Volume 17, Number 1—January 2011
Dispatch
Foreign Travel and Decreased Ciprofloxacin Susceptibility in Salmonella enterica Infections
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. |