Emergency Of Multi Drug Resistant And Extensive Drug Resistant Strains Of Salmonella Typhi Isolated From Children presenting to Hayatabad Medical Complex Peshawar
Keywords:
Typhoid Fever, Salmonella typhi, Drug Resistance, Bacterial Drug Resistance, Anti-Bacterial Agents, Blood Culture, Child, Child, Preschool, Cross-Sectional StudiesAbstract
Background
Salmonella typhi is a non-spore-forming, motile, pathogenic bacterium responsible for causing typhoid fever, a potentially life-threatening systemic infection. Typhoid fever is characterized by a prolonged and debilitating febrile illness, accompanied by symptoms such as abdominal pain, headaches, and gastrointestinal disturbances. Inadequate sanitation and poor hygiene practices contribute to the prevalence of Salmonella typhi.
Material and Method
This study aims at determining the prevalence of XDR and MDR strains of Salmonella typhi at Hayatabad Medical Complex Hospital, Hayatabad Peshawar, Pakistan. All the blood samples (n=287) were analyzed aseptically after fulfilling the inclusion and exclusion criteria. Initial incubation was performed by employing the BacT/ALERT-3D system. Sub-culturing of the samples was done using bacteriological culture media (Blood agar, MacConkey agar). Identification of the organisms was done on the basis of morphological characteristics of bacterial colonies, Gram staining, and biochemical tests. Antimicrobial susceptibility testing and result interpretation were carried out according to the Kirby-Bauer disc diffusion method, following CLSI, 2021 guidelines.
Results
Out of 287 cases 119(41.4%) blood samples were found culture positive. Overall frequency of MDR and XDR strains of Salmonella typhi was 76.5% and 14.3% respectively. Least number (9.2%) of cases was found susceptible to antimicrobial agents. Imipenem, aminoglycosides and azithromycin were drugs of choice against MDR cases of Salmonella typhi. Imipinem was considered only drug of choice against against XDR cases of Salmonella typhi.
Conclusion
It is concluded that overall of prevalence of Salmonella typhi was 41.4%. Frequency of MDR Salmonella typhi strains was higher than XDR strains. Carbapenem was considered drug of choice against both MDR and XDR cases of Salmonella typhi.
