Epidemiology of Multidrug Resistance among Salmonella enterica serovars typhi and paratyphi A at a Tertiary Pediatric Hospital in India Over a Decade; In-silico Approach to Elucidate the Molecular Mechanism of Quinolone Resistance. (June 2022)

• Record Type: Journal Article
• Authors: Manoharan, Anand; Dey, Dipjyoti; Putlibai, Sulochana; Ramaiah, Sudha; Anbarasu, Anand; Balasubramanian, S.
• Is Part Of: International journal of infectious diseases. Volume 119(2022)
• Page Start: 146
• Page End: 149
• Publication Date: 2022-06
• Subjects: Enteric fever -- S. typhi -- S. paratyphi A -- Molecular docking -- Gyrase A -- Fluoroquinolone; Communicable diseases -- Periodicals; Communicable Diseases -- Periodicals; Communicable diseases; Periodicals; Electronic journals; 616.9
• DOI: 10.1016/j.ijid.2022.03.050
• Languages: English
• ISSNs: 1201-9712

Abstract

Abstract: Background: Enteric fever caused by Salmonella enterica serovar typhi and Salmonella enterica serovar paratyphi A remains one of the most common causes of community-acquired bloodstream infection among children in India. Multidrug resistance is emerging and is a cause of concern as it affects the choice of treatment in enteric fever. Method: In this study, a 10-year analysis of resistance patterns was done along with in-silico homology modeling and molecular docking to understand the commonly occurring quinolone resistance. Results: A total of 1010 cases of blood culture–confirmed enteric fevers ( S. typhi n=849; S. paratyphi A n=161) were recorded at the study hospital during the period from 2011-2020. Multidrug resistance among cases of S. typhi was 2.12 %, whereas it was completely absent among cases of S. paratyphi A . Fluoroquinolone resistance was high (>95%) throughout the study period. Resistance to ampicillin, chloramphenicol and co-trimoxacole was low (<3%) among S. typhi cases. No deaths were observed among study participants. Molecular docking analysis showed that quinolone had less binding affinity to mutated gyrase A than to its wild type for both S. typhi and S. paratyphi A . Conclusion: Quinolone resistance was high among cases of enteric fever, whereas no resistance was observed among third-generation cephalosporins. In-silico studies indicated that a mutation in gyrase A might be the cause of the gradual increase in ciprofloxacin resistance over the study period.