Abstract
To determine the use of pefloxacin as a surrogate marker to detect fluoroquinolone (ciprofloxacin) susceptibility against Salmonella enterica serotypes Typhi and Paratyphi A. The prospective, descriptive cross-sectional study was conducted at the Aga Khan University Hospital, Karachi, from September 2016 to March 2018, and comprised Salmonella Typhi and Paratyphi A isolates of blood cultures. Disk susceptibility tests and broth microdilution to test minimum inhibitory concentration were performed as per standard guidelines. Data was analysed using SPSS 21. Of the 138 isolates, 91(66%) were intermediate resistant to ciprofloxacin but were resistant to pefloxacin, 42(30%) were resistant to both ciprofloxacin and pefloxacin, and 5(4%) were susceptible to both ciprofloxacin and pefloxacin. Of the isolates that were intermediate resistant to ciprofloxacin, 85(93%) had minimum inhibitory concentration range0.12-0.5mg\L, while 6(7%) had MIC>1mg\L (p<0.0001). Pefloxacin disk diffusion test was found to be reliable in detecting fluoroquinolone resistance among enteric fever causing Salmonella.
Highlights
Salmonella spp. cause significant morbidity and mortality in the developing world, especially when they cause enteric fever.[1]
Pefloxacin disk diffusion test was found to be reliable in detecting fluoroquinolone resistance among enteric fever causing Salmonella
Fluoroquinolone resistance is mainly caused by chromosomal mutations in the quinolone resistancedetermining regions (QRDRs) of the topoisomerase genes
Summary
Salmonella spp. cause significant morbidity and mortality in the developing world, especially when they cause enteric fever.[1]. Due to good cellular uptake in macrophages and subsequent high concentration in bile, fluoroquinolones, especially ciprofloxacin, remains a preferred therapeutic option to treat enteric fever in the fluoroquinolonesusceptible strains.[4,5] the concern about its resistance in Salmonella Typhi and Paratyphi still exists. Low-level quinolone resistance is not detected by using nalidixic acid disc
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