Multiple drug resistance in salmonellae in England and Wales: a comparison between 1981 and 1988.
Each year from 1981 through to 1988 the most common serotypes isolated from man in England and Wales and identified at the Division of Enteric Pathogens were S typhimurium, S enteritidis, and S virchow. In 1981 these three serotypes accounted for 45%, 12%, and 7% of isolations. The remaining 35% comprised strains belonging to a further 188 different serotypes, none of which accounted for more than 1% of the total. In 1988 S typhimurium accounted for 24% of isolations, S enteritidis 57%, and S virchow 4%. The remaining 15% comprised strains of a further 184 serotypes. The resistances to the common antimicrobial drugs in non-typhoidal salmonellas isolated in England and Wales in 1981 and 1988 were reported with particular reference to resistance to four or more antimicrobial drugs (multiple resistance). For S typhimurium the overall percentage of resistant strains varied little, but multiple resistance more than doubled from 5% to 12%; in S enteritidis the incidence remained the same. In S virchow the percentages of strains resistant to all the antimicrobial drugs and in particular, to chloramphenicol, streptomycin, trimethoprim and furazolidone, rose from 0.2% to 10.4%. Salmonella enteritis in man is usually a self limiting disease and antimicrobial treatment is seldom required; but should spread beyond the intestine occur, effective antimicrobial treatment is essential. Under these circumstances a knowledge of the likelihood of resistances to commonly available drugs could be of considerable value to the clinician.