title: Antibiogram of Salmonella Isolates: Time to Consider Antibiotic Salvage.
abstract: BACKGROUND
  Enteric fever is a major problem especially in developing countries. Timely and appropriate treatment plays a very important role in reducing the mortality. Fluoroquinolones and cephalosporins are the treatment options for enteric fever. Recent studies have shown that it is time to reconsider the use of earlier antibiotics.
  
  
  OBJECTIVE
  The study was aimed to know whether salvage is possible and to avoid treatment failures following fluoroquinolone usage.
  
  
  METHODS
  A one year retrospective data of Salmonella species isolated from 319 blood samples from our hospital and other diagnostic centers were studied. Demographic data, organism isolated and their changing pattern of antibiogram were analysed.
  
  
  RESULTS
  Out of 319 Salmonella isolates, 52.4% (167) was Salmonella typhi (S. typhi) and 47.6% (152) Salmonella paratyphi A (S. paratyphi A), with a male preponderance. Most of the salmonellae were isolated in the months of June and July, with the majority being in the 1-10 and 21-30 years age groups. Both species were highly susceptible to chloramphenicol (95.2% and 100%) followed by third generation cephalosporins (97% and 98%), cotrimoxazole (95.8% and 98.6%) and ampicillin (94.6% and 93.4%) respectively. Highest resistance was seen for nalidixic acid (90.4% and100%) among both S. typhi and S. paratyphi A isolates followed by ciprofloxacin (62.2% and 54.6%) respectively. MDR to first line drugs was observed in a small proportion of S. typhi (1.7%) only.
  
  
  CONCLUSIONS
  The frequency of isolation of S. typhi and S. paratyphi A are in equal proportion and enteric fever is more prevalent in younger age group. It is ideal to adopt bivalent vaccination in Universal immunization schedule. The isolates show sensitivity to first line drugs, paving the way for salvage of the earlier drugs. Cephalosporins still remain the treatment of choice in MDR salmonella isolates.
authors.affiliation: Assistant Professor, Department of Microbiology, Sapthagiri Institute of Medical Science and Research Centre , Bangalore, Karnataka, India .
authors.forename: R
authors.initials: R
authors.lastname: Sharvani
authors.affiliation: Professor, Department of Microbiology, Sapthagiri Institute of Medical Science and Research Centre , Bangalore, Karnataka, India .
authors.lastname: Hemavathi
authors.affiliation: Tutor, Department of Microbiology, Sapthagiri Institute of Medical Science and Research Centre , Bangalore, Karnataka, India .
authors.forename: D K
authors.initials: DK
authors.lastname: Dayanand
authors.affiliation: Professor, Department of Microbiology, Sapthagiri Institute of Medical Science and Research Centre , Bangalore, Karnataka, India .
authors.forename: Poornima
authors.initials: P
authors.lastname: Shenoy
authors.affiliation: Assistant Professor, Department of Microbiology, Sapthagiri Institute of Medical Science and Research Centre , Bangalore, Karnataka, India .
authors.forename: Pooja
authors.initials: P
authors.lastname: Sarmah
keywords: Cephalosporins; MDR; NAR; Salmonella paratyphi A; Salmonella typhi