AJTMH Transactions of the Royal Society of Tropical Medicine and Hygiene
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Am. J. Trop. Med. Hyg., 80(6), 2009, pp. 1012-1013
Copyright © 2009 by The American Society of Tropical Medicine and Hygiene

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SHORT REPORT


Increasing Fluoroquinolone Resistance in Salmonella typhi in Ontario, 2002–2007

Shaun K. Morris*, Susan E. Richardson, Laura J. Sauve, E. Lee Ford-Jones, AND Frances Jamieson
Division of Infectious Diseases, Hospital for Sick Children and The University of Toronto, Toronto, Canada; Department of Microbiology, Hospital for Sick Children, The University of Toronto, and Ontario Agency for Health Protection and Promotion, Toronto, Canada; Division of Infectious and Immunologic Diseases, British Columbia Children’s Hospital and The University of British Columbia, Vancouver, Canada; Division of Social Pediatrics, Hospital of Sick Children and The University of Toronto, Toronto, Canada; Department of Laboratory Medicine and Pathobiology, The University of Toronto and Ontario Agency for Health Protection and Promotion, Toronto, Canada

 

ABSTRACT

We reviewed the antibiotic susceptibility patterns of all isolates of Salmonella typhi in Ontario, Canada from January 2002 to December 2007. We identified a total of 381 unique cases over the 5-year period (50–73 cases per year). Of the 381 cases, 171 were female, 164 were male, and no gender was identified for 33 cases. Age of the patients ranged from less than 1 to 102 years of age (median age of 20 years). Although resistance patterns for ampicillin, trimethoprim-sulfamethoxazole, third generation cephalosporins (cefotaxime until May 2005 and ceftriaxone from June 2005 to present), and chloramphenicol remained stable, nalidixic acid resistance rose sharply between 2003 and 2005 and has remained at approximately 80% of isolates since 2005. The significant and sustained increase in nalidixic acid-resistant S. typhi suggests that ciprofloxacin should no longer be used as the drug of choice for the empiric treatment of typhoid fever in Ontario.

Received October 30, 2008. Accepted for publication February 3, 2009.

Acknowledgments: We acknowledge and offer sincere thanks for the contributions of Prasad Rawte and Shirley Brown at the Central Public Health Laboratory (CPHL).

* Address correspondence to Shaun K. Morris, Division of Infectious Diseases, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8. E-mail: shaun.morris{at}utoronto.ca

Authors’ addresses: Shaun K. Morris, Division of Infectious Diseases, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8, and the University of Toronto, Tel: 416-813-7807, Fax: 416-813-5032, E-mail: shaun.morris{at}utoronto.ca. Susan E. Richardson, Division of Microbiology, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8, the University of Toronto, and Ontario Agency for Health Protection and Promotion, E-mail: susan.richardson{at}sickkids.ca. Laura J. Sauve, Division of Infectious Diseases, British Columbia Children’s Hospital, 4480 Oak Street, Vancouver, British Columbia, Canada, V6H 3N1, and the University of British Columbia, E-mail: lsauve{at}cw.bc.ca. E. Lee Ford-Jones, Division of Social Pediatrics, Hospital for Sick Children, 555 University Avenue, Toronto, Ontario, Canada, M5G 1X8, and the University of Toronto, E-mail: lee.ford-jones{at}sickkids.ca. Frances Jamieson, Public Health Laboratories – Toronto, Ontario Agency for Health Protection and Promotion, 81 Resources Rd., Toronto, Ontario, Canada, M9P3T1, Ontario Agency for Health Protection and Promotion, and Department of Laboratory Medicine and Pathobiology, University of Toronto, E-mail: frances.jamieson{at}oahpp.ca.






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