Skip to main content
    • Aa
    • Aa
  • Get access
    Check if you have access via personal or institutional login
  • Cited by 9
  • Cited by
    This article has been cited by the following publications. This list is generated based on data provided by CrossRef.

    Tatavarthy, Aparna Luna, Vicki A. and Amuso, Philip T. 2014. How multidrug resistance in typhoid fever affects treatment options. Annals of the New York Academy of Sciences, Vol. 1323, Issue. 1, p. 76.

    Pfeifer, Yvonne Matten, Jens and Rabsch, Wolfgang 2009. Salmonella entericaSerovar Typhi with CTX-M β-Lactamase, Germany. Emerging Infectious Diseases, Vol. 15, Issue. 9, p. 1533.

    Kim, Koo-Youn Park, Jong-Hyun Kwak, Hyo-Sun and Woo, Gun-Jo 2011. Characterization of the quinolone resistance mechanism in foodborne Salmonella isolates with high nalidixic acid resistance. International Journal of Food Microbiology, Vol. 146, Issue. 1, p. 52.

    Ballesté-Delpierre, Clara Fàbrega, Anna Ferrer-Navarro, Mario Mathur, Ramkumar Ghosh, Sankar and Vila, Jordi 2016. Attenuation ofin vitrohost–pathogen interactions in quinolone-resistantSalmonellaTyphi mutants. Journal of Antimicrobial Chemotherapy, Vol. 71, Issue. 1, p. 111.

    Deekshit, V.K. Kumar, B.K. Rai, P. Karunasagar, I. and Karunasagar, I. 2015. Differential expression of virulence genes and role ofgyrAmutations in quinolone resistant and susceptible strains ofSalmonellaWeltevreden and Newport isolated from seafood. Journal of Applied Microbiology, Vol. 119, Issue. 4, p. 970.

    Chen, Yen-Ping Tseng, Chun-Hsien Lee, Shu-Hwae Chou, Chung-Hsi and Tsai, Hsiang-Jung 2014. ALTERATIONS OF DNA TOPOISOMERASES OFRIEMERELLA ANATIPESTIFERWITHIN VITRO-REDUCED SUSCEPTIBILITY TO QUINOLONES. Taiwan Veterinary Journal, Vol. 40, Issue. 01, p. 57.

    Ferrari, Rafaela Gomes Galiana, Antonio Cremades, Rosa Rodríguez, Juan Carlos Magnani, Marciane Tognim, Maria Cristina Bronharo Oliveira, Tereza C.R.M. and Royo, Gloria 2013. Expression of the marA, soxS, acrB and ramA genes related to the AcrAB/TolC efflux pump in Salmonella enterica strains with and without quinolone resistance-determining regions gyrA gene mutations. The Brazilian Journal of Infectious Diseases, Vol. 17, Issue. 2, p. 125.

    Cheng, Chi Keung Cheung, Man Kit Nong, Wenyan Law, Patrick Tik Wan Qin, Jing Ling, Julia Mei-Lun Kam, Kai Man Cheung, William Man Wai and Kwan, Hoi Shan 2015. Next generation genome sequencing reveals phylogenetic clades with different level of virulence among Salmonella Typhimurium clinical human isolates in Hong Kong. BMC Genomics, Vol. 16, Issue. 1,

    Shen, Dandan Xu, Yanling Pan, Shiyang Li, Yun Lu, Yuan Xu, Ting Xia, Wenying Liu, Genyan and Gu, Bing 2015. Prevalence and characterization of class 1 integrons in multi-drug resistantSalmonellasp. from China in 2010. Journal of Chemotherapy, Vol. 27, Issue. 1, p. 57.


Molecular analysis of high-level ciprofloxacin resistance in Salmonella enterica serovar Typhi and S. Paratyphi A: need to expand the QRDR region?

  • M. R. CAPOOR (a1), D. NAIR (a1), N. S. WALIA (a1), R. S. ROUTELA (a2), S. S. GROVER (a2), M. DEB (a1), P. AGGARWAL (a1), P. K. PILLAI (a3) and P. J. BIFANI (a4)
  • DOI:
  • Published online: 08 August 2008

Fourteen strains of S. Typhi (n=13) and S. Paratyphi A (n=1) resistant to ciprofloxacin were compared with 30 ciprofloxacin decreased-susceptibility strains on the basis of qnr plasmid analysis, and nucleotide substitutions at gyrA, gyrB, parC and parE. In ciprofloxacin-resistant strains, five S. Typhi and a single S. Paratyphi A showed triple mutations in gyrA (Ser83→Phe, Asp87→Asn, Glu133→Gly) and a novel mutation outside the quinolone resistance determining region (QRDR) (Met52→Leu). Novel mutations were also discovered in an isolate (minimum inhibitory concentration 8 μg/ml) in gyrA gene Asp76→Asn and outside the QRDR Leu44→Ile. Out of 30 isolates with reduced susceptibility, single mutation was found in 12 strains only. Genes encoding qnr plasmid (qnr A, qnr B, AAC1-F) were not detected in ciprofloxacin-resistant or decreased-susceptibility strains. Antimicrobial surveillance coupled with molecular analysis of fluoroquinolone resistance is warranted for reconfirming novel and established molecular patterns of resistance, which is quintessential for reappraisal of enteric fever therapeutics.

