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Volume 20, Number 4—April 2014

Dispatch

Salmonella Subtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands

Robert-Jan HassingComments to Author , Wil H.F. Goessens, Wilfrid van Pelt, Dik J. Mevius, Bruno H. Stricker, Nicky Molhoek, Annelies Verbon, and Perry J.J. van Genderen
Author affiliations: Erasmus Medical Centre, Rotterdam, the Netherlands (R.-J. Hassing, W.H.F. Goessens, B.H. Stricker, A. Verbon); Inspectorate of Health Care, The Hague, the Netherlands (R.-J. Hassing, B.H. Stricker); National Institute for Public Health and the Environment (RIVM), Bilthoven, the Netherlands (W. van Pelt); Utrecht University, Utrecht, the Netherlands (D.J. Mevius); Central Veterinary Institute of Wageningen UR, Lelystad, the Netherlands (D.J. Mevius); Travel Clinic Havenziekenhuis, Rotterdam (N. Molhoek, P.J.J. van Genderen); Institute for Tropical Diseases, Havenziekenhuis, Rotterdam (P.J.J. van Genderen)

Main Article

Table

Isolates with elevated MICs for ciprofloxacin and isolates with an MIC for azithromycin above that for wild type (>16 mg/L) in Salmonella enterica serotype Typhi and Paratyphi isolates collected in travelers returning to the Netherlands, 1999–2012

Region
No. (%) isolates
No. (%) isolates with elevated MICs
Azithromycin
Ciprofloxacin
Azithromycin and ciprofloxacin
All 205 36 (17.6) 83 (40.5) 20 (9.8)
Asia 161 (78.5) 31 (19.3) 80 (49.7) 20 (12.4)
Southern Asia* 84 (40.0) 21 (25) 69 (82.1) 18 (21.4)
South-Eastern Asia† 44 (21.5) 5 (12.2) 3 (6.8) 1 (2.3)
Western Asia‡ 27 (13.2) 1 (3.7) 6 (22.2) 1 (3.7)
Eastern Asia§ 5 (2.4) 1 (20) 2 (40) 0
Unknown 1 (0.5) 0 0 0
Africa¶ 35 (17.1) 5 (14.3) 1 (2.9) 0
Europe** 4 (2.0) 0 2 (50) 0
Latin America†† 5 (2.4) 0 0 0

*India, Pakistan, Bangladesh, Nepal, Afghanistan, Nepal, Sri Lanka.
†Indonesia, Cambodia, Malaysia, Thailand.
‡Turkey, Iraq, Syria.
§China.
¶Morocco, Ghana, Nigeria, Senegal, Tunisia, Malawi, Tanzania.
**Gibraltar (Great Britain), Greece, Italy, Romania.
††Peru, Mexico, unknown.

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