Infections Due to Salmonella

2021 ◽  
Author(s):  
Marcia B Goldberg ◽  
Molly Paras
Keyword(s):  
Antibiotic Resistance ◽  
Antibiotic Therapy ◽  
Enteric Fever ◽  
Carrier State ◽  
Surgical Removal ◽  
Third Generation ◽  
Food Borne ◽  
Extraintestinal Disease ◽  
Immunocompromised Hosts ◽  
Third Generation Cephalosporins

Salmonella, which is acquired via ingestion, is classified as nontyphoidal or typhoidal disease. Typhoidal disease is caused by S typhi or S paratyphi, and nontyphoidal disease is caused by all other serovars. Salmonella causes a range of infectious syndromes that include gastroenteritis, bacteremia, endovascular infections, and enteric fever. For immunocompromised hosts or patients with extraintestinal disease, antibiotic therapy should be provided. Effective agents often include third-generation cephalosporins and fluoroquinolones, although rates of resistance of Salmonella isolates to many antibiotics are increasing. A carrier state exists whereby patients may shed bacteria despite being asymptomatic. To eradicate the carrier state, longer courses of antibiotics and, in rare instances, surgical removal of the reservoir, which is most commonly the gallbladder, may be required.  This review contains 2 figures, 4 tables, and 24 references. Key Words: Salmonella, typhoidal, non-typhoidal, enteric fever, endovascular infection, gastroenteritis, carrier, food-borne, antibiotic resistance

scholarly journals Comparison of beta-lactamase genes in clinical and food bacterial isolates in India

2009 ◽  
Vol 3 (08) ◽  
pp. 593-598 ◽  
Author(s):  
Mohd. Shahid ◽  
Abida Malik ◽  
Mohd. Adil ◽  
Noor Jahan ◽  
Ritu Malik
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Species ◽  
Enteric Bacteria ◽  
Generation Cephalosporin ◽  
Clinical Isolates ◽  
Third Generation ◽  
Bacterial Isolates ◽  
Food Borne ◽  
Resistance Rates ◽  
Third Generation Cephalosporins

BACKGROUND: The present study aimed to determine the occurrence of human disease-causing enteric bacteria on raw vegetables, fruits, meats, and milk products sold in Indian markets. The study further aimed to analyze antibiotic resistance rates and the presence of blaCTX-M, blaTEM, blaSHV, and blaAmpC. METHODOLOGY: Twenty-three food-borne and 23 clinical isolates were compared for antibiotic resistance rates and the presence of blaCTX-M, blaTEM, blaSHV, and blaAmpC. Swabs were taken from unwashed and washed food items, as well as from some chopped food specimens, and inoculated on appropriate culture medium. Bacterial isolates were identified, antibiotic susceptibility was performed, and bla genes were detected by PCR. RESULTS: Thirty-eight bacterial isolates were obtained from the food specimens, of which 36 (94.7%) were Gram-negative and two (5.3%) were Gram-positive bacterial species. Klebsiella pneumoniae was the most prevalent (52.6%; 20/38) bacterial species isolated, followed by Citrobacter koseri (18.4%; 7/38). In food isolates, the majority of the isolates were resistant to gentamicin (33.3%) followed by amikacin (11.1%). Resistance to a third-generation cephalosporin was noticed in only 5.6% isolates. However, in clinical isolates, maximal resistance was noticed against third-generation cephalosporins followed by ofloxacin in 91.3% and 86.9% isolates, respectively, and resistance to gentamicin and amikacin was noticed in 78.3% and 52.2% isolates, respectively. The presence of blaCTX-M, blaTEM, blaSHV, and blaAmpC in clinical isolates was noticed in 52.2%, 60.9%, 21.7%, and 43.5%, respectively. None of the isolates from food showed the presence of any of the above-cited genes. CONCLUSIONS: Probably bla genes have not yet disseminated to raw-food vegetation in India.

