Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan
Kokab Jabeen,1 Sidrah Saleem,1 Shah Jahan,1 Summiya Nizamudin,2 Faiqa Arshad,1 Zill-e Huma,1 Syed Mohsin Raza,3 Maria Mehmood,1 Muhammad Roman,1 Faiz Ul Haq1 1Department of Microbiology, University of Health Sciences, Lahore, Pakistan; 2Department of Microbiology, Shaukat Khanum Memorial Cancer Hosp...
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| Format: | Article |
| Language: | English |
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Dove Medical Press
2023-05-01
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| Series: | Infection and Drug Resistance |
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| Online Access: | https://www.dovepress.com/molecular-characterization-of-extensively-drug-resistant-salmonella-en-peer-reviewed-fulltext-article-IDR |
| _version_ | 1797827216129654784 |
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| author | Jabeen K Saleem S Jahan S Nizamudin S Arshad F Huma ZE Raza SM Mehmood M Roman M Haq FU |
| author_facet | Jabeen K Saleem S Jahan S Nizamudin S Arshad F Huma ZE Raza SM Mehmood M Roman M Haq FU |
| author_sort | Jabeen K |
| collection | DOAJ |
| description | Kokab Jabeen,1 Sidrah Saleem,1 Shah Jahan,1 Summiya Nizamudin,2 Faiqa Arshad,1 Zill-e Huma,1 Syed Mohsin Raza,3 Maria Mehmood,1 Muhammad Roman,1 Faiz Ul Haq1 1Department of Microbiology, University of Health Sciences, Lahore, Pakistan; 2Department of Microbiology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan; 3Department of Allied Health Sciences, University of Health Sciences, Lahore, PakistanCorrespondence: Kokab Jabeen, Tel +92 3128878893, Email kaukab_jabeen@yahoo.comBackground: The emergence of extensively drug-resistant (XDR) typhoid in Pakistan has endangered the treatment options available to manage this infection. Third generation cephalosporin were the empiric choice to treat typhoid fever in Pakistan, but acquisition of ESBLs have knocked them out of the arsenal. The current empiric choice is azithromycin which is vulnerable to resistance too. This study aimed to assess the burden of XDR typhoid and the frequency of resistance determinants in blood culture samples collected from different hospitals in Lahore, Pakistan.Methods: A total of 835 blood cultures were collected from different tertiary care hospitals in Lahore during January 2019 to December 2021. Among 835 blood cultures, 389 Salmonella Typhi were identified, and 150 were XDR S. Typhi (resistant to all recommended antibiotics). Antibiotics resistance genes of the first-line drugs (blaTEM-1, catA1, sul 1, and dhfR7) and second line drugs (gyrB, gyrA, qnrS, ParC and ParE) were investigated among XDR S. Typhi. There were different CTX-M genes isolated using the specific primers, blaCTX-M-U, blaCTX-M-1, blaCTX-M-15, blaCTX-M-2, blaCTX-M-8 and blaCTX-M-9.Results: Antibiotic resistant genes of the first-line drugs were isolated with different frequency, blaTEM-1 (72.6%), catA1 (86.6%), sul 1 (70%), and dhfR7 (56%). Antibiotics resistance genes of second-line drugs were isolated as: gyrB (60%), gyrA (49.3%), qnrS (32.6%), parC (44%) and parE (28%). Among CTX-M genes, blaCTX-M-U (63.3%) was the most frequent followed by blaCTX-M-15 (39.3%) and blaCTX-M-1 (26%).Conclusion: Our study concluded that XDR isolates circulating in Pakistan have acquired first-line and second-line antibiotic resistant genes quite successfully along with CTX-M genes (ESBLs) rendering them resistant to the third generation cephalosporins as well. Emergence of azithromycin resistance in XDR S. Typhi which is currently used as an empiric treatment option is worrisome and needs to be monitored carefully in endemic countries like Pakistan.Keywords: Salmonella, antimicrobial resistance, plasmids, XDR typhoid |
| first_indexed | 2024-04-09T12:44:42Z |
| format | Article |
| id | doaj.art-03f1dee1b0b343fc87b26b6d50d806b5 |
| institution | Directory Open Access Journal |
| issn | 1178-6973 |
| language | English |
| last_indexed | 2024-04-09T12:44:42Z |
| publishDate | 2023-05-01 |
| publisher | Dove Medical Press |
| record_format | Article |
| series | Infection and Drug Resistance |
