Azithromycin resistance mechanisms in typhoidal salmonellae in India: A 25 years analysis

Autor: Bhavana Kumari, Sambuddha Kumar, Arti Kapil, Sangeeta Pandey, Umay Kulsum, Punit Kaur, Bimal Kumar Das, Priyanka Sharma, Neelam Manral, Sushila Dahiya, Seema Sood
Jazyk: angličtina
Rok vydání: 2019
Předmět:
0301 basic medicine
medicine.drug_class
030106 microbiology
Antibiotics
India
enteric fever
lcsh:Medicine
Drug resistance
Biology
Antimicrobial resistance - azithromycin - enteric fever - resistance mechanism - Salmonella - typhoid
Antimicrobial resistance
Azithromycin
Salmonella typhi
General Biochemistry
Genetics and Molecular Biology
Typhoid fever
Microbiology
Macrolide Antibiotics
03 medical and health sciences
Minimum inhibitory concentration
0302 clinical medicine
Bacterial Proteins
Salmonella
Drug Resistance
Bacterial
medicine
Humans
030212 general & internal medicine
Typhoid Fever
azithromycin
lcsh:R
Salmonella enterica
General Medicine
bacterial infections and mycoses
medicine.disease
Multiple drug resistance
Salmonella paratyphi A
Mutation
Original Article
typhoid
resistance mechanism
medicine.drug
Zdroj: Indian Journal of Medical Research, Vol 149, Iss 3, Pp 404-411 (2019)
The Indian Journal of Medical Research
ISSN: 0971-5916
Popis: Background & objectives: Azithromycin has been in use as an alternate treatment option for enteric fever even when the guidelines on the susceptibility testing were not available. There is lack of data on susceptibility and mechanisms of resistance of azithromycin in Salmonella Typhi and S. Paratyphi A. The aim of the present study was to determine the azithromycin susceptibility and resistance mechanisms in typhoidal salmonellae isolates archived in a tertiary care centre in north India for a period of 25 years. Methods: Azithromycin susceptibility was determined in 602 isolates of S. Typhi (469) and S. Paratyphi A (133) available as archived collection isolated during 1993 to 2016, by disc diffusion and E-test method.PCR was done for ereA, ermA, ermB, ermC, mefA, mphA and msrA genes from plasmid and genomic DNA and sequencing was done to detect mutations in acrR, rplD and rplV genes. Results: Azithromycin susceptibility was seen in 437/469 [93.2%; 95% confidence interval (CI), 90.5 to 95.1%] isolates of S. Typhi. Amongst 133 isolates of S. Paratyphi A studied, minimum inhibitory concentration (MIC) of ≤16 mg/l was found in 102 (76.7%; 95% CI, 68.8 to 83.0). MIC value ranged between 1.5 and 32 mg/l with an increasing trend in MIC50 and MIC90 with time. Mutations were found in acrR in one and rplV in two isolates of S. Typhi. No acquired mechanism for macrolide resistance was found. Interpretation & conclusions: Azithromycin could be considered as a promising agent against typhoid fever on the basis of MIC distribution in India. However, due to emergence of resistance in some parts, there is a need for continuous surveillance of antimicrobial susceptibility and resistance mechanisms. There is also a need to determine the breakpoints for S. Paratyphi A.
Databáze: OpenAIRE
Externí odkaz:
Nepřihlášeným uživatelům se plný text nezobrazuje