Changing patterns and widening of antibiotic resistance inShigellaspp. over a decade (2000–2011), Andaman Islands, India

2014 ◽  
Vol 143 (3) ◽  
pp. 470-477 ◽  
Author(s):  
D. BHATTACHARYA ◽  
H. BHATTACHARYA ◽  
D. S. SAYI ◽  
A. P. BHARADWAJ ◽  
M. SINGHANIA ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antibiotic Resistance ◽  
Wide Spectrum ◽  
Resistance Pattern ◽  
Third Generation ◽  
Isolation And Identification ◽  
Antimicrobial Drugs ◽  
Drug Resistance Pattern ◽  
Resistance Patterns ◽  
Third Generation Cephalosporins

SUMMARYThis study is a part of the surveillance study on childhood diarrhoea in the Andaman and Nicobar Islands; here we report the drug resistance pattern of recent isolates ofShigellaspp. (2006–2011) obtained as part of that study and compare it with that ofShigellaisolates obtained earlier during 2000–2005. During 2006–2011, stool samples from paediatric diarrhoea patients were collected and processed for isolation and identification ofShigellaspp. Susceptibility to 22 antimicrobial drugs was tested and minimum inhibitory concentrations were determined for third-generation cephalosporins, quinolones, amoxicillin-clavulanic acid combinations and gentamicin. A wide spectrum of antibiotic resistance was observed in theShigellastrains obtained during 2006–2011. The proportions of resistant strains showed an increase from 2000–2005 to 2006–2011 in 20/22 antibiotics tested. The number of drug resistance patterns increased from 13 in 2000–2005 to 43 in 2006–2011. Resistance to newer generation fluoroquinolones, third-generation cephalosporins and augmentin, which was not observed during 2000–2005, appeared during 2006–2011. The frequency of resistance inShigellaisolates has increased substantially between 2000–2006 and 2006–2011, with a wide spectrum of resistance. At present, the option for antimicrobial therapy in shigellosis in Andaman is limited to a small number of drugs.

scholarly journals Drug-Resistant Salmonella typhi in Pakistan

2019 ◽  
Vol 59 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Christine E. Petrin ◽  
Russell W. Steele ◽  
Elizabeth A. Margolis ◽  
Justin M. Rabon ◽  
Holly Martin ◽  
...  
Keyword(s):  
United States ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
The United States ◽  
Salmonella Typhi ◽  
Antimicrobial Treatment ◽  
Third Generation ◽  
Drug Resistant ◽  
Oral Transmission ◽  
Third Generation Cephalosporins

Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of Salmonella typhi or paratyphi. In early 2018, an outbreak of Salmonella typhi resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed “extensively resistant typhi,” has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant typhi requires treatment with carbapenems such as meropenem or azithromycin.

scholarly journals Antibacterial therapy in the treatment of ascites peritonitis in liver cirrhosis

2018 ◽  
Vol 16 (2) ◽  
pp. 49-56
Author(s):  
Sergey Ya Ivanusa ◽  
Igor Ev Onnitsev ◽  
Alexey V Khokhlov ◽  
Petr N Zubarev ◽  
Alexander V Yankovsky ◽  
...  
Keyword(s):  
Liver Cirrhosis ◽  
Antibiotic Therapy ◽  
Antibacterial Therapy ◽  
Antibacterial Effect ◽  
Decompensated Cirrhosis ◽  
Antibacterial Drug ◽  
Third Generation ◽  
Results Of Treatment ◽  
Main Component ◽  
Third Generation Cephalosporins

Ascites-peritonitis is a severe complication in patients with decompensated cirrhosis. The effectiveness of treatment of ascites of peritonitis depends largely on its early diagnosis. The main component of the treatment of ascites-peritonitis - a complex and targeted antibiotic therapy. Third-generation cephalosporins are recommended as empirical antibiotic therapy. The article presents the results of treatment of ascites peritonitis depending on the method of administration of antibacterial drug - cefbactam. The drug was administered in three ways: intravenous, endolymphatic and combined. The results of pharmacokinetics of the drug depending on the method of administration, as well as the results of the effectiveness of the antibacterial effect in the compared groups of patients. (For citation: Ivanusa SY, Onnitsev IE, Khokhlov AV, et al. Antibacterial therapy in the treatment of ascites peritonitis in liver cirrhosis. Reviews on Clinical Pharmacology and Drug Therapy. 2018;16(2):49-56. doi: 10.17816/RCF16249-56).

scholarly journals Piperacillin-tazobactam should be preferred to third-generation cephalosporins to treat wild-type inducible AmpC-producing Enterobacteriaceae in critically ill patients with hospital or ventilator-acquired pneumonia. A propensity score-matched analysis

