Pattern of Antibiotic Resistance in Salmonella Typhi Isolates with Special Consideration to Extended Drug Resistant Typhoid

Abstract

Background: Typhoid or enteric fever is potentially fatal multisystem illness caused by salmonella typhi and Para typhi transmittedthrough consumption of contaminated food and water. Salmonella behave in a wide spectrum of resistance from Multi DrugResistant typhoid to now Extended Drug Resistant typhoid.Objective: To analyze the culture, sensitivity and resistance of salmonella typhi in patients with clinical suspicion of typhoid fever.Material and methods: A cross sectional study was performed on 624 clinically suspected cases of typhoid fever admitted to theinpatient ward facility of Pediatric unit STH Swat from 1st July 2019 to 30th June 2020. Data was analyzed using SPSS version 22.Results: Out of 624 clinically suspected cases of typhoid fever reported to the Pediatric unit of STH Swat, only 239 cases had apositive blood culture for salmonella typhi during the period of 1 year. Drug resistance pattern of salmonella typhi in our study wasceftriaxone 91.86%, chloramphenicol 83.72% ampicillin 75.58%, co-trimoxazole 72.09%, Quinolones 83.72% , azithromycin55.81%, Cefoperazone/Sulbactum 77.9%, Piperacillin/Tazobactam 65.11%, and meropenem was low at 4.65% and no resistancewas reported to imipenem.Conclusion: In the light of our study the highest resistance of salmonella specie and emergence of XDR typhoid to the i.e. 3rdgeneration cephalosporins and Azithromycin, it is necessary to rationalize the use of antibiotics in acute febrile illness and toeducate the community for vaccination against salmonella typhi, proper sanitation and use of safe water supply . Blood cultureshould be the gold standard test for diagnosis of enteric fever in the first week of illness.Key words: Salmonella typhi, XDR-typhoid