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Indian Journal of Medical Sciences
Medknow Publications on behalf of Indian Journal of Medical Sciences Trust
ISSN: 0019-5359
EISSN: 0019-5359
Vol. 58, No. 1, 2004, pp. 16-23
Bioline Code: ms04003
Full paper language: English
Document type: Research Article
Document available free of charge

Indian Journal of Medical Sciences, Vol. 58, No. 1, 2004, pp. 16-23

 en REDUCED MINIMUM INHIBITORY CONCENTRATION OF CHLORAMPHENICOL FOR SALMONELLA ENTERICA SEROVAR TYPHI
S Mandal, M D Mandal, N K Pal

Abstract

BACKGROUND: Ciprofloxacin replaced chloramphenicol (C), the best choice of antibiotic in the treatment of enteric fever, when C-resistant enteric fever emerged and caused outbreaks in different parts of the world. C-sensitive S. enterica serovar Typhi emerged again due to withdrawal of the antibiotic pressure.
AIMS: To assess the in vitro efficacy of C against Salmonella enterica serovar Typhi isolates (1991-2003).
MATERIAL AND METHODS: A total of 464 blood culture isolates of S. enterica serovar Typhi were subjected to C susceptibility by disc diffusion and agar dilution methods using Mueller-Hinton agar. The antibiotic susceptibility of S. enterica serovar Typhi isolates obtained in the year 2002 and 2003 was determined using ampicillin, cotrimoxazole, ciprofloxacin, nalidixic acid, ceftriaxone and cefotaxime, in addition to C. Escherichia coli strain ATCC 25922 was used as the control. Changes in C sensitivity of the isolates were analyzed using χ2 test with Yates correction.
RESULTS AND CONCLUSIONS: All the isolates of 1991 were C-resistant with minimum inhibitory concentration values (MICs) of 2000-5000 mg/ml. In the following years decrease in frequency of C resistance was noticed: 1992 (50%), 1993 (32%), 1994 (27%) and 1995 (05%). The isolates of 1996-99 and 2001 were 100% C-sensitive. In 2000, sensitivity was also high (79%). The strains isolated in the year 2002 and 2003, showing reduced susceptibility of ciprofloxacin, were nalidixic acid resistant, but sensitive to the third-generation cephalosporins (ceftriaxone and cefotaxime). The MICs for C-sensitive isolates (1991-2003) ranged 0.1-5 mg/ml. Results suggest the necessity for re-evaluation of C therapy in typhoid fever.

Keywords
Chloramphenicol, Minimum inhibitory concentration, Salmonella enterica serovar typhi

 
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