2019 ◽  
Author(s):  
Cédric Carrié ◽  
Guillaume Bardonneau ◽  
Laurent Petit ◽  
Alexandre Ouattara ◽  
Didier Gruson ◽  
...  
Keyword(s):  
Propensity Score ◽  
Antibiotic Therapy ◽  
Pulmonary Infection ◽  
Therapeutic Failure ◽  
Third Generation ◽  
Pulmonary Infections ◽  
Wild Type ◽  
First Line ◽  
Emergence Of Resistance ◽  
Third Generation Cephalosporins

Abstract BACKGROUND The aim of this study was to compare the rate of therapeutic failure and emergence of resistance in critically ill patients treated by third-generation cephalosporins (3GCs) or piperacillin-tazobactam (PTZ) for wild-type AmpC-producing Enterobacteriaceae pulmonary infections. METHODS In a multicenter retrospective cohort study over a 4-year period, all patients treated for a pulmonary infection related to wild-type AmpC-producing Enterobacteriaceae who received documented antibiotic therapy with 3GCs or PTZ after less than 48 hours of empirical antibiotic therapy were eligible. The main outcome was the rate of therapeutic failure, defined by an impaired clinical response under treatment and/or a relapse of pulmonary infection related to the same pathogen. The secondary outcome was a secondary acquisition of derepressed cephalosporinase-producing Enterobacteriaceae. RESULTS Over the study period, 244 patients were included; 56 (23%) experienced therapeutic failure and 19 (8%) experienced secondary acquisition of resistance. In the non-adjusted cohort, the rate of therapeutic failure and emergence of resistance were significantly higher in the 3GCs group (32 vs. 18%, p = 0.011 and 13 vs. 5%, p = 0.035, respectively). In the propensity score-matched population, the 3GCs group was associated with higher rates of therapeutic failure (HR = 1.61 [1.27 – 2.07]). The secondary de-escalation to 3GCs after 48h of PTZ as a first-line antibiotic therapy was not associated with increased rate of emergence of resistance. CONCLUSION Our study confirms that third-generation cephalosporins should be avoided as first-line antibiotic therapy in wild-type AmpC-producing Enterobacteriaceae pulmonary infections.

Successful Treatment of PD Peritonitis Due to Morganella morganii Resistant to Third-Generation Cephalosporins – A Case Report

2017 ◽  
Vol 37 (2) ◽  
pp. 241-242 ◽  
Author(s):  
Vaibhav Keskar ◽  
Mohan Biyani ◽  
Syed Obaid Amin ◽  
Greg Knoll
Keyword(s):  
Peritoneal Dialysis ◽  
Case Report ◽  
Antibiotic Therapy ◽  
Successful Treatment ◽  
Third Generation ◽  
Morganella Morganii ◽  
Oral Ciprofloxacin ◽  
Microbiologic Diagnosis ◽  
Third Generation Cephalosporins

Morganella morganii is a rare cause of peritonitis in patients on peritoneal dialysis (PD). Most of the reported cases have resorted to a switch to hemodialysis. We herein report a case of peritonitis due to M. morganii resistant to third-generation cephalosporins, which was treated successfully with intraperitoneal (IP) tobramycin followed by oral ciprofloxacin. Early microbiologic diagnosis is essential in the treatment of peritonitis from rare microorganisms such as Morganella morganii, and appropriate antibiotic therapy is the key to avoiding catheter loss and subsequent switch to hemodialysis.

scholarly journals Increasingly limited options for the treatment of enteric fever in travellers returning to England, 2014–2019: a cross-sectional analytical study

2021 ◽  
Vol 70 (8) ◽  
Author(s):  
M. Trent Herdman ◽  
Basel Karo ◽  
Jayshree Dave ◽  
Parisha Katwa ◽  
Joanne Freedman ◽  
...  
Keyword(s):  
Drug Resistance ◽  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Significant Risk ◽  
Empirical Treatment ◽  
Multi Drug Resistance ◽  
Third Generation ◽  
Returning Travellers ◽  
Empirical Antibiotics ◽  
Third Generation Cephalosporins

