Frequency and Antimicrobial Resistance Pattern of Extensive-Drug Resistance Salmonella typhi Isolates

Authors : Ashraf MEMON, Mubashir AHMED, Khalid IQBAL

Pages : 68-74

Doi:10.5799/jmid.748642

View : 258 | Download : 571

Publication Date : 2020-11-29

Article Type : Research Paper

Abstract :ABSTRACT Objectives: Extensive drug resistance insert ignore into journalissuearticles values(XDR); typhoid fever, caused by resistance strain of Salmonella typhi, is an emerging public health concern in Pakistan. XDR typhoid fever severely limits the therapeutic options in outbreak cities of Pakistan. Antimicrobial resistance insert ignore into journalissuearticles values(AMR); surveillance has been carried out at study hospital in Karachi and here reporting the 15 months surveillance data. Methods: A cross-sectional study was conducted on 969 Salmonella typhi isolates obtained from the blood culture samples of suspected typhoid fever cases at Kharadar General Hospital insert ignore into journalissuearticles values(KGH); from Jan 2018 to Mar 2019. Isolates were tested against 8 antimicrobial agents by quality controlled disk diffusion technique. Salmonella typhi Isolates resistance to first- line drugs; ampicillin, chloramphenicol, and co-trimoxazole referred as Multi-drug resistant insert ignore into journalissuearticles values(MDR);, Whereas first-line, second-line drug insert ignore into journalissuearticles values(Ciprofloxacin); and third generation Cephalosporin insert ignore into journalissuearticles values(Ceftriaxone); resistance were considered as XDR. Results: Of total 969 isolates, 777 insert ignore into journalissuearticles values(80%); were MDR showed resistance to all three first-line antibiotics and 517 insert ignore into journalissuearticles values(53%); were XDR resistant to five antibiotics insert ignore into journalissuearticles values(Ampicillin, Chloramphenicol, Co-trimoxazole, Ciprofloxacin and Ceftriaxone);. Azithromycin and Imipenem were seen sensitive to all Salmonella typhi isolates insert ignore into journalissuearticles values(100%); among tested antibiotics. More than half of study S. typhi isolates 513 insert ignore into journalissuearticles values(53%); came from children under five years of age, among them 284 insert ignore into journalissuearticles values(55%); were XDR. Conclusions: A large proportion of S. typhi isolates showed XDR-ST strain. Only Azithromycin and Imipenem were sensitive against XDR-ST strain. Current limited antibiotic option poses a serious threat of complete antibiotic failure in future against rapidly changing strain of S. typhi. J Microbiol Infect Dis 2020; 10insert ignore into journalissuearticles values(2);:68-74.
Keywords : Typhoid fever, Multi drug resistance, Extensive drug resistance, Salmonella typhi, Surveillance

ORIGINAL ARTICLE URL