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Volume 17, Number 6—June 2011


Ciprofloxacin-Resistant Salmonella enterica Serotype Typhi, United States, 1999–2008

Felicita MedallaComments to Author , Maria Sjölund-Karlsson, Sanghyuk Shin, Emily Harvey, Kevin Joyce, Lisa Theobald, Benjamin L. Nygren, Gary Pecic, Kathryn Gay, Jana Austin, Andrew Stuart, Elizabeth Blanton, Eric D. Mintz, Jean M. Whichard, and Ezra J. Barzilay
Author affiliations: Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (F. Medalla, M. Sjölund-Karlsson, K. Joyce, L. Theobald, B.L. Nygren, G. Pecic, K. Gay, J. Austin, A. Stuart, E. Blanton, E.D. Mintz, J.M. Whichard, E.J. Barzilay); California Emerging Infections Program, Oakland, California, USA (S. Shin); Massachusetts Department of Public Health, Jamaica Plain, Massachusetts, USA (E. Harvey)

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Table 2

Patient and isolate description, resistance to other antimicrobial agents, PFGE pattern, and travel reported for 9 ciprofloxacin-resistant Salmonella enterica serotype Typhi infections detected in the National Antimicrobial Resistance Monitoring System, United States, 1999–2008*

Patient no. (isolate) Age, y/ sex Site Specimen collection year Specimen source Resistance to other agents PFGE XbaI pattern† PFGE BlnI pattern‡ Travel§
1 (MA-03) 1/F MA 2003 Blood Cot, Fis, Nal, Tet JPPX01.0026 JPPA26.0110 India
2 (CA-05) 2/F CA 2005 Blood Cot, Fis, Nal, Tet JPPX01.0026 JPPA26.0110 India
3 (CA-06) 26/F CA 2006 Blood Nal JPPX01.0506 JPPA26.0187 India
4 (TX-06) 8/M TX 2006 Blood Amp, Chl, Cot, Fis, Nal, Str JPPX01.0465 JPPA26.0170 India, other
5 (AZ-06) 5/M AZ 2006 Stool Cot, Fis, Nal, Tet JPPX01.0026 JPPA26.0110 India
6 (NY-07) 6/M NYC 2007 Stool Nal JPPX01.0506 JPPA26.0187 India
7 (CA-07) 22/M CA 2007 Stool Cot, Fis, Nal, Tet JPPX01.0026 JPPA26.0110 India
8 (NJ-07) 28/M NJ 2007 Blood Nal JPPX01.0026 JPPA26.0002 India
9 (LAC-07) 48/F LAC 2007 Blood Nal JPPX01.0506 JPPA26.0187 Unknown

*PFGE, pulsed-field gel electrophoresis. State/local public health laboratories that submitted isolates: MA, Massachusetts; CA, California; TX, Texas; AZ, Arizona; NYC, New York City; NJ, New Jersey; LAC, Los Angeles County, California. Resistance to antimicrobial agents other than ciprofloxacin: Cot, trimethoprim–sulfamethoxazole; Fis, sulfamethoxazole or sulfisoxazole; Nal, nalidixic acid; Tet, tetracycline; Amp, ampicillin; Chl, chloramphenicol; Str, streptomycin.
†National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet)–designated PFGE patterns using restriction enzyme XbaI (data as of 2009 Oct 21): JPPX01.0026, the most common XbaI pattern among 3,233 isolates with reported XbaI pattern in PulseNet, was detected in 486 (15.0%); JPPX01.0465 and JPPX01.0506 each were detected in 12 (0.4%) isolates.
‡PulseNet-designated PFGE patterns using restriction enzyme BlnI (data as of 2009 Oct 21): JPPA26.0002, the most common BlnI pattern among 409 isolates with reported BlnI pattern in PulseNet, was detected in 61 (14.9%) isolates; JPPA26.0110 was detected in 5 (1.2%), JPPA26.0187 was detected in 3 (0.7%), and JPPA26.0170 was detected in 1 (0.2%).
§Travel outside the United States reported in the 30 d before illness onset; patient 4 also traveled to Bangladesh and the United Arab Emirates.

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