| spelling | doaj.art-03f1dee1b0b343fc87b26b6d50d806b52023-05-14T16:00:11ZengDove Medical PressInfection and Drug Resistance1178-69732023-05-01Volume 162987300183705Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, PakistanJabeen KSaleem SJahan SNizamudin SArshad FHuma ZERaza SMMehmood MRoman MHaq FUKokab Jabeen,1 Sidrah Saleem,1 Shah Jahan,1 Summiya Nizamudin,2 Faiqa Arshad,1 Zill-e Huma,1 Syed Mohsin Raza,3 Maria Mehmood,1 Muhammad Roman,1 Faiz Ul Haq1 1Department of Microbiology, University of Health Sciences, Lahore, Pakistan; 2Department of Microbiology, Shaukat Khanum Memorial Cancer Hospital & Research Centre, Lahore, Pakistan; 3Department of Allied Health Sciences, University of Health Sciences, Lahore, PakistanCorrespondence: Kokab Jabeen, Tel +92 3128878893, Email kaukab_jabeen@yahoo.comBackground: The emergence of extensively drug-resistant (XDR) typhoid in Pakistan has endangered the treatment options available to manage this infection. Third generation cephalosporin were the empiric choice to treat typhoid fever in Pakistan, but acquisition of ESBLs have knocked them out of the arsenal. The current empiric choice is azithromycin which is vulnerable to resistance too. This study aimed to assess the burden of XDR typhoid and the frequency of resistance determinants in blood culture samples collected from different hospitals in Lahore, Pakistan.Methods: A total of 835 blood cultures were collected from different tertiary care hospitals in Lahore during January 2019 to December 2021. Among 835 blood cultures, 389 Salmonella Typhi were identified, and 150 were XDR S. Typhi (resistant to all recommended antibiotics). Antibiotics resistance genes of the first-line drugs (blaTEM-1, catA1, sul 1, and dhfR7) and second line drugs (gyrB, gyrA, qnrS, ParC and ParE) were investigated among XDR S. Typhi. There were different CTX-M genes isolated using the specific primers, blaCTX-M-U, blaCTX-M-1, blaCTX-M-15, blaCTX-M-2, blaCTX-M-8 and blaCTX-M-9.Results: Antibiotic resistant genes of the first-line drugs were isolated with different frequency, blaTEM-1 (72.6%), catA1 (86.6%), sul 1 (70%), and dhfR7 (56%). Antibiotics resistance genes of second-line drugs were isolated as: gyrB (60%), gyrA (49.3%), qnrS (32.6%), parC (44%) and parE (28%). Among CTX-M genes, blaCTX-M-U (63.3%) was the most frequent followed by blaCTX-M-15 (39.3%) and blaCTX-M-1 (26%).Conclusion: Our study concluded that XDR isolates circulating in Pakistan have acquired first-line and second-line antibiotic resistant genes quite successfully along with CTX-M genes (ESBLs) rendering them resistant to the third generation cephalosporins as well. Emergence of azithromycin resistance in XDR S. Typhi which is currently used as an empiric treatment option is worrisome and needs to be monitored carefully in endemic countries like Pakistan.Keywords: Salmonella, antimicrobial resistance, plasmids, XDR typhoidhttps://www.dovepress.com/molecular-characterization-of-extensively-drug-resistant-salmonella-en-peer-reviewed-fulltext-article-IDRsalmonellaantimicrobial resistanceplasmidsxdr typhoid |
| spellingShingle | Jabeen K Saleem S Jahan S Nizamudin S Arshad F Huma ZE Raza SM Mehmood M Roman M Haq FU Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan Infection and Drug Resistance salmonella antimicrobial resistance plasmids xdr typhoid |
| title | Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan |
| title_full | Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan |
| title_fullStr | Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan |
| title_full_unstemmed | Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan |
| title_short | Molecular Characterization of Extensively Drug Resistant Salmonella Enterica Serovar Typhi Clinical Isolates from Lahore, Pakistan |
| title_sort | molecular characterization of extensively drug resistant salmonella enterica serovar typhi clinical isolates from lahore pakistan |
| topic | salmonella antimicrobial resistance plasmids xdr typhoid |
| url | https://www.dovepress.com/molecular-characterization-of-extensively-drug-resistant-salmonella-en-peer-reviewed-fulltext-article-IDR |
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