Quinolone-resistant Salmonella typhi in Viet Nam: molecular basis of resistance and clinical response to treatment

Research output: Contribution to journalArticle

Authors

  • J Wain
  • N T Hoa
  • N T Chinh
  • H Vinh
  • M J Everett
  • T S Diep
  • N P Day
  • T Solomon
  • N J White
  • C M Parry

Colleges, School and Institutes

Abstract

Nalidixic acid-resistant Salmonella typhi (NARST) was first isolated in Viet Nam in 1993. Analysis of the quinolone resistance-determining region of gyrA in 20 NARST isolates by polymerase chain reaction and single-stranded conformational polymorphism yielded two novel patterns: pattern II corresponding to a point mutation at nucleotide 87 Asp-->Gly (n = 17), and pattern III corresponding to a point mutation at nucleotide 83 Ser-->Phe (n = 3). In trials of short-course ofloxacin therapy for uncomplicated typhoid, 117 (78%) of 150 patients were infected with multidrug-resistant S. typhi, 18 (15%) of which were NARST. The median time to fever clearance was 156 hours (range, 30-366 hours) for patients infected with NARST and 84 hours (range, 12-378 hours) for those infected with nalidixic acid-susceptible strains (P

Details

Original languageEnglish
Pages (from-to)1404-10
Number of pages7
JournalClinical Infectious Diseases
Volume25
Issue number6
Publication statusPublished - Dec 1997

Keywords

  • 4-Quinolones, Anti-Infective Agents, Child, DNA Gyrase, DNA Topoisomerases, Type II, Drug Resistance, Microbial, Drug Resistance, Multiple, Female, Humans, Male, Microbial Sensitivity Tests, Prospective Studies, Salmonella typhi, Sequence Analysis, DNA, Typhoid Fever, Vietnam