title: Decreased susceptibility to fluoroquinolones and gyrA gene mutation in the Salmonella enterica serovar Typhi and Paratyphi A isolated in Katmandu, Nepal, in 2003.
abstract: Typhoid fever is the most common clinical diagnosis among febrile patients presenting to hospital in Katmandu. Salmonella enterica serovar Typhi (S. enterica serovar Typhi) and Salmonella enterica serovar Paratyphi A (S. enterica serovar Paratyphi A) with decreased susceptibility to fluoroquinolones and resistance to nalidixic acid are common in recent years. In the present study, we examined the in vitro susceptibility to fluoroquinolones and the presence of gyrA gene mutations in 30 clinical strains of S. Typhi and 39 of S. Paratyphi A, all of which were isolated in Katmandu, Nepal, in 2003. In those strains, we found that 73.3% and 94.9% of S. Typhi and S. Paratyphi A strains contained gyrA gene mutation, and showed the resistance to a quinolone, nalidixic acid, and decreased susceptibility to fluoroquinolones, ciprofloxacin, and levofloxacin. Although fluoroquinolones may still be useful as antibiotics for the treatment of typhoid fever, clinicians should be aware of the possibility of treatment failures of infections with S. Typhi and S. Paratyphi A strains with decreased susceptibility to fluoroquinolones.
authors.affiliation: International Center for Medical Research and Treatment, Kobe University School of Medicine, Japan. toshiro@med.kobe-u.ac.jp
authors.forename: Toshiro
authors.initials: T
authors.lastname: Shirakawa
authors.forename: Bishnu
authors.initials: B
authors.lastname: Acharya
authors.forename: Shohiro
authors.initials: S
authors.lastname: Kinoshita
authors.forename: Shunichi
authors.initials: S
authors.lastname: Kumagai
authors.forename: Akinobu
authors.initials: A
authors.lastname: Gotoh
authors.forename: Masato
authors.initials: M
authors.lastname: Kawabata
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D027081:DNA Gyrase / Q000235:genetics*; D024901:Drug Resistance, Multiple, Bacterial / Q000235:genetics*; D024841:Fluoroquinolones / Q000494:pharmacology*; D005798:Genes, Bacterial / Q000235:genetics; D006801:Humans; D009154:Mutation; D009390:Nepal; D012482:Salmonella paratyphi A / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D012485:Salmonella typhi / Q000187:drug effects* / Q000235:genetics / Q000302:isolation & purification; D014435:Typhoid Fever / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D024841:Fluoroquinolones; D027081:DNA Gyrase