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ORIGINAL CONTRIBUTION |
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| Year : 1996 | Volume
: 50
| Issue : 8 | Page : 277-279 |
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Prevalence of multi-drug resistant salmonella typhi in ludhiana Punjab
H Prabhakar, Harjit Kaur, Madan Lal
Department of Microbiology, Christian Medical College, Ludhiana, India
| Date of Submission | 04-Nov-1995 |
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Correspondence Address:
H Prabhakar
Department of Microbiology, Christian Medical College, Ludhiana
India
PMID: 9018985
How to cite this article:
Prabhakar H, Kaur H, Lal M. Prevalence of multi-drug resistant salmonella typhi in ludhiana Punjab. Indian J Med Sci 1996;50:277-9 |
Enteric fever is endemic in all parts of India, and continue to be a significant health hazard. Resistance of S. typhi to chloramphenicol was known earlier but the problem was realised with reports of an outbreak in Mexico [1] and Kerala [2] in 1972. Since then chloramphenicol resistant strains cf Si typhi have been reported from many parts of India. [3],[4],[5],[6],[7]
The present study reports the prevalence of drug resistant S. typhi isolated from patients attending the Christian Medical College Hospital, Ludhiana during the last six years from 1989 to 1994.
| ¤ Material and Methods | |  |
Blood samples were collected from febrile patients prior to antibiotic therapy in bile broth and processed by standard recommended techniques. [8] Suspected non non-lactose fermenter colonies from MacConkey agar were screened biochemically and their identify confirmed serologically. The antibiotic sensitivity was tested by Kirby Bauers [9] disc diffusion technique using Mueller Hinton Agar and the following discs-Ampicillin (A 10µg), Chloramphenicol (C 30µg), Cephelosporin (Ce 30µg), Cotrimaxazole (Co 25µg) , Gentamicin (G 10µg), Tetracyclline (T 30µg) and Ciprofloxacin (Cip 5µg).
| ¤ Results | | |
A total of 945 Salmonella More Details typhi isolates were obtained from blood cultures during the last six years from 1989 to 1994. The maximum number of isolates 339 were obtained in the year 1990 followed by 206 in the year 1991. Out of the total 945 isolates of S. typhi 650 (68.7%) were isolated from adults and 295 (31.3%) from children below the age of 12 years. In 1989 31 (21.8%) of the strains were resistant to chioramphenicol, while in 1990, 1991 and 1994, 224 (66%), 125 (60.7%) and 37 (71%)
were resistant to this drug respectively. Most of these strains were also resistant to ampicillin, cotrimaxazole and tetracycline. The resistance to cephelosporin and gentamicin varied between 2-6%. The 464 strains tested for their susceptibility to ciprofloxacin, were all sensitive to the drug. During the period of study in addition to the S. typhi isolates 128 strains of S. paratyphi A and one stain of S. paratyphi B were isolated. Three (11.5%) of the 26 strains of S. paratyphi 'A' isolated in 1993 and twenty (62%) of the 32 strains isolated in 1994 were resistant to chloramphenicol. The sole isolate of S. paratyphi B was sensitive to all antibiotics tested.
| ¤ Discussion | | |
Out of a total of 34,816 blood samples cultured over a period of six years 945 (2.7%) revealed the growth of S. iyphi. The antibiotic susceptibility of these strains showed 580(61.4%) to be multidrug resistant. There was a high rate of multidrug resistance in the years 1990, 1991 and 1994 - 70.8% 78.6% and 75% respectively. Multidrug resistance mediated by transferable R-plasmids has been reported from several parts of India and the incidence has varied from 11 to 91%. [10],[11] All the strains tested in this study were sensitive to ciprofloxacin which is the drug used in multidrug resistant enteric fever in this hospital. Resistance of Si typhi to quinolones has also been reported in 22 strains (11.5%) to norfioxacin and in 11 strains (5.8.%, to ciprofloxacin. [12] In a six year study from Delhi [13] resistance to ciprofloxacin ranged from 0-3% Others [14],[15] , have reported their isolates to be sensitive to quinolones.
| ¤ Summary | | |
A total of 945 strains of S. typhi isolated from blood cultures during 1989 to 1994 were studied. Their antibiotic susceptibility showed 580 (61.4%) of strains tobe multidrug resistant. The 464 strains tested for their susceptibility to ciprofloxacin were all sensitive to the drug. Twenty three (17.9%) of the 128 strains of S. paratyphi A were resistant to chloramphenicol. The sole isolate of S. paratyphi B was sensitive to z II antibiotics tested.
| ¤ References | | |
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| 2. | Paniker CKJ, Vimla KM. Transferable Chloramphenicol resistance in S. typhi. Nature 1972:239:109-110. |
| 3. | Aggarwal KC, Panhotra BR, Mohanto J. Arya VK. Gargh RK. Typhoid fever due to Chloramphenicol resistant S, typhi associated with R. plasmids. Ind J Med Res 1981:73:484-488. |
| 4. | Sexena SN, Mago ML, Kumari N. Increasing Prevalence of high degree resistant strains of salmonedda to Ampicillin, Chloramphenicol and Furazolidone in India. Ind J Med Sci 1985:39:97-101. |
| 5. | 5.Jesudasan MV, Jacob John T. Multi resistant Salmonlla typhi in India. Lancet 1990:336;252-252. |
| 6. | Halder KK. Sahadalal B, Ghose E, Sanyal S. Chloramphenicol resistant Salmonella typhi the cause of recent outbreak of enteric fever in Calcutta. Ind J Pathol and Microbiol 1992:35:11-17. |
| 7. | Kamili MA. Ali G, Shah MY, Khan RS, Alladquaband GQ. Multiple , drug resistance typhoid fever outbreak in Kashmir Valley. Ind J Med Sci 1993:47:147-151. |
| 8. | Cowan ST. Manual for identification of medical bacteria. 2nd ed PP. 103 London, Cambridge University Press, 1974. |
| 9. | Bauer AW, Kirby WMM, Sherris JC, Truck M. Antibiotic susceptibility testing by standardised single disc method. Am J Clin Pathol 1066:45;493-496. |
| 10. | Jesudasan MV, John TJ. Plasmid mediated multidrug resistance in Salmonella typhi. Ind J Med Res 1992:95;66-67. |
| 11. | Aggarwal V, Brahamne RB, Dhanvijaya AG, Jalgaonkar PD, Pathak AA, Saoji AM. Antibiogram, phage types and biotypes of Salmonella typpi isolated in Nagpur Ind J Med Res 1992:95:14-16. |
| 12. | Rathish KC, Chandrashekar MR. Nagesha CN. Multidrug resistant. Salmonella typhi i i Bangalore. Ind J Mead Sci 1995:48:85-88. |
| 13. | Srivastava L, Aggarwala P. Multidrug resistant Salmonella typhi in Delhi. Ind J Med Microbiol 1994: 12:102-185. |
| 14. | Sheorcy HS, Kaundinya DV, Hulyalkar VS, Deshpande AK. Multicirug Resistant Salmonella typhi in Bombay. Ind J Path Microbiol 1993:36:8-12. |
| 15. | Gupta B, Kun.ar K, Khurana S. Multidrug Resistant Salmonella typhi in Lud:hiana Punjab Ind J Path Microbiol 1993:36:5-7. |
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