Suitable Disk Antimicrobial Susceptibility Breakpoints Defining Salmonella enterica Serovar Typhi Isolates with Reduced Susceptibility to Fluoroquinolones
Paediatrics and Child Health
Infections with Salmonella enterica serovar Typhi isolates that have reduced susceptibility to ofloxacin (MIC >= 0.25 mu g/ml) or ciprofloxacin (MIC >= 0.125 mu g/ml) have been associated with a delayed response or clinical failure following treatment with these antimicrobials. These isolates are not detected as resistant using current disk susceptibility breakpoints. We examined 816 isolates of S. Typhi from seven Asian countries. Screening for nalidixic acid resistance (MIC >= 16 mu g/ml) identified isolates with an ofloxacin MIC of >= 0.25 mu g/ml with a sensitivity of 97.3% (253/260) and specificity of 99.3% (552/556). For isolates with a ciprofloxacin MIC of >= 0.125 mu g/ml, the sensitivity was 92.9% (248/267) and specificity was 98.4% (540/549). A zone of inhibition of = 0.25 mu g/ml with a sensitivity of 94.6% (246/260) and specificity of 94.2% (524/556). A zone of inhibition of = 0.125 mu g/ml with a sensitivity of 94.0% (251/267) and specificity of 94.2% (517/549). An ofloxacin MIC of >= 0.25 mu g/ml and a ciprofloxacin MIC of >= 0.125 mu g/ml detected 74.5% (341/460) of isolates with an identified quinolone resistance-inducing mutation and 81.5% (331/406) of the most common mutant (carrying a serine-to-phenylalanine mutation at codon 83 in the gyrA gene). Screening for nalidixic acid resistance or ciprofloxacin and ofloxacin disk inhibition zone are suitable for detecting S. Typhi isolates with reduced fluoroquinolone susceptibility.
Antimicrobial Agents and Chemotherapy
Chau Tran Thuy, .,
Ha Vinh, .,
Nguyen Tran Chinh, .,
Pham Thanh Duy, .,
Tran Vu Thieu Nga, .,
Nguyen Van Minh Hoang, .,
Bhutta, Z. A.,
Do Gia Canh, .,
Tran Tinh Hien, .,
(2010). Suitable Disk Antimicrobial Susceptibility Breakpoints Defining Salmonella enterica Serovar Typhi Isolates with Reduced Susceptibility to Fluoroquinolones. Antimicrobial Agents and Chemotherapy, 54(12), 5201-5208.
Available at: http://ecommons.aku.edu/pakistan_fhs_mc_women_childhealth_paediatr/138