The Influence of Reduced Susceptibility to Fluoroquinolones in Salmonella enterica Serovar Typhi on the Clinical Response to Ofloxacin Therapy
摘要：
Author Summary Typhoid fever is an infection of the bloodstream caused by the organism Salmonella Typhi (S. Typhi). Treatment with antimicrobials is critical for preventing severe infection and even death, yet antimicrobial resistant organisms have become a problem in many places where typhoid is common. Fluoroquinolones are a group of antimicrobials that are commonly used to treat typhoid, we analysed data from 540 enteric fever patients treated with ofloxacin (a fluoroquinolone) to identify a level of resistance (minimum inhibitory concentration (MIC)) from the infecting organism which is associated with treatment failure. The proportion of patients failing treatment was higher in those infected with a bacterium with an MIC≥0.25 µg/mL, compared with those infections with an MIC of ≤0.125 µg/mL. Treatment success was 96% when the ofloxacin MIC was ≤0.125 µg/mL, yet only 53% when the MIC was 1.00 µg/mL. Our data demonstrates that an S. Typhi bacterium with an ofloxacin MIC of ≥0.25 µg/mL correlates with a poor outcome when treated with this antimicrobial. Therefore, we propose an amendment in the current MIC guidelines for microbiology laboratories to aid clinicians treating typhoid and suggest the use of alternative therapy in these patients.
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关键词：
Humans Salmonella typhi Typhoid Fever Treatment Failure Microbial Sensitivity Tests Drug Resistance, Bacterial Ofloxacin Vietnam Fluoroquinolones
DOI：
10.1371/journal.pntd.0001163
被引量：
年份：
2011
BMJ
EBSCO
BMJ
万方
掌桥科研
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