Epidemiology of Multidrug-Resistant Salmonella Typhi and Paratyphi Isolated From Stool Culture.

Abstract

Enteric fever is a significant health problem in developing countries caused by Salmonella enterica serovars Typhi and Paratyphi. Unfortunately, the burden of the disease remains high not only because of the complications related to the disease but also, especially, because of the spread of the strains of Salmonella resistant to antibiotics. The aim of the present study was to evaluate the antibiotic resistance patterns of Salmonella Typhi and Paratyphi clinical isolates as well as the risk factors associated with infection. This cross-sectional study was conducted from June 2020 to September 2021. One thousand and seventy-six patients in the age range (1- ≥ 50 years) were recruited including 423 (39.31%) infected with S. Typhi, 115 (10.68%) infected with S. Paratyphi, and 538 (50%) noninfected after obtaining their informed consent using a face-to-face interview and questionnaire. The stool samples were collected in clean and sterile boxes reserved for this purpose and were cultured. Demographic parameters such as sex, age, occupation, water source, level of education, as well as clinical signs and symptoms were obtained. The resistance profile determination was carried out by the disk diffusion method. A multivariate logistic regression analysis was performed to identify factors associated with infection. Results of multivariate logistic regression analysis showed positive and significant associations (OR > 1; p < 0.05) between enteric fever and women among the age groups: 1-10 years, 11-20 years, and 21-30 years. These positive associations were also noted in patients who ate shellfish, salads, fruits, and vegetables; in patients who consumed ice cubes; as well as those who consumed food and drinks offered by ambulant merchants. This indicated that they are more likely to be infected by S. enterica than others. The level of multidrug-resistant (MDR) S. enterica to first-line antimicrobial agents ampicillin, chloramphenicol, and co-trimoxazole was high and selectively distributed according to age groups, marital status, profession, level of education, source of water, and lifestyle. The results highlighted the emergence of MDR S. enterica isolated in the study population, demonstrating resistance to first-line drugs, fluoroquinolones, and third-generation cephalosporins. Further studies with large-scale samples are needed to validate the present results and to monitor MDR S. Typhi and S. Paratyphi serovars in other parts of Cameroon.