巴基斯坦开伯尔-普赫图赫瓦省血液样本中分离的多重耐药伤寒沙门氏菌的发病率和抗微生物药物耐药性

IF 1.8 4区医学 Q3 INFECTIOUS DISEASES

Diagnostic microbiology and infectious disease Pub Date : 2025-09-26 DOI:10.1016/j.diagmicrobio.2025.117122

Jawad Ahmad , Muhammad Ahmar Khan , Muhammad Atif , Zia Ur Rahman , Ayesha Nasir , Hafiza Misbah Ahmad , Ayesha Haroon , Azeem Sarwar , Muhammad Afrasiab Khan , Numan Fazal

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引用次数: 0

摘要

近年来，伤寒沙门氏菌对抗生素的耐药性越来越强，给治疗带来了严峻的挑战。在不进行细菌敏感性检测的情况下不适当使用抗生素往往导致治疗失败，这突出了细菌分离和药敏试验的重要性。2022年7月至2023年7月开展了一项研究，以评估临床样本中耐多药伤寒沙门氏菌的发病率，并评估其在巴基斯坦开伯尔-普赫图赫瓦省不同地区的敏感性。从白沙瓦、迪尔、马尔丹和斯瓦特的疑似肠热病患者身上共采集了1625份血液样本。其中341株（20.98%）经生化检测和fliC基因PCR扩增证实为伤寒沙门氏菌。男性感染率最高（57.7%），10岁以下儿童感染率最高（54.25%）。季节分布以夏季最高（38.41%）。各区发病率以白沙瓦最高（78.29%），其次是迪尔（14.36%）和马尔丹（7.03%）。地区与感染率有显著相关性，但年龄和性别无显著相关性。抗菌试验对美罗培南（90.71%）和四环素（71.83%）敏感，对氨苄西林（77.40%）、复方新诺明（74.61%）、头孢曲松（73.68%）和红霉素（71.52%）敏感。值得注意的是，71.94%的菌株为MDR， 22.38%的菌株为广泛耐药（XDR）。PCR检测证实耐药基因的高流行率，特别是blaTEM（61%）、sul2（76%）和sul1（57%）。这项研究强调了开伯尔-普赫图赫瓦省耐多药伤寒沙门氏菌的惊人增长，并强调迫切需要进行有效的监测、预防和抗菌药物管理。

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Incidence and antimicrobial resistance profile of multi-drug resistant Salmonella typhi isolated from blood samples in Khyber Pakhtunkhwa, Pakistan

Salmonella typhi has shown increasing resistance to antibiotics in recent years, creating serious challenges in treatment. Inappropriate use of antibiotics without testing bacterial sensitivity often results in therapeutic failure, highlighting the importance of bacterial isolation and susceptibility testing. A study was carried out from July 2022 to July 2023 to assess the incidence of multidrug-resistant (MDR) S. typhi in clinical samples and evaluate its susceptibility profile across different districts of Khyber Pakhtunkhwa, Pakistan.

A total of 1,625 blood samples were collected from patients with suspected enteric fever in Peshawar, Dir, Mardan, and Swat. Of these, 341 isolates (20.98 %) were confirmed as S. typhi using biochemical tests and PCR amplification of the fliC gene. Infection was more common in males (57.7 %), while children ≤10 years were most affected (54.25 %). Seasonal distribution revealed highest prevalence in summer (38.41 %). Among districts, Peshawar reported the highest occurrence (78.29 %), followed by Dir (14.36 %) and Mardan (7.03 %). A significant correlation was found between districts and infection rate, though age and gender showed no significant association.

Antimicrobial testing revealed high susceptibility to meropenem (90.71 %) and tetracycline (71.83 %), but marked resistance to ampicillin (77.40 %), co-trimoxazole (74.61 %), ceftriaxone (73.68 %), and erythromycin (71.52 %). Notably, 71.94 % isolates were MDR and 22.38 % were extensively drug-resistant (XDR). PCR detection confirmed high prevalence of resistance genes, particularly blaTEM (61 %), sul2 (76 %), and sul1 (57 %).

This study underscores the alarming rise of MDR S. typhi in Khyber Pakhtunkhwa and stresses the urgent need for effective surveillance, prevention, and antimicrobial stewardship.

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来源期刊

Diagnostic microbiology and infectious disease 医学-传染病学

CiteScore

5.30

自引率

3.40%

发文量

149

审稿时长

56 days

期刊介绍： Diagnostic Microbiology and Infectious Disease keeps you informed of the latest developments in clinical microbiology and the diagnosis and treatment of infectious diseases. Packed with rigorously peer-reviewed articles and studies in bacteriology, immunology, immunoserology, infectious diseases, mycology, parasitology, and virology, the journal examines new procedures, unusual cases, controversial issues, and important new literature. Diagnostic Microbiology and Infectious Disease distinguished independent editorial board, consisting of experts from many medical specialties, ensures you extensive and authoritative coverage.