A 6-year retrospective study of bloodstream Salmonella infection and antibiotic susceptibility of Salmonella enterica serovar Typhi and Paratyphi in a tertiary care hospital in Dhaka, Bangladesh

Abstract

ObjectivesBloodstream infections (BSI) are a serious cause of morbidity and mortality worldwide. Emerging antimicrobial drug resistance among bacterial pathogens causing BSI can limit therapeutic options and complicate patient management. This retrospective study was conducted to determine trends in Salmonella BSI and antibiotic susceptibility patterns over 6 years (2008–2013) in a tertiary care hospital in Dhaka, Bangladesh. MethodsA total of 3584 blood samples were collected from patients with clinically diagnosed enteric fever at Dhaka Medical College Hospital, Dhaka from January 2008 to December 2013. Isolates of Salmonella enterica serovars Typhi and Paratyphi were identified by standard microbiological and biochemical procedures. ResultsA total of 168 isolates of S. enterica serovar Typhi and 160 isolates of S. enterica serovar Paratyphi were found. The average prevalence rate of Salmonella in the blood was 9.15%. Young patients, neonates, and elderly individuals were more prone to Salmonella infection than other patients, and females were more susceptible to Salmonella septicemia than males. Among Salmonella spp. isolates, 20.92% were multidrug resistant and showed high resistance against amoxicillin, trimethoprim–sulfamethoxazole, ciprofloxacin, nalidixic acid, and chloramphenicol. Resistance rates to cefipime, cefixime, and ceftriaxone are increasing slowly. Among Salmonella spp. isolates, 57.01% showed extended-spectrum β-lactamase production capability. ConclusionSpecific antibiotic utilization strategies such as antibiotic restriction, combination therapy and usage according to standard antimicrobial susceptibility testing may help decrease or prevent the emergence of resistance and incidence of BSI.