New Quinolone Resistance Phenomenon in
            <i>Salmonella enterica</i>
            : Nalidixic Acid-Susceptible Isolates with Reduced Fluoroquinolone Susceptibility

Hakanen, Antti; Lindgren, Marianne; Huovinen, Pentti; Jalava, Jari; Siitonen, Anja; Kotilainen, Pirkko

doi:10.1128/jcm.43.11.5775-5778.2005

Cited by 35 publications

(31 citation statements)

References 18 publications

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“…However, non-typhoidal Salmonella strains have been reported from southeast Asia that are susceptible to nalidixic acid but show reduced susceptibility to ciprofloxacin [11]. This phenomenon occludes the use of nalidixic acid resistance determination by the disk diffusion method as a tool to screen for decreased ciprofloxacin susceptibility in non-typhoidal Salmonella.…”

Section: Resultsmentioning

confidence: 98%

“…This phenomenon occludes the use of nalidixic acid resistance determination by the disk diffusion method as a tool to screen for decreased ciprofloxacin susceptibility in non-typhoidal Salmonella. This resistance pattern may possibly be due to the presence of an efflux pump mechanism [12,13] or mutations at locations other than gyrA [11]. Fluoroquinolone resistance in non-typhoidal Salmonella has emerged as a threat to the health community in the past few years [14,15,16]; therefore, invasive infections with serious complication caused by non-typhoidal Salmonella should be treated with increased caution to avoid treatment failures [17].…”

Section: Resultsmentioning

confidence: 99%

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High Level of Resistance to nalidixic acid in Salmonella enterica serovar Typhi in Central India

Kumar

Sharma

Mani

2009

J Infect Dev Ctries

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Background: Fluoroquinolones are the drugs of choice for the treatment of typhoid fever. But the recent increase in minimum inhibitory concentration (MIC) values of ciprofloxacin in Salmonella Typhi may result in delayed response and serious complications. Nalidixic acid resistance has been used as an indirect evidence of increased minimum inhibitory concentration for ciprofloxacin in Salmonella Typhi. Methods: We evaluated the isolates received at the National Salmonella and Escherichia Centre for nalidixic acid and ciprofloxacin susceptibility using standard methods. Minimum inhibitory concentrations have also been evaluated. Results: Ninety-six percent of the isolates were found to be nalidixic acid resistant while all isolates were found to be ciprofloxacin sensitive. The difference between minimum inhibitory concentration values of ciprofloxacin for nalidixic acid resistant and nalidixic acid sensitive isolates was found to be statistically significant. Conclusion: The study may be helpful in revising treatment strategies for the infections caused by nalidixic acid resistant Salmonella Typhi in the country.

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Section: Resultsmentioning

confidence: 98%

Section: Resultsmentioning

confidence: 99%

High Level of Resistance to nalidixic acid in Salmonella enterica serovar Typhi in Central India

Kumar

Sharma

Mani

2009

J Infect Dev Ctries

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“…Mutations at codon Ser83 or Asp87 are known to be common sites of mutation in gyrA, resulting in quinolone resistance (16,30), and all gyrA mutations detected in the present study (Asp87Tyr, Asp87Asn, and Ser83Phe) have been reported previously (14,16,41).…”

Section: Discussionmentioning

confidence: 62%

“…Studies have reported that since 2003 in Finland, NTS isolates with reduced susceptibility to fluoroquinolone (referring to ciprofloxacin MIC AE0.125 mg/mL), which were either susceptible or had only low-level resistance to nalidixic acid, had been isolated from Finnish travelers returning from Thailand or Malaysia (30,32,33). These isolates were referred to as the``nonclassical quinolone resistance phenotype'' (32,33), and isolates that were tested did not have a gyrA mutation (30,33).…”