Introduction. Enteric fever (caused by Salmonella enterica serovars Typhi and Paratyphi) frequently presents as an acute, undifferentiated febrile illness in returning travellers, requiring timely empirical antibiotics. Gap Statement. Determining which empirical antibiotics to prescribe for enteric fever requires up-to-date knowledge of susceptibility patterns. Aim. By characterising factors associated with antimicrobial resistance in cases of S. Typhi and S. Paratyphi imported to England, we aim to guide effective empirical treatment. Methodology. All English isolates of S. Typhi and S. Paratyphi 2014–2019 underwent antimicrobial susceptibility testing; results were compared to a previous survey in London 2005–2012. Risk factors for antimicrobial resistance were analysed with logistic regression models to predict adjusted odds ratios (aOR) for resistance to individual antibiotics and multi-drug resistance. Results. We identified 1088 cases of S. Typhi, 729 S. Paratyphi A, 93 S. Paratyphi B, and one S. Paratyphi C. In total, 93 % were imported. Overall, 90 % of S. Typhi and 97 % of S. Paratyphi A isolates were resistant to ciprofloxacin; 26 % of S. Typhi were multidrug resistant to ciprofloxacin, amoxicillin, co-trimoxazole, and chloramphenicol (MDR+FQ). Of the isolates, 4 % of S. Typhi showed an extended drug resistance (XDR) phenotype of MDR+FQ plus resistance to third-generation cephalosporins, with cases of XDR rising sharply in recent years (none before 2017, one in 2017, six in 2018, 32 in 2019). For S. Typhi isolates, resistance to ciprofloxacin was associated with travel to Pakistan (aOR=32.0, 95 % CI: 15.4–66.4), India (aOR=21.8, 95 % CI: 11.6–41.2), and Bangladesh (aOR=6.2, 95 % CI: 2.8–13.6) compared to travel elsewhere, after adjusting for rising prevalence of resistance over time. MDR+FQ resistance in S. Typhi isolates was associated with travel to Pakistan (aOR=3.5, 95 % CI: 2.4–5.2) and less likely with travel to India (aOR=0.07, 95 % CI 0.04–0.15) compared to travel elsewhere. All XDR cases were imported from Pakistan. No isolate was resistant to azithromycin. Comparison with the 2005–2012 London survey indicates substantial increases in the prevalence of resistance of S. Typhi isolates to ciprofloxacin associated with travel to Pakistan (from 79–98 %) and Africa (from 12–60 %). Conclusion. Third-generation cephalosporins and azithromycin remain appropriate choices for empirical treatment of enteric fever in most returning travellers to the UK from endemic countries, except from Pakistan, where XDR represents a significant risk.

scholarly journals 1672. Imported Enteric Fever in an Ethnically Diverse Area of London

2019 ◽  
Vol 6 (Supplement_2) ◽  
pp. S612-S612
Author(s):  
Hannah Gorgui-Naguib ◽  
Adnan Aali ◽  
Padmasayee Papineni
Keyword(s):  
Enteric Fever ◽  
Indian Subcontinent ◽  
Ethnically Diverse ◽  
Blood Cultures ◽  
High Rate ◽  
Third Generation ◽  
North West ◽  
Diverse Area ◽  
Visiting Friends And Relatives ◽  
Third Generation Cephalosporins

Abstract Background Typhoid is a leading cause of fever in returning travelers, particularly those visiting friends and relatives in the Indian subcontinent. We reviewed a cohort of patients with enteric fever from our hospitals in North West London, which serves a large Indian resident population. Methods Retrospective analysis of electronic laboratory, microbiology and medical records of all patients with blood cultures positive for Salmonella enterica serotypes typhi (S.typhi) or paratyphi (S.paratyphi) A, B and C from January 1, 2016 to December 31, 2018 at London North West University Healthcare NHS Trust. Organisms were cultured on selective media and identified by API 20E (BioMerieux) or MALDI TOF MS (Bruker). Results 37 blood cultures positive for S.typhi were identified from 26 patients and 37 blood cultures positive for S.paratyphi were identified from 23 patients. The median age was 28 years (range 1–79 years). Infection was more common in males (27/49, 55%) compared with females (22/49, 45%) but this was not statistically significant. Most patients (31/49) had traveled to India. Travel history was not identified for 9 patients. Laboratory results at presentation were available for all patients. Lymphopenia (defined as <1.5 × 109/L) was found in 12/23 (52%) patients with S.paratyphi compared with 10/26 (38%) of those with S. typhi. Thrombocytopenia (defined as <150 × 109/L) was found equally in both groups (22% in S. paratyphi, 27% in S. typhi). Raised alanine transferase (ALT) (defined as >35 IU/L) was seen in 14/23 (61%) in S. paratyphi compared with 19/26 (73%) in S. typhi. Median platelet count was similar in both groups (199 × 109/L in S. paratyphi, 202 × 109/L in S. typhi). Absolute eosinopenia was seen in all patients, consistent with other observational studies. For 3 patients, antibiotic sensitivities were not available. Regarding S. paratyphi cases, 16/21 (76%) were resistant to ciprofloxacin compared with 20/25 (80%) in S. typhi. Azithromycin resistance was seen in 5/46 (11%). All isolates were susceptible to third-generation cephalosporins. Conclusion There is a high rate of ciprofloxacin resistance in this cohort of patients with enteric fever, confirming that the use of third-generation cephalosporins and macrolides in travelers to India is most appropriate for treatment. Disclosures All authors: No reported disclosures.

