Multidrug-resistant Salmonella typhi: A worldwide epidemic
Multidrug-resistant Salmonella typhi: A worldwide epidemic
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DOI：
10.1093/clinids/24.supplement_1.s106
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发表时间：
1997-01-01
影响因子：
11.8
通讯作者：
Threlfall, EJ
中科院分区：
文献类型：
--
作者：
Rowe, B;Ward, LR;Threlfall, EJ
自1989年以来，对氯霉素、氨苄青霉素和甲氧苄啶耐药的伤寒沙门氏菌菌株（即，多药耐药[MDR]菌株）是印度次大陆、东南亚和非洲国家多次暴发的原因。MDR菌株也越来越频繁地从阿拉伯湾国家的移民工人以及发达国家的归国旅行者中分离出来。在迄今为止检查的所有MDR菌株中，多重耐药性已由II，不相容组的质粒编码。由于这类菌株的广泛传播，氯霉素不能再被视为治疗伤寒的一线药物。由于菌株对氨苄青霉素和甲氧苄啶也有耐药性，这些抗生素的疗效也受到损害，环丙沙星现在是伤寒的首选药物。在英国从印度次大陆返回的患者中分离出的少数菌株中，现已观察到染色体编码的环丙沙星耐药性，至少有一例患者对这种抗生素治疗没有反应。令人遗憾的是，耐药菌株已对环丙沙星产生耐药性。因此，我们必须限制不必要地使用这种重要药物，以免进一步损害其疗效。
Since 1989, strains of Salmonella typhi resistant to chloramphenicol, ampicillin, and trimethoprim (i.e., multidrug-resistant [MDR] strains) have been responsible for numerous outbreaks in countries in the Indian subcontinent, Southeast Asia, and Africa. MDR strains have also been isolated with increasing frequency from immigrant workers in countries in the Arabian Gulf, as well as in developed countries from returning travelers. In all MDR strains so far examined, multiple resistance has been encoded by plasmids of the Il, incompatibility group. As a result of the widespread dissemination of such strains, chloramphenicol can no longer be regarded as the first-line drug for typhoid fever. Because strains are also resistant to ampicillin and trimethoprim, the efficacy of these antibiotics has also been impaired, and ciprofloxacin is now the drug of choice for typhoid fever. Chromosomally encoded resistance to ciprofloxacin has now been observed in a small number of strains isolated in the United Kingdom from patients returning from the Indian subcontinent, and in at least one case the patient did not respond to treatment with this antibiotic. It is regrettable that resistance to ciprofloxacin has now emerged in MDR S. typhi, and it is of paramount importance to limit the unnecessary use of this vital drug so that its efficacy should not be further jeopardized.