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1
Statistics Canada, 2006 Census. Available at: http://www.fin.gov.on.ca/english/economy/demographics/census/cenhi06-7.html. Accessed April 11, 2008.
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2
Rowe B, Ward LR, Threlfall EJ, 1997. Multidrug-resistant Salmonella typhi: a worldwide epidemic. Clin Infect Dis 24 (Suppl 1):S106–S109.
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3
Threlfall EJ, Ward LR, Skinner JA, Smith HR, Lacey S, 1999. Ciprofloxacin-resistant Salmonelle typhi and treatment failure. Lancet 353 :1590–1591.
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4
Slinger R, Desjardins M, McCarthy AE, Ramotar K, Jessamine P, Guibord C, Toye B, 2004. Suboptimal clinical response to ciprofloxacin in patients with enteric fever due to Salmonella spp. with reduced fluoroquinolone susceptibility: a case series. BMC Infect Dis 4 :36.
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5
Hakanen A, Kotilainen P, Jalava J, Siitonen A, Huovinen P, 1999. Detection of decreased fluoroquinolone susceptibility in Salmonellas and validation of nalidixic acid screening test. J Clin Microbiol 37 :3572–3577.
-
6
NCCLS, 2003. Performance standards for antimicrobial susceptibility testing: Thirteenth informational supplement. NCCLS document M100-S13 (M7). Wayne, PA: NCCLS.
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7
Crump JA, Barrett TJ, Nelson JT, Angulo FJ, 2003. Reevaluating fluoroquinolone breakpoints for Salmonella enterica serotypeTyphi and for non-Typhi Salmonellae. Clin Infect Dis 37 :75–81.
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8
Clinical Laboratory and Standards Institute, 2007. Performance standards for antimicrobial susceptibility testing: seventeenth informational supplement. CLSI document M100-S17. Wayne, PA: CLSI.
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9
Steinberg EB, Bishop R, Haber P, Dempsey AF, Hoekstra RM, Nelson JM, Ackers M, Calugar A, Mintz ED, 2004. Typhoid fever in travelers: who should be targeted for prevention? Clin Infect Dis 39 :186–191.
-
10
Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, Bhutta ZA, Canh do G, Ali M, Shin S, Wain J, Page AL, Albert MJ, Farrar J, Abu-Elyazeed R, Pang T, Galindo CM, von Seidlein L, Clemens JD; Domi Typhoid Study Group, 2008. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ 86 :260–268.
| Past two years | Past Year | Past 30 Days | |
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| Abstract Views | 540 | 479 | 11 |
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| PDF Downloads | 47 | 8 | 0 |
Increasing Fluoroquinolone Resistance in Salmonella typhi in Ontario, 2002–2007
Shaun K. Morris
Shaun K. Morris
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
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Susan E. Richardson
Susan E. Richardson
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
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Laura J. Sauve
Laura J. Sauve
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
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E. Lee Ford-Jones
E. Lee Ford-Jones
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
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Frances Jamieson
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
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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.
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-
1
Statistics Canada, 2006 Census. Available at: http://www.fin.gov.on.ca/english/economy/demographics/census/cenhi06-7.html. Accessed April 11, 2008.
-
2
Rowe B, Ward LR, Threlfall EJ, 1997. Multidrug-resistant Salmonella typhi: a worldwide epidemic. Clin Infect Dis 24 (Suppl 1):S106–S109.
-
3
Threlfall EJ, Ward LR, Skinner JA, Smith HR, Lacey S, 1999. Ciprofloxacin-resistant Salmonelle typhi and treatment failure. Lancet 353 :1590–1591.
-
4
Slinger R, Desjardins M, McCarthy AE, Ramotar K, Jessamine P, Guibord C, Toye B, 2004. Suboptimal clinical response to ciprofloxacin in patients with enteric fever due to Salmonella spp. with reduced fluoroquinolone susceptibility: a case series. BMC Infect Dis 4 :36.
-
5
Hakanen A, Kotilainen P, Jalava J, Siitonen A, Huovinen P, 1999. Detection of decreased fluoroquinolone susceptibility in Salmonellas and validation of nalidixic acid screening test. J Clin Microbiol 37 :3572–3577.
-
6
NCCLS, 2003. Performance standards for antimicrobial susceptibility testing: Thirteenth informational supplement. NCCLS document M100-S13 (M7). Wayne, PA: NCCLS.
-
7
Crump JA, Barrett TJ, Nelson JT, Angulo FJ, 2003. Reevaluating fluoroquinolone breakpoints for Salmonella enterica serotypeTyphi and for non-Typhi Salmonellae. Clin Infect Dis 37 :75–81.
-
8
Clinical Laboratory and Standards Institute, 2007. Performance standards for antimicrobial susceptibility testing: seventeenth informational supplement. CLSI document M100-S17. Wayne, PA: CLSI.
-
9
Steinberg EB, Bishop R, Haber P, Dempsey AF, Hoekstra RM, Nelson JM, Ackers M, Calugar A, Mintz ED, 2004. Typhoid fever in travelers: who should be targeted for prevention? Clin Infect Dis 39 :186–191.
-
10
Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, Bhutta ZA, Canh do G, Ali M, Shin S, Wain J, Page AL, Albert MJ, Farrar J, Abu-Elyazeed R, Pang T, Galindo CM, von Seidlein L, Clemens JD; Domi Typhoid Study Group, 2008. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ 86 :260–268.
| Past two years | Past Year | Past 30 Days | |
|---|---|---|---|
| Abstract Views | 540 | 479 | 11 |
| Full Text Views | 246 | 5 | 0 |
| PDF Downloads | 47 | 8 | 0 |