Suitable Disk Antimicrobial Susceptibility Breakpoints Defining Salmonella enterica Serovar Typhi Isolates with Reduced Susceptibility to Fluoroquinolones

Parry, Christopher M., Thuy, Chau Tran, Dongol, Sabina, Karkey, Abhilasha, Vinh, Ha, Chinh, Nguyen Tran, Duy, Pham Thanh, Thieu Nga, Tran Vu, Campbell, James I., Van Minh Hoang, Nguyen, Arjyal, Amit, Bhutta, Zulfiqar A., Bhattacharya, Sujit K., Agtini, Magdarina D., Dong, Baiqing, Canh, Do Gia, Naheed, Aliya, Wain, John, Tinh Hien, Tran, Basnyat, Buddha, Ochiai, Leon, Clemens, John, Farrar, Jeremy J., Dolecek, Christiane and Baker, Stephen (2010) Suitable Disk Antimicrobial Susceptibility Breakpoints Defining Salmonella enterica Serovar Typhi Isolates with Reduced Susceptibility to Fluoroquinolones. Antimicrobial Agents and Chemotherapy, 54 (12). pp. 5201-5208. ISSN 0066-4804

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Abstract

Infections with Salmonella enterica serovar Typhi isolates that have reduced susceptibility to ofloxacin (MIC = 0.25 µg/ml) or ciprofloxacin (MIC = 0.125 µg/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 µg/ml) identified isolates with an ofloxacin MIC of =0.25 µg/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 µg/ml, the sensitivity was 92.9% (248/267) and specificity was 98.4% (540/549). A zone of inhibition of =28 mm around a 5-µg ofloxacin disc detected strains with an ofloxacin MIC of =0.25 µg/ml with a sensitivity of 94.6% (246/260) and specificity of 94.2% (524/556). A zone of inhibition of =30 mm detected isolates with a ciprofloxacin MIC of =0.125 µg/ml with a sensitivity of 94.0% (251/267) and specificity of 94.2% (517/549). An ofloxacin MIC of =0.25 µg/ml and a ciprofloxacin MIC of =0.125 µg/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.

Item Type: Article
Faculty \ School: Faculty of Medicine and Health Sciences > Norwich Medical School
Depositing User: Rhiannon Harvey
Date Deposited: 13 Jul 2011 09:13
Last Modified: 21 Apr 2020 16:57
URI: https://ueaeprints.uea.ac.uk/id/eprint/33559
DOI: 10.1128/AAC.00963-10

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