Emerging Trends of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) <i>Salmonella</i> Typhi in a Tertiary Care Hospital of Lahore, Pakistan

oleh: Muhammad Zakir, Maryam Khan, Muhammad Ihtisham Umar, Ghulam Murtaza, Muhammad Ashraf, Saba Shamim

Format: Article
Diterbitkan: MDPI AG 2021-11-01

Deskripsi

<i>Salmonella</i> Typhi is a Gram-negative pathogen that causes typhoid fever in humans. The use of antibiotics to treat typhoid has considerably mitigated its fatality risk, but rising multidrug-resistant (MDR) and extensively drug-resistant (XDR) resistance in Pakistan threatens effective treatment. This study determined the prevalence of MDR and XDR <i>S</i>. Typhi at a local hospital in Lahore. Blood samples (<i>n</i> = 3000) were obtained and processed for bacterial identification. Antibiotic susceptibility test was performed using VITEK<sup>®</sup> 2 Compound 30 System. Statistical data analysis was performed using a Mann–Whitney U and Kruskal–Wallis H test, respectively. The results revealed 600 positive cultures, of which the majority were found to be XDR <i>S</i>. Typhi (46.1%) and MDR <i>S</i>. Typhi (24.5%) strains. The disease burden of resistant <i>Salmonella</i> strains was greater in males (60.67%) than females (39.33%), with the most affected age group being 0–10 years old (70.4 %). In both the outpatient department (OPD) and general ward, the prevalence of XDR <i>S</i>. Typhi cases was found to be alarmingly high (48.24%), followed by MDR <i>S</i>. Typhi (25.04 %). The results of the statistical analysis demonstrated that the incidence of resistance in MDR and XDR <i>S</i>. Typhi strains was not affected by the age as well as the gender of patients (<i>p</i> > 0.05). The occurrence of resistant strains against four tested antibiotics (azithromycin, ciprofloxacin, imipenem, and meropenem) was found to be similar in different wards and among hospitalized and OPD patients (<i>p</i> > 0.05). Maximum resistance was observed against chloramphenicol and ampicillin in the OPD and pediatric ward. Piperacillin/Tazobactam was observed to be the most effective antibiotic, followed by co-amoxiclav (<i>p</i> < 0.001). This study is effective in validating the existence of MDR and XDR <i>S</i>. Typhi in Lahore, where stringent methods should be applied for controlling its spread.