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Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management

BACKGROUND: Systematic studies to estimate the disease burden of typhoid and paratyphoid in India are limited. Therefore, a multicenter study on the Surveillance of Enteric Fever in India was carried out to estimate the incidence, clinical presentation, and antimicrobial resistance (AMR) trend. The...

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Autores principales: Veeraraghavan, Balaji, Pragasam, Agila K, Ray, Pallab, Kapil, Arti, Nagaraj, Savitha, Perumal, Sulochana Putli Bai, Saigal, Karnika, Thomas, Maria, Gupta, Madhu, Rongsen-Chandola, Temsunaro, Jinka, Dasaratha Ramaiah, Shastri, Jayanthi, Alexander, Anna P, Koshy, Roshine Mary, De, Anuradha, Singh, Ashita, Evelyn Ebenezer, Sheena, Dutta, Shanta, Bavdekar, Ashish, More, Deepak, Sanghavi, Sonali, Nayakanti, Raghuprakash Reddy, Jacob, Jobin J, Amladi, Anushree, Anandan, Shalini, Abirami, Baby S, Bakthavatchalam, Yamuna D, Sethuvel, Dhiviya P M, John, Jacob, Kang, Gagandeep
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2021
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892543/
https://www.ncbi.nlm.nih.gov/pubmed/35238369
http://dx.doi.org/10.1093/infdis/jiab144
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author Veeraraghavan, Balaji
Pragasam, Agila K
Ray, Pallab
Kapil, Arti
Nagaraj, Savitha
Perumal, Sulochana Putli Bai
Saigal, Karnika
Thomas, Maria
Gupta, Madhu
Rongsen-Chandola, Temsunaro
Jinka, Dasaratha Ramaiah
Shastri, Jayanthi
Alexander, Anna P
Koshy, Roshine Mary
De, Anuradha
Singh, Ashita
Evelyn Ebenezer, Sheena
Dutta, Shanta
Bavdekar, Ashish
More, Deepak
Sanghavi, Sonali
Nayakanti, Raghuprakash Reddy
Jacob, Jobin J
Amladi, Anushree
Anandan, Shalini
Abirami, Baby S
Bakthavatchalam, Yamuna D
Sethuvel, Dhiviya P M
John, Jacob
Kang, Gagandeep
author_facet Veeraraghavan, Balaji
Pragasam, Agila K
Ray, Pallab
Kapil, Arti
Nagaraj, Savitha
Perumal, Sulochana Putli Bai
Saigal, Karnika
Thomas, Maria
Gupta, Madhu
Rongsen-Chandola, Temsunaro
Jinka, Dasaratha Ramaiah
Shastri, Jayanthi
Alexander, Anna P
Koshy, Roshine Mary
De, Anuradha
Singh, Ashita
Evelyn Ebenezer, Sheena
Dutta, Shanta
Bavdekar, Ashish
More, Deepak
Sanghavi, Sonali
Nayakanti, Raghuprakash Reddy
Jacob, Jobin J
Amladi, Anushree
Anandan, Shalini
Abirami, Baby S
Bakthavatchalam, Yamuna D
Sethuvel, Dhiviya P M
John, Jacob
Kang, Gagandeep
author_sort Veeraraghavan, Balaji
collection PubMed
description BACKGROUND: Systematic studies to estimate the disease burden of typhoid and paratyphoid in India are limited. Therefore, a multicenter study on the Surveillance of Enteric Fever in India was carried out to estimate the incidence, clinical presentation, and antimicrobial resistance (AMR) trend. The data presented here represent the national burden of AMR in Salmonella Typhi and Salmonella Paratyphi A. METHODS: Antimicrobial susceptibility testing was performed for S. Typhi and S. Paratyphi A (n = 2373) isolates collected prospectively during a 2-year period from November 2017 to January 2020. RESULTS: Of 2373 Salmonella isolates, 2032 (85.6%) were identified as S. Typhi and 341 (14.4%) were S. Paratyphi A. Approximately 2% of S. Typhi were multidrug-resistant (MDR), whereas all 341 (100%) of S. Paratyphi A isolates were sensitive to the first-line antimicrobials. Among 98% of ciprofloxacin nonsusceptible isolates, resistance (minimum inhibitory concentration [MIC] >0.5 µg/mL) was higher in S. Typhi (37%) compared with S. Paratyphi A (20%). Azithromycin susceptibility was 99.9% and 100% with a mean MIC of 4.98 μg/mL for S. Typhi and 7.39 μg/mL for S. Paratyphi A respectively. Ceftriaxone was the only agent that retained 100% susceptibility. Moreover, beta-lactam/beta-lactamase inhibitors showed potent in vitro activity against the study isolates. CONCLUSIONS: Data obtained from this systematic surveillance study confirms the declining trend of MDR Salmonella isolates from India. The higher prevalence of ciprofloxacin nonsusceptibility enforces to limit its use and adhere to the judicious usage of azithromycin and ceftriaxone for enteric fever management.
