Highly resistant Salmonella enterica serovar Typhi with a novel gyrA mutation raises questions about the long-term efficacy of older fluoroquinolones for treating typhoid fever.

Abstract

As a consequence of multidrug resistance, clinicians are highly dependent on fluoroquinolones for treating the serious systemic infection typhoid fever. While reduced susceptibility to fluoroquinolones, which lessens clinical efficacy, is becoming ubiquitous, comprehensive resistance is exceptional. Here we report ofloxacin treatment failure in typhoidal patient infected with a novel, highly fluoroquinolone-resistant isolate of Salmonella enterica serovar Typhi. The isolation of this organism has serious implications for the long-term efficacy of ciprofloxacin and ofloxacin for typhoid treatment.

• Authors: Kanika Deshpande Koirala, Duy Pham Thanh, Sudeep Dhoj Thapa, Amit Arjyal, Abhilasha Karkey, Sabina Dongol, Upendra Man Shrestha, Jeremy J Farrar, Buddha Basnyat, Stephen Baker
• Journal: Antimicrobial agents and chemotherapy (Antimicrob Agents Chemother) Vol. 56 Issue 5 Pg. 2761-2 (May 2012) ISSN: 1098-6596 [Electronic] United States
• PMID: 22371897 (Publication Type: Case Reports, Journal Article, Research Support, Non-U.S. Gov't)

Chemical References

• Anti-Bacterial Agents
• Bacterial Proteins
• Fluoroquinolones
• Azithromycin
• Ofloxacin
• DNA Gyrase

Topics

• Adolescent
• Amino Acid Sequence
• Anti-Bacterial Agents (therapeutic use)
• Azithromycin (therapeutic use)
• Bacterial Proteins (genetics)
• DNA Gyrase (genetics)
• Drug Resistance, Multiple, Bacterial (genetics)
• Fluoroquinolones (therapeutic use)
• Humans
• Male
• Microbial Sensitivity Tests
• Molecular Sequence Data
• Mutation
• Nepal
• Ofloxacin (therapeutic use)
• Salmonella typhi (drug effects, genetics, isolation & purification, pathogenicity)
• Treatment Failure
• Typhoid Fever (drug therapy, microbiology)