In vitro activity of azithromycin, newer quinolones and cephalosporins in ciprofloxacin-resistant Salmonella causing enteric fever.
The therapeutic alternatives available for use against ciprofloxacin-resistant enteric fever isolates in an endemic area are limited. The antibiotics currently available are the quinolones, third-generation cephalosporins and conventional first-line drugs. In this study, the MICs of various newer drugs were determined for 31 ciprofloxacin-resistant enteric fever isolates (26 Salmonella enterica serovar Typhi and 5 S. enterica serovar Paratyphi A). MICs for ciprofloxacin, ofloxacin, gatifloxacin, levofloxacin, cefotaxime, cefixime, cefepime and azithromycin were determined using Etest strips and the agar dilution method. By Etest, all of the ciprofloxacin-resistant isolates had ciprofloxacin MICs >/=32 mug ml(-1). S. Typhi showed MIC(90) values of 0.50, 0.25 and 0.38 mug ml(-1) for cefixime, cefotaxime and cefepime, respectively. For the cephalosporins, a negligible difference in MIC(90) and MIC(50) values for S. Typhi and S. Paratyphi A was observed. A single isolate of S. Typhi showed a high azithromycin MIC of 64 mug ml(-1). The MIC(90) value for azithromycin in S. Typhi and S. Paratyphi was 24 mug ml(-1). Gatifloxacin demonstrated lower resistance (80.8 %) compared with the other quinolones (92-100 %) in S. Typhi. The rise in MIC levels of these antimicrobials is a matter for serious concern.
Capoor
Malini R
MR
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Rawat
Deepti
D
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Nair
Deepthi
D
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Hasan
Azra S
AS
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Deb
Monorama
M
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Aggarwal
Pushpa
P
Department of Microbiology, Vardhman Mahavir Medical College and Safdarjung Hospital, New Delhi, India.
Pillai
Parukutty
P
Department of Microbiology, Majeedia Hospital, Hamdard University, New Delhi, India.
D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D017963:Azithromycin / Q000494:pharmacology*; D002511:Cephalosporins / Q000494:pharmacology*; D024881:Drug Resistance, Bacterial; D006801:Humans; D008826:Microbial Sensitivity Tests / Q000379:methods; D010284:Paratyphoid Fever / Q000382:microbiology; D015363:Quinolones / Q000494:pharmacology*; D012482:Salmonella paratyphi A / Q000187:drug effects* / Q000302:isolation & purification; D012485:Salmonella typhi / Q000187:drug effects* / Q000302:isolation & purification; D014435:Typhoid Fever / Q000382:microbiology
D000900:Anti-Bacterial Agents; D002511:Cephalosporins; D015363:Quinolones; D017963:Azithromycin