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Abstract

Objective: To find out the frequency of MDR Salmonella enterica serovars typhi and paratyphi in blood cultures.
Material and Methods: This prospective study was conducted at Department of Microbiology, SIUT, Karachi. A required sample size was 116 patients. Blood samples were collected for culture. Pus, urine and stool specimens of those received with blood cultures were also processed accordingly. Colonies giving biochemical reactions suggestive of Salmonellae were confirmed serologically with specific O and H antisera (BD Laboratories). Antimicrobial susceptibilities for seven antimicrobial agents were performed. For XDR isolates, Meropenem(10µg) and Azithromycin(15µg) discs were used additionally. Descriptive statistics were calculated. Stratification was done and Post-stratification Chi-square test was applied. P-value ≤0.05 was considered as significant.
Results: There were 94.8% male and 5.2% female patients. Mean age was 21.51±12.11 years. Blood culture alone was done for 87.9% patients. Total 72.4% of patients were Salmonella enterica serovars typhi positive and 27.6% were Salmonella enterica serovars paratyphi positive with 37.5% type-A, 46.9% type-B, and 15.6% type-C. Further, MDR pattern was observed in 8.6% patients, while MDR+quinolone resistance was observed in 7.8% patients and XDR resistance was observed in 61.2% patients.
Conclusion: In our study, XDR pattern was observed more as compared to MDR. Cefixime and Ceftriaxone were found sensitive to MDR. Among XDR, Azithromycin and Meropenem were found sensitive.
Keywords: Blood cultures, Enteric fever, Multi-drug resistance, Salmonella enterica serovar Typhi