Abstract
Objective: To determine the recent antibiotic resistance patterns of Salmonella species in children in a tertiary care hospital.
 Materials and Methods: This descriptive cross-sectional study was conducted in the Department of Pediatrics of Akbar Niazi Teaching Hospital, Bhara Kahu, from 18th March 2020 to 31st January 2021. A total of one hundred and seventy-eight (n=178) patients of either gender having age between 1 month to 12 years who had signs and symptoms of enteric fever and positive blood culture report of Salmonella species were enrolled in this study through non-probability, consecutive sampling. The demographic characteristics of patients along with the antibiotic sensitivity pattern of the Salmonella species were recorded on the predesigned proforma and analyzed through SPSS version 25.
 Results: Out of the total of 178 patients, reports of blood cultures of 164(92.1%) patients showed Salmonella Typhi while those of 14(7.9%) patients showed Salmonella Paratyphi. Out of the total of 178 Salmonella cases, 11(6.2%) were extensively drug-resistant and 58(32.6%) were multidrug-resistant. All XDR cases were of Salmonella Typhi. Out of 14 Salmonella Paratyphi, 2(14%) were MDR but no XDR Salmonella Paratyphi was found. Nalidixic acid had the highest resistance (96.4%) followed by sulphamethoxazole (65.5%). Azithromycin had the least resistance (0%) followed by imipenem (1.8%), piperacillin-tazobatam (1.9%), and meropenem (2%). Resistance of ceftriaxone was 20.8% and that of ciprofloxacin was 28.2%.
 Conclusion: No resistance of Salmonella species against azithromycin was found in our study. The presence of XDR typhoid fever cases and the rising resistance of Salmonella species to ceftriaxone and carbapenems are very alarming. To prevent this resistance, we should reserve carbapenems for complicated cases of resistant typhoid fever only. Minocycline and pipercillin-tazobactam are two other good cost-effective drugs in resistance to typhoid fever.
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