Salmonella strains resistant to multiple antibiotics: therapeutic implications.

Abstract

In summary we are confronted with the awareness that Salmonella organisms of various species have developed simultaneous resistance to ampicillin, chloramphenicol and trimethoprim-sulfamethoxazole. These strains are now widespread throughout much of Asia and the Middle East and have caused outbreaks of disease in man and animals in many different countries. Several reports document the appearance of these clinically resistant organisms in the United States, usually as a result of importation from abroad. Since most of the reported cases have been in infants, and given the duration of carriage and the impossibility of adequate hygienic precautions in this age group, secondary spread is to be expected. In this regard the Centers for Disease Control have already noted increased reports of S. mbandaka and S. alachua isolates from the states of Minnesota, Oregon and Washington and have attributed this increase to the infected infants adopted from India. Furthermore current patterns of international social mobility would seem to dictate the inevitability of continued importation of such multiply resistant organisms, especially from Third-World countries. In addition to immigration from abroad the selective pressure of antimicrobial usage in this country might contribute to the emergence of similar resistance patterns. Resistance to ampicillin and chloramphenicol has significantly increased in recent years, and one would expect to see more frequent resistance to TMP-SMX as this drug is used more commonly for the management of otitis media, urinary tract infections and other diseases of high prevalence.(ABSTRACT TRUNCATED AT 250 WORDS)