{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,5]],"date-time":"2026-04-05T05:22:41Z","timestamp":1775366561289,"version":"3.50.1"},"reference-count":23,"publisher":"Scientific Scholar","issue":"5","content-domain":{"domain":["lww.com","ovid.com"],"crossmark-restriction":true},"short-container-title":[],"published-print":{"date-parts":[[2017,5]]},"abstract":"\n Background & objectives:<\/jats:title>\n The emergence of resistance to fluoroquinolones in enteric fever despite the pathogen being susceptible by in vitro<\/jats:italic> laboratory results, led to repeated changes in Clinical and Laboratory Standard Institute (CLSI) guidelines for this class of antibiotics to have specific and sensitive interpretative criteria. In 2015, CLSI added pefloxacin disk diffusion criteria as a surrogate marker for fluoroquinolone susceptibility. This study was carried out to evaluate the use of pefloxacin as a surrogate marker for ciprofloxacin, ofloxacin and levofloxacin susceptibility in clinical isolates of Salmonella<\/jats:italic> Typhi and S. Paratyphi A.<\/jats:p>\n <\/jats:sec>\n \n Methods:<\/jats:title>\n A total of 412 strains of S. Typhi and S. Paratyphi A were studied for pefloxacin disk diffusion test as a surrogate marker for susceptibility to ciprofloxacin, ofloxacin and levofloxacin as per CLSI and the European Committee on Antimicrobial Susceptibility Testing (EUCAST) guidelines. Molecular mechanisms of resistance to fluoroquinolones were also determined and correlated with pefloxacin susceptibility breakpoints.<\/jats:p>\n <\/jats:sec>\n \n Results:<\/jats:title>\n Of the total 412 strains, 34 were susceptible to ciprofloxacin and 33 each to levofloxacin and ofloxacin using CLSI minimum inhibitory concentration (MIC) breakpoints. There was a positive correlation between MICs with correlation coefficients 0.917, 0.896 and 0.958 for the association between ciprofloxacin and ofloxacin, ciprofloxacin and levofloxacin and ofloxacin and levofloxacin, respectively (P<\/jats:italic> <0.001). The sensitivity, specificity and positive predictive value of pefloxacin as a surrogate marker using ciprofloxacin MIC as a gold standard were 100, 99.5 and 94.4 per cent, while 100, 99.2 and 91.7 per cent taking ofloxacin and levofloxacin MIC as gold standard. Mutations in target genes correlated with the pefloxacin susceptibility results.<\/jats:p>\n <\/jats:sec>\n \n Interpretation & conclusions:<\/jats:title>\n Our results showed that pefloxacin served as a good surrogate marker for the detection of susceptibility to ciprofloxacin, ofloxacin and levofloxacin in S. Typhi and S. Paratyphi A. Further studies are required to confirm these findings.<\/jats:p>\n <\/jats:sec>","DOI":"10.4103\/ijmr.ijmr_494_16","type":"journal-article","created":{"date-parts":[[2024,12,19]],"date-time":"2024-12-19T19:19:09Z","timestamp":1734635949000},"page":"687-692","update-policy":"https:\/\/doi.org\/10.1097\/lww.0000000000001000","source":"Crossref","is-referenced-by-count":7,"title":["Pefloxacin as a surrogate marker for quinolone susceptibility in Salmonella enterica serovars Typhi & Paratyphi A in India"],"prefix":"10.25259","volume":"145","author":[{"given":"Priyanka","family":"Sharma","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sushila","family":"Dahiya","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bhavana","family":"Kumari","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Veeraraghavan","family":"Balaji","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Seema","family":"Sood","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Bimal Kumar","family":"Das","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Arti","family":"Kapil","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"10894","reference":[{"key":"R1-16-20241212","doi-asserted-by":"crossref","first-page":"749","DOI":"10.1016\/S0140-6736(05)67181-4","article-title":"Typhoid and paratyphoid fever","volume":"366","author":"Bhan","year":"2005","journal-title":"Lancet"},{"key":"R2-16-20241212","doi-asserted-by":"crossref","first-page":"e570","DOI":"10.1016\/S2214-109X(14)70301-8","article-title":"Burden of typhoid fever in low-income and middle-income countries: A systematic, literature-based update with risk-factor adjustment","volume":"2","author":"Mogasale","year":"2014","journal-title":"Lancet Glob Health"},{"key":"R3-16-20241212","doi-asserted-by":"crossref","first-page":"961","DOI":"10.1017\/S0950268805005844","article-title":"Antibiogram pattern and seasonality of Salmonella serotypes in a North Indian tertiary care hospital","volume":"134","author":"Mohanty","year":"2006","journal-title":"Epidemiol Infect"},{"key":"R4-16-20241212","doi-asserted-by":"crossref","first-page":"164","DOI":"10.1016\/S0140-6736(05)75300-9","article-title":"Ciprofloxacin in typhoid fever","volume":"354","author":"Kapil","year":"1999","journal-title":"Lancet"},{"key":"R5-16-20241212","doi-asserted-by":"crossref","first-page":"37","DOI":"10.1186\/1471-2334-5-37","article-title":"Clinical outcomes in typhoid fever: Adverse impact of infection with nalidixic acid-resistant Salmonella typhi","volume":"5","author":"Kadhiravan","year":"2005","journal-title":"BMC Infect Dis"},{"key":"R6-16-20241212","doi-asserted-by":"crossref","first-page":"1289","DOI":"10.1016\/S0140-6736(05)79356-9","article-title":"Quinolone-resistant Salmonella typhi in Vietnam","volume":"351","author":"Parry","year":"1998","journal-title":"Lancet"},{"key":"R7-16-20241212","first-page":"49","article-title":"Nalidixic acid susceptibility test to screen ciprofloxacin resistance in Salmonella typhi","volume":"115","author":"Kapil","year":"2002","journal-title":"Indian J Med Res"},{"key":"R13-16-20241212","doi-asserted-by":"crossref","first-page":"e0126560","DOI":"10.1371\/journal.pone.0126560","article-title":"Structure based in silico analysis of quinolone resistance in clinical isolates of Salmonella typhi from India","volume":"10","author":"Kumar","year":"2015","journal-title":"PLoS One"},{"key":"R14-16-20241212","doi-asserted-by":"crossref","first-page":"146","DOI":"10.1089\/1076629041310028","article-title":"Reduced susceptibility to ciprofloxacin and gyrA gene mutation in North Indian strains of Salmonella enterica serotype typhi and serotype Paratyphi A","volume":"10","author":"Renuka","year":"2004","journal-title":"Microb Drug Resist"},{"key":"R15-16-20241212","first-page":"746","article-title":"Induction of resistant mutants of Salmonella enterica serotype Typhi under ciprofloxacin selective pressure","volume":"139","author":"Dahiya","year":"2014","journal-title":"Indian J Med Res"},{"key":"R16-16-20241212","doi-asserted-by":"crossref","first-page":"374","DOI":"10.4103\/0255-0857.118898","article-title":"Study of the role of efflux pump in ciprofloxacin resistance in Salmonella enterica serotype Typhi","volume":"31","author":"Sharma","year":"2013","journal-title":"Indian J Med Microbiol"},{"key":"R19-16-20241212","first-page":"431","article-title":"Occurrence & antibiogram of Salmonella Typhi & S. 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