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A case report and review of the literature: ciprofloxacin resistant Salmonella enterica serovar Typhi in India.

BACKGROUND
Enteric fever is a major public health problem in India. The current treatment of choice is the fluoroquinolones.


METHODS
The minimum inhibitory concentration (MIC) of ciprofloxacin was determined by E-test, HIMEDIA HiComb MIC test and agar dilution.


RESULTS
An isolate of Salmonella enterica serovar Typhi (S. Typhi) from a case of enteric fever gave a ciprofloxacin MIC of 64 microg/ml.


CONCLUSIONS
To our knowledge there have been no reports of such high-level resistance to ciprofloxacin in S. Typhi from southern India. HIMEDIA HiComb MIC test method is an alternative to the E-test. Ciprofloxacin resistant typhoid fever responds to treatment with ceftriaxone.