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spelling pubmed-88925432022-03-04 Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management Veeraraghavan, Balaji Pragasam, Agila K Ray, Pallab Kapil, Arti Nagaraj, Savitha Perumal, Sulochana Putli Bai Saigal, Karnika Thomas, Maria Gupta, Madhu Rongsen-Chandola, Temsunaro Jinka, Dasaratha Ramaiah Shastri, Jayanthi Alexander, Anna P Koshy, Roshine Mary De, Anuradha Singh, Ashita Evelyn Ebenezer, Sheena Dutta, Shanta Bavdekar, Ashish More, Deepak Sanghavi, Sonali Nayakanti, Raghuprakash Reddy Jacob, Jobin J Amladi, Anushree Anandan, Shalini Abirami, Baby S Bakthavatchalam, Yamuna D Sethuvel, Dhiviya P M John, Jacob Kang, Gagandeep J Infect Dis Supplement Articles BACKGROUND: Systematic studies to estimate the disease burden of typhoid and paratyphoid in India are limited. Therefore, a multicenter study on the Surveillance of Enteric Fever in India was carried out to estimate the incidence, clinical presentation, and antimicrobial resistance (AMR) trend. The data presented here represent the national burden of AMR in Salmonella Typhi and Salmonella Paratyphi A. METHODS: Antimicrobial susceptibility testing was performed for S. Typhi and S. Paratyphi A (n = 2373) isolates collected prospectively during a 2-year period from November 2017 to January 2020. RESULTS: Of 2373 Salmonella isolates, 2032 (85.6%) were identified as S. Typhi and 341 (14.4%) were S. Paratyphi A. Approximately 2% of S. Typhi were multidrug-resistant (MDR), whereas all 341 (100%) of S. Paratyphi A isolates were sensitive to the first-line antimicrobials. Among 98% of ciprofloxacin nonsusceptible isolates, resistance (minimum inhibitory concentration [MIC] >0.5 µg/mL) was higher in S. Typhi (37%) compared with S. Paratyphi A (20%). Azithromycin susceptibility was 99.9% and 100% with a mean MIC of 4.98 μg/mL for S. Typhi and 7.39 μg/mL for S. Paratyphi A respectively. Ceftriaxone was the only agent that retained 100% susceptibility. Moreover, beta-lactam/beta-lactamase inhibitors showed potent in vitro activity against the study isolates. CONCLUSIONS: Data obtained from this systematic surveillance study confirms the declining trend of MDR Salmonella isolates from India. The higher prevalence of ciprofloxacin nonsusceptibility enforces to limit its use and adhere to the judicious usage of azithromycin and ceftriaxone for enteric fever management. Oxford University Press 2021-11-23 /pmc/articles/PMC8892543/ /pubmed/35238369 http://dx.doi.org/10.1093/infdis/jiab144 Text en © The Author(s) 2021. Published by Oxford University Press for the Infectious Diseases Society of America. https://creativecommons.org/licenses/by/4.0/This is an Open Access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted reuse, distribution, and reproduction in any medium, provided the original work is properly cited.
spellingShingle Supplement Articles
Veeraraghavan, Balaji
Pragasam, Agila K
Ray, Pallab
Kapil, Arti
Nagaraj, Savitha
Perumal, Sulochana Putli Bai
Saigal, Karnika
Thomas, Maria
Gupta, Madhu
Rongsen-Chandola, Temsunaro
Jinka, Dasaratha Ramaiah
Shastri, Jayanthi
Alexander, Anna P
Koshy, Roshine Mary
De, Anuradha
Singh, Ashita
Evelyn Ebenezer, Sheena
Dutta, Shanta
Bavdekar, Ashish
More, Deepak
Sanghavi, Sonali
Nayakanti, Raghuprakash Reddy
Jacob, Jobin J
Amladi, Anushree
Anandan, Shalini
Abirami, Baby S
Bakthavatchalam, Yamuna D
Sethuvel, Dhiviya P M
John, Jacob
Kang, Gagandeep
Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title_full Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title_fullStr Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title_full_unstemmed Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title_short Evaluation of Antimicrobial Susceptibility Profile in Salmonella Typhi and Salmonella Paratyphi A: Presenting the Current Scenario in India and Strategy for Future Management
title_sort evaluation of antimicrobial susceptibility profile in salmonella typhi and salmonella paratyphi a: presenting the current scenario in india and strategy for future management
topic Supplement Articles
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8892543/
https://www.ncbi.nlm.nih.gov/pubmed/35238369
http://dx.doi.org/10.1093/infdis/jiab144
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