scholarly journals Salmonella Typhi Infections and Effect of Fluroquinolones and Third Generation Cephalosporins in Clinical Outcome

1970 ◽  
Vol 31 (3) ◽  
pp. 216-221 ◽  
Author(s):  
UK Singh ◽  
AK Neopane ◽  
M Thapa ◽  
N Aryal ◽  
K Agrawal
Keyword(s):  
Public Health ◽  
Nalidixic Acid ◽  
Health Problem ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Third Generation ◽  
Third Generation Cephalosporins ◽  
Culture Positive

Background: Enteric fever is a common public health problem in Nepal. The emerging fluoroquinolone resistance to Salmonella typhi is a major concern in every hospital and is a public health problem these days. Continuous antibiotic susceptibility patterns surveillance and standard treatment policies need to be established to control MDR typhoid. Objective: To detect the increasing pattern of fluoroquinolone resistant Salmonella typhi and to correlate its clinical response to third generation cephalosporins. Materials and Method: This is a cross- sectional prospective study conducted in the pediatric ward of Birendra Hospital, Kathmandu, from September 2009 to August 2010. Forty seven children aged between 3-14 years with the diagnosis of suspected, probable and confirmed cases of Enteric fever were enrolled in the study. Data was collected and statistical analysis was done using SPSS program. Result: Culture positive enteric fever was found in 21 cases (44.68%) and positive Widal test in 18 (38.29%). Among the culture positive cases, antibiotic sensitivity was highest for Ofloxacin (95.23%), followed by third generation Cephalosporins (Ceftriaxone, Cefixime) (90.47%). A significant number of isolates were resistant to Nalidixic acid (71.42%). All cases were successfully treated with parenteral antibiotics followed by oral third generation cephalosporins without any complications and/or mortality. Conclusion: There is an increasing trend to fluoroquinolone resistant Salmonella typhi. Third generation cephalosporin can be the appropriate antibiotic for treatment.of clinically suspected cases of Enteric fever and to minimize the risk of increasing emergence of MDR enteric fever including Nalidixic acid resistant Typhoid.(NARST). Key words: Cephalosporin; drug resistance; Enteric fever; Fluoroquinolone; Salmonella typhi. DOI: http://dx.doi.org/10.3126/jnps.v31i3.5361 J Nep Paedtr Soc 2011;31(3): 216-221

Cross-sectional survey of antibiotic resistance in Escherichia coli isolated from diseased farm livestock in England and Wales

2015 ◽  
Vol 143 (12) ◽  
pp. 2653-2659 ◽  
Author(s):  
T. E. A. CHENEY ◽  
R. P. SMITH ◽  
J. P. HUTCHINSON ◽  
L. A. BRUNTON ◽  
G. PRITCHARD ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antibiotic Resistance ◽  
Third Generation ◽  
Cross Sectional Survey ◽  
Cross Sectional ◽  
England And Wales ◽  
E Coli ◽  
Third Generation Cephalosporins ◽  
Farm Livestock ◽  
Government Laboratories

SUMMARYBetween 2005 and 2007, E. coli obtained from clinical diagnostic submissions from cattle, goats, pigs and sheep to government laboratories in England and Wales were tested for sensitivity to 16 antimicrobials. Resistance was most commonly observed against ampicillin, streptomycin, sulphonamides and tetracyclines. Resistance levels varied significantly between species, with isolates from cattle frequently showing the highest levels. Verocytotoxigenic E. coli (VTEC) expressed less resistance than non-VTEC. Only 19·3% of non-VTEC and 43·5% of VTEC were susceptible to all antimicrobials, while 47·1% and 30·4%, respectively, were resistant to ⩾5 antimicrobials. The resistance phenotype SSuT was commonly observed, and isolates resistant to third-generation cephalosporins were also identified. We recommend judicious antimicrobial usage in the livestock industry in order to preserve efficacy.

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