Corresponding author
*Author for correspondence: Dr D. Nair, D-2/2201, Vasant Kunj, New Delhi-110070, India. (Email:
Linked references
Hide All

This list contains references from the content that can be linked to their source. For a full set of references and notes please see the PDF or HTML where available.

1.EJ Threlfall , Ciprofloxacin-resistant Salmonella typhi and treatment failure. Lancet 1999; 353: 15901591.

2.MR Capoor , Salmonella enterica serovar Typhi: molecular analysis of ciprofloxacin decreased susceptibility and resistant isolates from India (2001–2003). Brazilian Journal of Infectious Diseases 2007; 11: 423425.

3.DD Levy , B Sharma , TA Cebula . Single-nucleotide polymorphism mutation spectra and resistance to quinolones in Salmonella enterica serovar enteritidis with a mutator phenotype. Antimicrobial Agents and Chemotherapy 2004; 48: 23552363.

4.S Nair , Molecular analysis of fluoroquinolone-resistant Salmonella Paratyphi A isolate, India. Emerging Infectious Diseases 2006 12: 489491.

5.K Hirose , DNA sequence analysis of DNA gyrase and DNA topoisomerase in the quinolone resistance determining regions of Salmonella enterica serovar Typhi and serovar Paratyphi A. Antimicrobial Agents and Chemotherapy 2002; 46: 32493252.

6.PK Lindgren , ASA Karlsson , D Hughes . Mutation rate and evolution of fluroquinolone resistance in E. coli isolates from patients in urinary tract infections. Antimicrobial Agents and Chemotherapy 2003; 47: 32223232.

7.DJ Eaves , Prevalence of mutations within the quinolone resistance determining region of gyrA, gyrB, parC, and parE and association with antibiotic resistance in quinolone-resistance Salmonella enterica. Antimicrobial Agents and Chemotherapy 2004; 48: 40124015.

8.S Baucheron , High level resistance to fluoroquinolones linked to mutations in gyr A, par C and par E in Salmonella enterica serovar Schwarzengrund isolated from humans in Taiwan. Antimicrobial Agents and Chemotherapy 2005; 49: 862863.

9.JM Ling , Mutations in topoisomerase genes of fluoroquinolone resistant Salmonella in Hong Kong. Antimicrobial Agents and Chemotherapy 2003; 47: 35673573.

10.CC Sanders . Mechanisms responsible for cross-resistance and dichotomous resistance among quinolones. Clinical Infectious Diseases 2001; 32: 8188.

11.JA Crump , Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United Stat FoodNet Multicenter Retospective Cohort study. Antimicrobial Agents and Chemotherapy 2008; 52: 12781284.

12.K Yamane , New plasmid-mediated fluoroquinolone efflux pump, QepA, found in an Escherichia coli clinical isolate. Antimicrobial Agents and Chemotherapy 2007; 51: 33543360.

13.K Renuka , High-level ciprofloxacin resistance in Salmonella enterica serovar Typhi in India. Journal of Medical Microbiology 2005; 54: 9991000.

14.MR Capoor , Enteric fever perspective in India: emergence of high-level ciprofloxacin resistance and rising MIC to cephalosporins. Journal of Medical Microbiology 2007; 56: 11311132.

15.H Kownhar , Emergence of nalidixic acid-resistant Salmonella enterica serovar Typhi resistant to ciprofloxacin in India. Journal of Medical Microbiology 2007; 56: 136137.

16.T Adachi , Fluoroquinolone-resistant Salmonella enterica serovar Paratyphi A. Emerging Infectious Diseases 2005; 11: 172174.

17.SK Saha , Molecular basis of resistance displayed by highly-ciprofloxacin resistant Salmonella enterica serovar Typhi in Bangladesh. Journal of Clinical Microbiology 2006; 44: 38113813.

18.R Gaind , Molecular characterization of ciprofloxacin-resistant Salmonella enterica serovar Typhi and S. Paratyphi A causing enteric fever in India. Journal of Antimicrobial Chemotherapy 2006; 58: 11391144.

20.Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. CLSI document (M100-S16), p. 26. Clinical and Laboratory Standards Institute, 2007. Wayne, Pennsylvania.

22.M Wang , Plasmid-mediated Quinolone resistance in clinical isolated in clinical isolates of Escherichia coli from Shanghai, China. Antimicrobial Agents and Chemotherapy 2003; 47: 22422248.

23.H Mammarei , Emergence of plasmid-mediated quinolone resistance in Escherichia coli in Europe. Antimicrobial Agents and Chemotherapy 2005; 49: 7176.

24.S Kariuki , Genotypic analysis of multidrug-resistant Salmonella enterica serovar Typhi, Kenya. Emerging Infectious Diseases 2000; 6: 649651.

25.SM Friedman , T Lu , K Drlica . Mutation in the DNA Gyrase A gene of Escherichia coli that expands the quinolone resistance-determining region. Antimicrobial Agents and Chemotherapy 2001; 45: 23782380.

26.MR Capoor , In vitro activity of azithromycin, newer quinolones and cephalosporins in ciprofloxacin resistant Salmonella causing enteric fever. Journal of Medical Microbiology 2007; 58: 14901494.

Recommend this journal

Email your librarian or administrator to recommend adding this journal to your organisation's collection.

Epidemiology & Infection
  • ISSN: 0950-2688
  • EISSN: 1469-4409
  • URL: /core/journals/epidemiology-and-infection
Please enter your name
Please enter a valid email address
Who would you like to send this to? *