Typhoidal Salmonella strains in Pakistan: an impending threat of extensively drug-resistant Salmonella Typhi
Autor: | Luqman Satti, Nadia Midhat Zehra, Tariq Mehmood Bangash, Ashfaq Hussain, Saman Nadeem, Aqeel Peter, Faisal Hanif |
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Rok vydání: | 2019 |
Předmět: |
Adult
Male 0301 basic medicine Microbiology (medical) Salmonella Adolescent 030106 microbiology Drug resistance Salmonella typhi medicine.disease_cause complex mixtures Typhoid fever Microbiology Young Adult 03 medical and health sciences 0302 clinical medicine Disk Diffusion Antimicrobial Tests Drug Resistance Bacterial Humans Medicine Pakistan Blood culture Prospective Studies 030212 general & internal medicine Typhoid Fever Antiinfective agent medicine.diagnostic_test business.industry Salmonella paratyphi A General Medicine Middle Aged bacterial infections and mycoses medicine.disease Anti-Bacterial Agents Multiple drug resistance Treatment Outcome Infectious Diseases Female business |
Zdroj: | European Journal of Clinical Microbiology & Infectious Diseases. 38:2145-2149 |
ISSN: | 1435-4373 0934-9723 |
Popis: | The aim of this study is to see the frequency, clinical presentation, and therapeutic response of extensively drug-resistant Salmonella enterica serovar Typhi and current susceptibility pattern of typhoidal Salmonella strains in our setup. This study was carried out at the Department of Medical Microbiology and Immunology and Department of Medicine, Pakistan Navy Ship (PNS) Shifa Hospital, Karachi, from January 1 to December 31, 2018. All the blood culture samples of patients (indoor and outdoor) with suspicion of enteric fever were processed. Isolates were cultured and identified using standard microbiological procedures. The antimicrobial sensitivity against the typhoidal Salmonellae was determined using Kirby-Bauer disc diffusion method as per the guidelines of Clinical and Laboratory Standards Institute (2018) and all the extensively drug-resistant (XDR) isolates were confirmed by Vitek 2 system. Clinical presentation and response to treatment of patients were followed. A total of 292 typhoidal Salmonella isolates were cultured. Resistance to ciprofloxacin against both Salmonella Typhi and Salmonella Paratyphi A was found to be very high (91%). Percentage of multidrug-resistant (MDR) isolates in Salmonella Typhi was 76% (182 isolates) and in Salmonella Paratyphi it was 34% (18 isolates). XDR isolates in Salmonella Typhi were significant that is 48% (115 isolates). Only 10 cases were given azithromycin who responded to treatment in mean 4.3 days. Out of 115 cases of XDR Salmonella Typhi, 103 patients were given parenteral meropenem and clinical response was seen in mean 5 days. The emergence and rapid spread of extensively drug-resistant Salmonella Typhi is alarming and highlights the significance of strict antimicrobial susceptibility surveillance programs with antimicrobial stewardship. |
Databáze: | OpenAIRE |
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