever-changing pattern and emerging resistance to ciprofloxacin. Journal of the Association of Physicians of India. 42(8), 599-600.
Ishaleku, D., Umeh, E.U., Amali, O., Gberikon, G.M. (2015). The re-emergence of chloramphenicol sensitive Salmonella species among typhoid fever patients in the southern geographical zone of Nasarawa state, Nigeria. Journal of Infectious Disease and Therapy. 3(3), 586-7
Joshi, S. & Amarnath, S.K. (2007) Fluoroquinolone resistance in Salmonella Typhi and S Paratyphi A in Bangalore, India. Transactions of the Royal Society of Tropical Medicine and Hygiene. 101(3), 308-10.
Khanal, B., Sharma, S. K., Bhattacharya, S.K., Bhattarai, N.R., Deb, M.,Kanungo,R. (2007). Antimicrobial susceptibility patterns of Salmonella enterica serotype Typhi in eastern Nepal. Journal of Health, Populaton and Nutriton. 25(1), 82-7.
Karki, S., Shakya. P., Cheng, A.C., Dumre, S.P., Leder, K. (2013). Trends of etiology and drug resistance in enteric fever in the last two decades in Nepal: A systematic review and metaanalysis. Cinical Infectious Disease. 57 (10), e167-76.
Mandal, S., Mandal, M.D., Pal, N.K. (2004) Reduced minimum inhibitory concentration of chloramphenicol for salmonella enterica serovar typhi. Indian Journal of Medical Sciences. 58 (1), 16-23.
Maskey A.P., Day, J.N., Phung,Q.T., Thwaites, G.E., Campbell, J.I., Zimmerman, M. et al. (2006) Salmonella enterica serovar Paratyphi A and S. enteric serovar Typhi cause indistinguishable clinical syndromes in Kathmandu, Nepal. Clinical Infectious Disease. 42(9), 1247–53.
Parry, C.M., Thuy, C.T., Dongol, S., Karkey, A., Vinh, H., Chinh, N.T. et al. (2010). Suitable disk antimicrobial susceptibility breakpoints defining Salmonella enterica serovar Typhi isolates with reduced susceptibility to fluoroquinolones. Antimicrobial Agents and Chemotherapy. 54(12), 5201–8.
Parry, C. M., Hien, T.T., Dougan, G., White, N.J., Farrar, J.J. et al. (2002) Typhoid Fever. New England Journal of Medicine. 347(22), 1770-82.
Prashant Khandeparkar. (2010) Reemergence of Chloramphenicol in Typhoid Fever In the Era of Antibiotic Resistance.SUPPLEMENT TO JAPI. (58), 45-46.
Prajapati, B., Rai, G. K., Rai, S. K., Upreti, H.C., Thapa, M., Singh, G., Shrestha, R. M. (2008) Prevalence of Salmonella typhi and paratyphi infection in children: a hospital based study; Nepal Medical College Journal.10 (4): 238-41.
Pokharel, B.M., Koirala, J., Dahal, R.K., Mishra, S.K., Khadga, P.K., Tuladhar, N.R. et al. (2006) Multidrug resistant and extended spectrum beta lactamase (ESBL) producing Salmonella enterica (serotypes Typhi and paratyphi A) from blood isolates in Nepal: Surveillance of resistance and a search for newer alternatives. International Journal of Infectious Disease. 10(6), 434-8.
Rauniar, G.P., Das, B.P., Baral, D.D., Naga Rani, M.A. et al. (2000) Treatment pattern of typhoid fever at a tertiary care teaching hospital in eastern Nepal. Journal of Nepal Medical Association. 39, 218- 21.
Sharma, N., Koju, R., Karmacharya, B., Tamang, M. D., Makaju, R., Nepali, N., et al. (2003). Typhoid fever in Dhulikhel hospital, Nepal. Kathmandu University Medical Journal. 2(3), 188-92
Sood, S., Kapil, A., Das, B., Jian, Y., Kabra, S. K. (1999) Reemergence of chloramphenicol sensitive Salmonella typhi. Lancet. 353(916), 1241-2.
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Nayak, N., Shrestha, R., Bhatta, D., Hamal, D., Subramanya, S., & Gokhale, S. (2018). Reemergence of Chloramphenicol Sensitivity among Salmonella enterica serovars Typhi and Paratyphi : a six year experience in a tertiary care hospital in Nepal. International Journal of Advancement in Life Sciences Research, 1(4), 8- 12. Retrieved from https://ijalsr.org/index.php/journal/article/view/36