UNIVERSITAS AIRLANGGA



Detail Article

Indonesian Journal of Clinical Pathology and Medical Laboratory

ISSN 0854-4263

Vol. 18 / No. 1 / Published : 2011-01

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Original Article :

Detecting fluoroquinolone resistance of salmonella sp using nalidixic acid succeptibility test

Author :

  1. Lim Bing Tiam*1
  2. Tjan Sian Hwa*2
  3. Sri Mulyani*3
  4. Widiyani*4
  5. Diyah Asmawati*5
  1. Consultant Clinical Microbiologist RS Premier Jatinegara
  2. Laboratorium Klinik RS Premier Jatinegara
  3. Laboratorium Klinik RS Premier Jatinegara
  4. Laboratorium Klinik RS Premier Jatinegara
  5. Laboratorium Klinik RS Premier Jatinegara

Abstract :

  Fluoroquinolone is used as first line drug  for Salmonella sp infection, but there were reports of increasing treatment failure with fluoroquinolone in infection  caused by Salmonella sp, which in vitro is still succeptible to fluoroquinolone. The identification of nalidixic acid resistance, a first generation quinolone provides a high sensitivity and specifity for the detection of such fluoroquinolone resistance. The researchers aim is to study  the prevalence and the minimum ciprofloxacin inhibitory concentration of nalidixic acid resistant but fluoroquinolone sensitive Salmonella sp at Premier Jatinegara Hospital. BBlood cultures sent to Premier Jatinegara Hospital Laboratory during 2010 were evaluated according to Clinical and Laboratory Standards Institute guidelines. Identification and MIC succeptibility testing were determined by VITEK® 2 Compact (Biomerieux®) and nalidixic acid succeptibility testing was performed by disc diffusion method according to Kirby Bauer. Thirty eight  Salmonella sp isolates were identified, all were succeptible to ciprofloxacin (MIC < 0,25 mg/L), but 5 (13,2%) isolates were resistant to nalidixic acid and reported as resistant. This study found that 13,2%  of  Salmonella sp were resistant to fluoroquinolone but not detected by the recommended CLSI breakpoint values. The researchers recommend that nalidixic acid testing be included in Salmonella sp succeptibility testing in Indonesia and consider 3rd generation cephalosporin as the first line drug before a succeptibility test result is available.       Fluorokuinolon merupakan pengobatan lini pertama infeksi Salmonella sp, tetapi dilaporkan adanya peningkatan kegagalan pengobatan fluorokuinolon untuk infeksi Salmonella sp yang pada pemeriksaan in vitro didapatkan masih peka terhadap fluorokuinolon. Pengenalian adanya resistensi asam nalidiksat, salah satu kuinolon generasi pertama mempunyai kepekaan dan kekhasan yang tinggi untuk menemukan resistensi fluorokuinolon tersebut. Tujuan penelitian ini adalah untuk mendapatkan prevalensi dan konsentrasi hambatan terkecil siprofloksasin untuk Salmonella sp yang peka terhadap fluorokuinolon tetapi resisten terhadap asam nalidiksat di rumah sakit Premier Jatinegara. Biakan darah yang dikirim ke laboratorium rumah sakit Premier Jatinegara pada tahun 2010 diperiksa menurut  pedoman Clinical and Laboratory Standards Institute (CLSI). Pengenalian dan uji kepekaan dengan cara kadar hambatan terkecil dilakukan dengan alat VITEK® 2 Compact (Biomerieux®), sedangkan uji kepekaan asam nalidiksat dilakukan dengan cara difusi cakram  menurut Kirby Bauer. Pada penelitian ini didapatkan 38 isolat Salmonella sp yang semuanya peka terhadap siprofloksasin (MIC <0,25 mg/L). Lima (5) (13,2%) dari isolat didapatkan resisten terhadap asam nalidiksat serta dilaporkan sebagai resisten terhadap siprofloksasin. Kami menganjurkan agar asam nalidiksat juga dimasukkan pada uji kepekaan antibiotik untuk Salmonella sp di  Indonesia dan pemakaian sefalosporin generasi ketiga sebagai pengobatan lini pertama sebelum didapatkan hasil uji kepekaan. 

Keyword :

Salmonella, fluoroquinolone, resistance, nalidixic acid succeptibility test,


References :

Murray PR., Baron EJ, Jorgensen JM, Phaller MA eds,(2007) Escherichia, Shigella, and Salmonella Washington DC : ASM Press

Crump JA, Mintz ED,(2010) Global trends in typhoid and paratyphoid fever USA : Clin Infect Dis

Boyle EC, Bishop JL, Grass GA, Finlay BB,(2007) Meeting review. Salmonella: from Pathogenesis to Therapeutics USA : J Bacteriol

Crump JA, Luby SP, Mintz ED,(2004) The global burden of typhoid fever USA : Bull World Health Organ

Crump JA, Kretsinger K, Gay K etal,(2008) Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreases succeptibility to fluroquinolones USA : a United States FoodNet multicenter retrospective cohort study. Antimicrob Agents Chemother





Archive Article

Cover Media Content

Volume : 18 / No. : 1 / Pub. : 2011-01
  1. Aerob Microbes Pattern And Antimicrobial Sensitivity Of Diabetic Foot Ulcer
  2. Plasma Levels Of Interleukin 10 (il-10) In Malaria And Anaemia
  3. Identification Of Cryptosporidiosis In Paediatric Hiv-infected Patients With Chronic Diarrhoea At Paediatric Gastro
  4. Immunoglobulin A In Dengue Hemorrhagic Fever
  5. (comparison Of Determination For Thyroxine With Enzyme Linked Immunofluorescent Assay (elfa) And Enzyme Linked Immunosorbant Assay (elisa)}
  6. Plasma Interleukin-10 And Cd4+ Lymphocyte-t In Hiv Infected Patients
  7. Detecting Fluoroquinolone Resistance Of Salmonella Sp Using Nalidixic Acid Succeptibility Test
  8. Phyllanthus Niruri L The Effects Of Extract On Cellular Immunity Mice
  9. Fitoestrogen Dalam Beberapa Daun Dan Buah
  10. Diagnostic Test Nt Pro Natriuretic Peptide (ntprobnp) On Congestive Heart Failure
  11. Human Immunodeficiency Virus (hiv) Infection In Babies And Children
  12. Decompensated Cirrhosis Hepatic In Children
  13. Human Resources Management In The Clinical Laboratory

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