Two hundred forty-one strains of Salmonella typhii isolated in Lima, Peru, from October 1981 through February 1983 were tested for susceptibility to antimicrobial agents. Seventy-two strains (29.9%) were resistant to chloramphenicol and other antibiotics, including ampicillin, sulfonamides, and trimethoprim. The minimal inhibitory concentrations of 17 antimicrobial agents were determined for all of these chloramphenicol-resistant strains. Sch 25393, new beta-lactams, new quinolones, and the formulation clavulanic acid-amoxicillin were effective against all the strains. Four different resistance patterns distributed among eight phage types were observed. The 72 resistant S. typhi could transfer the resistance marker into Escherichia coli C1, and all the plasmids belonged to the incompatibility group H1.

In spite of extensive DNA homology among IncHI1 plasmids, ApaI and XbaI restriction digests of plasmids from Peruvian Salmonella typhi varied considerably from other IncHI1 plasmids isolated previously. IncHI1 plasmids appear to be undergoing a process of modular evolution, probably by sequential acquisition of resistance determinants.

To investigate factors that could be involved in the emergence of antibiotic resistant S. typhi, we characterized R plasmids and antibiotic resistant S. typhi strains from two outbreaks of typhoid in Peru and Chile. Differences in the Inc HI1 plasmids of Peruvian and Chilean strains were identified by conjugation and incompatibility studies and plasmid DNA characterization. Antibiotic-resistant S. typhi harboring Inc HI1 plasmids belonged to a reduced number of Pst1 and Cla1 ribotypes and IS200 types, in contrast to the high genetic diversity found among epidemic antibiotic-susceptible S. typhi. The low diversity of antibiotic-resistant S. typhi suggests that they may express properties that are related to both their ability to harbor Inc HI1 R plasmids and to disseminate.

ResumenObjetivo