title: Characterisation of antimicrobial resistance inSalmonellaeduring 2014-2015 from four centres across India: An ICMR antimicrobial resistance surveillance network report.
abstract: OBJECTIVE
  The main purpose of this study was to establish 'Antimicrobial Resistance Surveillance Network' in India and to monitor the antimicrobial susceptibility profile of clinical isolates to establish a national network across the country for monitoring antimicrobial resistance in Salmonella.
  
  
  METHODS
  This study was conducted at All India Institute of Medical Sciences, nodal centre with clinical isolates of Salmonellae collected from four centres across India, which included Christian Medical College, Vellore; Postgraduate Institute of Medical Education and Research, Chandigarh and Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry. Total 20% of the selected strains from each centre were characterised for molecular studies which included molecular mechanism of fluoroquinolones resistance and multiple locus sequence type.
  
  
  RESULTS
  A total of 622 Salmonellae were received from all centres during January 2014 to December 2015. Out of these 622 isolates, 380 were Salmonella Typhi, 162 were Salmonella Paratyphi A and 7 were S. Paratyphi B isolated from blood and 73 were other Salmonella serotypes. Multiple drug resistance (resistant to ampicillin, chloramphenicol and co-trimoxazole) was less than 3% in S. Typhi. In S. Paratyphi A, chloramphenicol and co-trimoxazole susceptibility was 100% and 99%, respectively, whereas ampicillin susceptibility was 86% (139/161). Ciprofloxacin and nalidixic acid susceptibility was 15% (24/162) and 1% (2/162) from all centres. S. Paratyphi B was isolated from 7 patients. All isolates were third-generation cephalosporin sensitive. The most common mutations found were at codon 83 and at codon 87. We did not find any mutation in acrR gene. Efflux pump and qnr genes were not found in any isolate tested. All 86 S. Typhi isolates clustered into two sequence types - ST1 and ST2. Out of these 86 isolates, 70 S. Typhi were ST1 and 16 were ST2. All S. Paratyphi A was clustered in ST85 and ST129 on the basis of mutation in sucA gene. Out of 27 S. Paratyphi A, 13 were grouped into ST85 and 14 were grouped into ST129.
  
  
  CONCLUSIONS
  Enteric fever is one such infection which poses challenges in antimicrobial resistance. Hence, continuous surveillance is important to track bacterial resistance and to treat infections in a cost-effective manner.
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sushila
authors.initials: S
authors.lastname: Dahiya
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Priyanka
authors.initials: P
authors.lastname: Sharma
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bhavana
authors.initials: B
authors.lastname: Kumari
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Sangeeta
authors.initials: S
authors.lastname: Pandey
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Rooma
authors.initials: R
authors.lastname: Malik
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Neelam
authors.initials: N
authors.lastname: Manral
authors.affiliation: Department of Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Balaji
authors.initials: B
authors.lastname: Veeraraghavan
authors.affiliation: Department of Microbiology, Christian Medical College, Vellore, Tamil Nadu, India.
authors.forename: Agila Kumari
authors.initials: AK
authors.lastname: Pragasam
authors.affiliation: Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Pallab
authors.initials: P
authors.lastname: Ray
authors.affiliation: Department of Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India.
authors.forename: Vikas
authors.initials: V
authors.lastname: Gautam
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Sujata
authors.initials: S
authors.lastname: Sistla
authors.affiliation: Department of Microbiology, Jawaharlal Institute of Postgraduate Medical Education and Research, Puducherry, India.
authors.forename: Subhash Chandra
authors.initials: SC
authors.lastname: Parija
authors.affiliation: ICMR, New Delhi, India.
authors.forename: Kamini
authors.initials: K
authors.lastname: Walia
authors.affiliation: ICMR, New Delhi, India.
authors.forename: Vinod
authors.initials: V
authors.lastname: Ohri
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Bimal Kumar
authors.initials: BK
authors.lastname: Das
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Seema
authors.initials: S
authors.lastname: Sood
authors.affiliation: Department of Microbiology, All India Institute of Medical Sciences, New Delhi, India.
authors.forename: Arti
authors.initials: A
authors.lastname: Kapil
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D024881:Drug Resistance, Bacterial; D062665:Epidemiological Monitoring; D006801:Humans; D007194:India / Q000453:epidemiology; D008826:Microbial Sensitivity Tests; D015995:Prevalence; D012475:Salmonella / Q000145:classification / Q000187:drug effects* / Q000302:isolation & purification; D012480:Salmonella Infections / Q000453:epidemiology / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents