Antimicrobial resistance in typhoidal and nontyphoidal salmonellae

Current Opinion in Infectious Diseases
C M Parry, E John Threlfall

Abstract

Increasing occurrence of antimicrobial resistance in both typhoidal and nontyphoidal salmonellae is a major public health problem. Recent studies documenting the occurrence and types of resistance, with particular reference to quinolones and extended spectrum cephalosporins, and new approaches to treatment are reviewed. Community and hospital-based studies in different Asian and African countries show widely variable rates of resistance in Salmonella enterica serovars Typhi and Paratyphi A. Occurrence of multidrug resistance has declined in some areas, but the incidence of decreased ciprofloxacin susceptibility has reached high levels, particularly in the Indian subcontinent, and isolates with full resistance to this antimicrobial are increasingly reported. Similar variability in resistance rates occurs among nontyphoidal salmonellae, with variation between serovars and by region. There are reports of plasmid-mediated qnr genes and a variety of extended spectrum cephalosporin resistance genes in nontyphoidal serovars. Two randomized controlled trials report gatifloxacin as a potential treatment option in enteric fever caused by multidrug-resistant isolates with decreased ciprofloxacin susceptibility. Patterns of resistance in S...Continue Reading

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