Section: Discussionmentioning

confidence: 99%

“…Older CLSI (National Committee for Clinical Laboratory Stand-ards) guidelines from 2004 (29) recommended testing extraintestinal isolates of Salmonella for resistance to nalidixic acid, because isolates that are sensitive to fluoroquinolones but resistant to nalidixic acid may not be eliminated by treatment with a fluoroquinolone (29). However, with the emergence of NTS isolates with reduced susceptibility to ciprofloxacin, which are either sensitive or have low-level resistance to nalidixic acid, researchers have cautioned that nalidixic acid screening may not identify all isolates with reduced fluoroquinolone susceptibility (30,32,33). This type of resistance phenotype has been reported in isolates without common gyrA mutations but with qnr genes (33)(34)(35)(36).…”

Section: Introductionmentioning

confidence: 99%

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Molecular Analysis of Ciprofloxacin Resistance among Non-Typhoidal <i>Salmonella</i> with Reduced Susceptibility to Ciprofloxacin Isolated from Patients at a Tertiary Care Hospital in Kuala Lumpur, Malaysia

et al. 2014

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SUMMARY:We investigated the prevalence of non-typhoidal Salmonella (NTS) with``reduced susceptibility to ciprofloxacin'' (RS-Cip) (minimum inhibitory concentration [MIC], 0.12-1.0 mg/mL) as well as their resistance genes in 75 NTS isolates (53 from stool, 21 from blood, and 1 from urine) from patients at a tertiary care Malaysian hospital between January and December 2009. RS-Cip was detected in 24/75 (32.0z) isolates. Using the ciprofloxacin MIC interpretive criteria for Salmonella in the Clinical and Laboratory Standards Institute 2013 guidelines, 51/75 (68.0z) isolates were found to be sensitive, 22/75 (29.3z) were intermediate, and 2/75 (2.7z) were resistant to ciprofloxacin. The 24 isolates that were intermediate or resistant to ciprofloxacin were the same isolates categorized as having RS-Cip. Among the 23 tested isolates with RS-Cip, the qnrS gene was detected in 17/23 (73.9z) and single gyrA mutations were detected in 6/23 (26.1z) (Asp87Tyr [n ＝ 3], Asp87Asn [n ＝ 2], and Ser83Phe [n ＝ 1]). A parC (Thr57Ser) mutation was detected in 13/23 (56.5z) isolates, coexisting with either a qnrS gene or a gyrA mutation. The high incidence of the qnrS gene among isolates with RS-Cip needs to be monitored because qnr genes can spread via plasmids and aid in the emergence of increased resistance levels.

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Non-typhoidal Salmonella in Children: Microbiology, Epidemiology and Treatment

Haeusler

Curtis

2012

Advances in Experimental Medicine and Biology

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Non-typhoidal Salmonellae (NTS) are an important cause of infectious diarrhoea world-wide. In the absence of immune deficiency, gastroenteritis caused by NTS is usually mild, self limiting and rarely requires intervention. NTS are also an important cause of invasive disease, particularly in developing countries, likely secondary to the high prevalence of coexisting malnutrition, malaria and HIV infection. This review provides an overview of the microbiology, epidemiology and pathogenesis of NTS, and compares recommendations for the treatment of NTS gastroenteritis in children.

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New Quinolone Resistance Phenomenon in Salmonella enterica : Nalidixic Acid-Susceptible Isolates with Reduced Fluoroquinolone Susceptibility

Cited by 35 publications

References 18 publications

High Level of Resistance to nalidixic acid in Salmonella enterica serovar Typhi in Central India

High Level of Resistance to nalidixic acid in Salmonella enterica serovar Typhi in Central India

Molecular Analysis of Ciprofloxacin Resistance among Non-Typhoidal <i>Salmonella</i> with Reduced Susceptibility to Ciprofloxacin Isolated from Patients at a Tertiary Care Hospital in Kuala Lumpur, Malaysia

Non-typhoidal Salmonella in Children: Microbiology, Epidemiology and Treatment

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