Download PDF
CC BY-NC-ND 4.0 · J Lab Physicians 2020; 12(04): 263-267
DOI: 10.1055/s-0040-1721163
Original Article

Quinolone Susceptibility in Salmonella Isolates Based on Minimum Inhibitory Concentration Determination

Varsha Gupta
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
,
Kritika Pal
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
,
Alisha Bhagat
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
,
Anku Goel
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
,
Jagdish Chander
1   Department of Microbiology, Government Medical College and Hospital, Chandigarh, India
› Author Affiliations Source(s) of Support Not applicable.
› Further Information
   Permissions and Reprints

Abstract

Introduction Typhoid fever, caused by Salmonella typhi and paratyphi, is a generalized infection with case fatality of about 10%. The symptoms may be severe, with life threatening sequelae of infection in a proportion of cases. Antimicrobial agents are the mainstay of therapy in enteric fever so as to prevent the complications associated with severe illness and mortality in the patients. Fluoroquinolones (e.g., ciprofloxacin) are very effective against completely susceptible Salmonella bacteria. However, their efficacy is doubtful once any resistance is detected. Pefloxacin testing has ultimately helped in the accurate identification of quinolone susceptibility for a better therapeutic success rate. In the present study we have tried to evaluate the quinolone susceptibility in Salmonella isolates based on minimum inhibitory concentration (MIC) determination.

Materials and Methods The method used in the study is quinolone susceptibility in Salmonella isolates based on MIC determination. Salmonella isolates show intermediate susceptibility to ciprofloxacin using disk diffusion. Both ciprofloxacin and pefloxacin MIC evaluation has been done to corroborate the results with pefloxacin disk diffusion testing.

Results There was a positive correlation between the susceptibility to ciprofloxacin and pefloxacin. However, the isolates with intermediate susceptibility had variations in terms of susceptibility to pefloxacin. MIC values for pefloxacin and our findings suggested that pefloxacin susceptible on disk diffusion as per Clinical and Laboratory Standards Institute guidelines showed lower values for MIC using Pefloxacin HICOMB test and pefloxacin resistant isolates showed higher MIC values.

Keywords

MIC determination - pefloxacin - pefloxacin susceptible - quinolone susceptibility - Salmonella isolates


Publication History

Article published online:
30 December 2020

© 2020. The Indian Association of Laboratory Physicians. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial-License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/).

Thieme Medical and Scientific Publishers Pvt. Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 

  • References

  • 1 Li J, Hao H, Sajid A, Zhang H, Yuan Z. Fluoroquinolone resistance in Salmonella: mechanisms, fitness, and virulence. Intechopen. 2018; 6: 85-107
    Google Scholar
  • 2 Veeraraghavan B, Pragasam AK, Bakthavatchalam YD, Ralph R. Typhoid fever: issues in laboratory detection, treatment options & concerns in management in developing countries. Future Sci OA 2018; 4 (06) FSO312
    CrossrefPubMedGoogle Scholar
  • 3 Bhetwal A, Maharjan A, Khanal PR, Parajuli NP. Enteric fever caused by Salmonella enterica serovars with reduced susceptibility of fluoroquinolones at a community based teaching hospital of Nepal. Int J Microbiol 2017; 2017: 2869458
    CrossrefPubMedGoogle Scholar
  • 4 Colle JG, Duguid JP, Fraser AG, Marmion BP, Simmons A. Laboratory strategy in the diagnosis of infective syndromes. In: Colle JG, Fraser AG, Marmion BP, Simmons A. eds. Mackie and Mc Cartney Practical Medical Microbiology. 14th ed. Singapore: Churchill Livingstone; 2006
    Google Scholar
  • 5 Hakanen A, Kotilainen P, Huovinen P, Helenius H, Siitonen A. Reduced fluoroquinolone susceptibility in Salmonella enterica serotypes in travelers returning from Southeast Asia. Emerg Infect Dis 2001; 7 (06) 996-1003
    CrossrefPubMedGoogle Scholar
  • 6 Gupta V, Datta P, Mohi G, Chander J. Pefloxacin as a Surrogate Marker for Ciprofloxacin Resistance in Salmonella Study from North India. 2016; (e-pub ahead of print) DOI: 10.5281/zenodo.1124451.
    CrossrefGoogle Scholar
  • 7 CLSI. Performance Standards for Antimicrobial Disk Susceptibility Testing. Approved Standard-Twelfth Edition. CLSI document M02A12. Wayne, PA: Clinical and Laboratory Standards Institute; 2015
    Google Scholar
  • 8 Balaji V, Sharma A, Ranjan P, Kapil A. Revised ciprofloxacin breakpoints for Salmonella typhi: its implications in India. Indian J Med Microbiol 2014; 32 (02) 161-163
    CrossrefPubMedGoogle Scholar
  • 9 Parry CM, Vinh H, Chinh NT. et al. The influence of reduced susceptibility to fluoroquinolones in Salmonella enterica serovar typhi on the clinical response to ofloxacin therapy. PLoS Negl Trop Dis 2011; 5 (06) e1163
    CrossrefPubMedGoogle Scholar
  • 10 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Third Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute. CLSI document M100–S23; 2013
    Google Scholar
  • 11 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Second Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute. CLSI document M100–S22; 2012
    Google Scholar
  • 12 Capoor MR, Nair D, Aggarwal P, Mathys V, Dehem M, Bifani PJ. Salmonella enterica serovar typhi: molecular analysis of strains with decreased susceptibility and resistant to ciprofloxacin in India from 2001-2003. Braz J Infect Dis 2007; 11 (04) 423-425
    CrossrefPubMedGoogle Scholar
  • 13 Khan S, Kumar VA. Pitfalls of interpreting ciprofloxacin minimum inhibitory concentrations in Salmonella enterica serovar typhi. Indian J Med Res 2012; 136 (05) 884
    PubMedGoogle Scholar
  • 14 Sharma P, Dahiya S, Kumari B. et al. Pefloxacin as a surrogate marker for quinolone susceptibility in Salmonella enterica serovars typhi & paratyphi A in India. Indian J Med Res 2017; 145 (05) 687-692
    PubMedGoogle Scholar
  • 15 Skov R, Matuschek E, Sjölund-Karlsson M. et al. Development of a pefloxacin disk diffusion method for detection of fluoroquinolone-resistant Salmonella enterica. J Clin Microbiol 2015; 53 (11) 3411-3417
    CrossrefPubMedGoogle Scholar
  • 16 Deak E, Skov R, Hindler JA, Humphries RM. Evaluation of surrogate disk tests for detection of ciprofloxacin and levofloxacin resistance in clinical isolates of Salmonella enterica. J Clin Microbiol 2015; 53 (11) 3405-3410
    CrossrefPubMedGoogle Scholar
  • 17 Clinical and Laboratory Standards Institute. Performance Standards for Antimicrobial Susceptibility Testing. Twenty-Third Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute. CLSI document M100–S29; 2019
    Google Scholar