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Volume 17, Number 1—January 2011
Dispatch

Foreign Travel and Decreased Ciprofloxacin Susceptibility in Salmonella enterica Infections

Manar Al-Mashhadani, Robert Hewson, Roberto Vivancos, Alex Keenan, Nick J. Beeching, John Wain, and Christopher M. ParryComments to Author 
Author affiliations: Author affiliations: University of Liverpool, Liverpool, UK (M. Al-Mashhadani, R. Hewson, C.M. Parry); Health Protection Agency Moorgate Point, Liverpool (R. Vivancos, A. Keenan); University of Manchester, Manchester, UK (R. Vivancos); Liverpool School of Tropical Medicine, Liverpool (N.J. Beeching); Health Protection Agency Colindale, London, UK (J. Wain)

Main Article

Table A1

Clinical features and outcomes for 11 patients with nontyphoidal Salmonella enterica bacteremia, Liverpool, UK, 2003–2009*

Patient no.
 Strain no.
 Serovar and PT
 Resistance pattern
 Ciprofloxacin
MIC, µg/mL
 Age, y/ sex
 Preexisting condition
 Travel
 Clinical signs, symptoms
 Initial therapy
 Outcome
1 31711 Enteritidis PT4 ACSuTTm <0.060 41/F New HIV diagnosis, CD4 count 27 x 106 cells/L No Fever, cough Ciprofloxacin Initial resolution. Subsequent TB diagnosis.
2 33284 Enteritidis PT1 Pansusceptible <0.060 53/F Cholecystectomy for stones 2 years previously No Fever, complicated pancreatitis Ciprofloxacin Empirical ceftriaxone and metronidazole added
3 33474 Enteritidis PT1 NxCpL <0.060 57/F Previous breast cancer, duodenal ulcer No Acute cholecystitis Cefuroxime/
metronidazole Empyema, gall bladder disease, pancreatitis
4 43539 Enteritidis PT21 NxCpL 0.500 66/M Aortic aneurysm Turkey Fever Ciprofloxacin Persistent fever. Ciprofloxacin dose increased and ampicillin added. No evidence of graft infection. Resolution.
5 52612 Enteritidis PT21 Pansusceptible 0.060 25/F SLE, (mycophenolate and steroid treatment) Turkey Fever Amoxicillin and clavulanic acid Antimicrobial drug changed to ciprofloxacin. Resolution.
6 52981 Enteritidis PT21 ACCro 0.060 47/F Post bone marrow allograft No Fever Tazocin and gentamicin Antimicrobial drug changed to meropenem. Resolution.
7 61246 Newport NxCpL 1.000 75/F Gall bladder carcinoma
Previous isolation of salmonellae from gall bladder, DM, steroids No Fever Ciprofloxacin Recurrent bacteremia. Antimicrobial changed to ceftriaxone. Eventual resolution.
8 62856 Virchow ASuTTmNxCpL 0.250 34/F None Kenya Fever, abdominal pain Ceftriaxone Resolution.
9 71353 Enteritidis PT6a A 0.060 42/M New HIV diagnosis, CD4 count 7 × 106 cells/L No Fever, cough Ceftriaxone,
co-trimoxazole Also Pneumocystis pneumonia. Resolution.
10 76146 Enteritidis PT1 Pansusceptible 0.060 46/M Interferon treatment for chronic HBV infection No Collapse Tazocin Antimicrobial drug changed to ciprofloxacin. Resolution.
11
 72429
 Enteritidis PT24
 ANxCpL
 1.000
 34/M
 HIV, CD4 count
17 × 106/L, TB treatment
 Thailand
 Fever, cough
 Ciprofloxacin
 Antimicrobial drug changed to ceftriaxone because of slow response. Resolution.
*PT, phage type; A, ampicillin; C, chloramphenicol; Su, sulfamethoxazole; T, tetracycline, Tm, trimethoprim; TB, tuberculosis; Nx, nalidixic acid; CpL, decreased ciprofloxacin susceptibility; SLE, systemic lupus erythematosus; Cro, ceftriaxone; DM, diabetes mellitus; HBV, hepatitis B virus.

Main Article

Page created: July 08, 2011
Page updated: July 08, 2011
Page reviewed: July 08, 2011
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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