Extensively drug-resistant Salmonella typhi in febrile patients at a tertiary care hospital of South Punjab, Bahawalpur Pakistan
DOI:
https://doi.org/10.61529/idjp.v34i4.428Abstract
Background: Typhoid fever, caused by Salmonella enterica serovar typhi (S. typhi), persists as a significant public health challenge in low- and middle-income countries. This study aimed to assess the prevalence and antimicrobial resistance patterns of multidrug resistant (MDR), and extensively drug resistant (XDR) Salmonella typhi (S. typhi) among febrile patients.
Material and Methods: This cross-sectional study was carried out in the Department of Pathology, Bahawal Victoria Hospital, Bahawalpur, from January to October 2024. Febrile patients with suspected typhoid fever undergoing blood culture were included, while those with recent antibiotic use, alternative diagnoses, or incomplete records were excluded. Using consecutive sampling, 1,364 patients were enrolled. Demographic, clinical, exposure, water source, and vaccination data were recorded, and blood cultures with susceptibility testing were performed according to standard protocols.
Results: Of 1364 patients, 808 (59.2%) were male, and 556 (40.8%) female, while the median age was 15.0 (6.0-38.0) years. Recent travel to endemic areas was reported in 93 (6.8%), and household contact in 29 (2.1%) patients. Blood culture-confirmed S. typhi was found in 34 (2.5%) cases, peaking in August (29.4%). Among these 34-culture positive Salmonella typhi cases, 10 (29.4%) were non-MDR/non-XDR, 3 (8.8%) MDR, and remaining 21 (61.7%) were XDR, while none of the cases were sensitive to all the tested antibiotics. All isolates, including those classified as XDR, were sensitive to meropenem.
Conclusion: This study highlights an ongoing and evolving challenge posed by XDR S. typhi in febrile patients in South Punjab, Pakistan.
Keywords: Blood culture, Fever, Pakistan, Pathology, Salmonella typhi
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