FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN

Objectives: To determine frequency of multidrug resistant (MDR) and extensive drug resistant (XDR) strains of Salmonella typhi (S. typhi) and Salmonella paratyphi (S. paratyphi) in Quetta, Balochistan of Pakistan Study Design: Descriptive Cross-Sectional Place and Duration: Department of Micro...

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Main Authors: Shafia Nasir, Naveed Asif, Oroosa Nasir, Sunila Tashfeen Arif, Muhammad Azam
Format: Article
Language:English
Published: Army Medical College Rawalpindi 2020-12-01
Series:Pakistan Armed Forces Medical Journal
Subjects:
Online Access:https://www.pafmj.org/index.php/PAFMJ/article/view/5006/3055
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author Shafia Nasir
Naveed Asif
Oroosa Nasir
Sunila Tashfeen Arif
Muhammad Azam
author_facet Shafia Nasir
Naveed Asif
Oroosa Nasir
Sunila Tashfeen Arif
Muhammad Azam
author_sort Shafia Nasir
collection DOAJ
description Objectives: To determine frequency of multidrug resistant (MDR) and extensive drug resistant (XDR) strains of Salmonella typhi (S. typhi) and Salmonella paratyphi (S. paratyphi) in Quetta, Balochistan of Pakistan Study Design: Descriptive Cross-Sectional Place and Duration: Department of Microbiology, CMH Quetta, Pakistan. from March 2019 to March 2020 Materials and Methods: A total of 2760 (n) suspected cases of typhoid fever, irrespective of age and gender, reporting at the hospital in this duration and underwent blood culture. Isolates were cultured and identified using standard microbiological procedures. Antimicrobial sensitivity against typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2018) and all the XDR isolates were confirmed by Vitek 2 system. Results: A total of 173 (6.3%) cultures showed positive results. with mean age of 18.9 ± 11.1 years, out of which 136 (78.6%) were male and 37 (21.1%) were female patients. Antibiotic susceptibility results showed that 166 (96%) of isolates were S. typhi. MDR strains were observed in 104(60.1%) and XDR strains were observed in 81 (46.8%) cases. Conclusion: A significant proportion of S. typhi isolates from confirmed cases of enteric fever demonstrated MDR (60.1%) and XDR (46.8%) strains in Quetta, Balochistan. We recommend empiric therapy with azithromycin in patients with uncomplicated and therapy with carbapenem for complicated cases of enteric fever acquired in Karachi or Quetta. Large scale population-based studies are recommended to get better information about antibiotic susceptibility pattern of S. typhi and S. paratyphi in other areas.
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spelling doaj.art-8b25ab56d169473ab783f37747199c972022-12-21T21:24:47ZengArmy Medical College RawalpindiPakistan Armed Forces Medical Journal0030-96482411-88422020-12-0170617451749FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTANShafia Nasir0Naveed Asif1Oroosa Nasir2Sunila Tashfeen Arif3Muhammad Azam4Combined Military Hospital Quetta/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Quetta/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Malir/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Quetta/National University of Medical Sciences (NUMS) PakistanCombined Military Hospital Quetta/National University of Medical Sciences (NUMS) PakistanObjectives: To determine frequency of multidrug resistant (MDR) and extensive drug resistant (XDR) strains of Salmonella typhi (S. typhi) and Salmonella paratyphi (S. paratyphi) in Quetta, Balochistan of Pakistan Study Design: Descriptive Cross-Sectional Place and Duration: Department of Microbiology, CMH Quetta, Pakistan. from March 2019 to March 2020 Materials and Methods: A total of 2760 (n) suspected cases of typhoid fever, irrespective of age and gender, reporting at the hospital in this duration and underwent blood culture. Isolates were cultured and identified using standard microbiological procedures. Antimicrobial sensitivity against typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2018) and all the XDR isolates were confirmed by Vitek 2 system. Results: A total of 173 (6.3%) cultures showed positive results. with mean age of 18.9 ± 11.1 years, out of which 136 (78.6%) were male and 37 (21.1%) were female patients. Antibiotic susceptibility results showed that 166 (96%) of isolates were S. typhi. MDR strains were observed in 104(60.1%) and XDR strains were observed in 81 (46.8%) cases. Conclusion: A significant proportion of S. typhi isolates from confirmed cases of enteric fever demonstrated MDR (60.1%) and XDR (46.8%) strains in Quetta, Balochistan. We recommend empiric therapy with azithromycin in patients with uncomplicated and therapy with carbapenem for complicated cases of enteric fever acquired in Karachi or Quetta. Large scale population-based studies are recommended to get better information about antibiotic susceptibility pattern of S. typhi and S. paratyphi in other areas.https://www.pafmj.org/index.php/PAFMJ/article/view/5006/3055enteric feverextensive drug resistance
spellingShingle Shafia Nasir
Naveed Asif
Oroosa Nasir
Sunila Tashfeen Arif
Muhammad Azam
FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
Pakistan Armed Forces Medical Journal
enteric fever
extensive drug resistance
title FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
title_full FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
title_fullStr FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
title_full_unstemmed FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
title_short FREQUENCY ASSESSMENT OF EMERGENCE OF EXTENSIVELY DRUG RESISTANT SALMONELLA TYPHI STRAINS IN QUETTA, BALOCHISTAN
title_sort frequency assessment of emergence of extensively drug resistant salmonella typhi strains in quetta balochistan
topic enteric fever
extensive drug resistance
url https://www.pafmj.org/index.php/PAFMJ/article/view/5006/3055
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