Sensitivity Pattern of Salmonella Typhi from Blood Culture in Paediatric Population

Abstract

Background: The bacterium Salmonella enterica serovar typhi causes typhoid fever which is a life-threatening systemic infection that mainly occurs in developing countries of the world and remains a major public health issue. Paratyphoid fever is caused by Salmonella enterica serovars Paratyphi A and B and (infrequently C). Appropriate and immediate antimicrobial therapy is required for the prevention of complications and mortality due to enteric fever. Therefore, this study is designed to investigate the current sensitivity pattern of Salmonella typhi so that appropriate antibiotics can be initiated on time. Objective: To determine the sensitivity pattern of Salmonella typhi in enteric fever among the pediatric population visiting a tertiary care hospital. Methods: This cross-sectional study was carried at the Department of Pediatrics in National Institute of Child Health Karachi from 13-12-2019 to 13-06-2020 after acquiring ethical approval from the hospital committee. There were 149 children aged 3-12 years of either gender diagnosed with enteric fever selected for this study. Patients' information was collected on pre-designed proforma. Blood of five milliliters quantity was drawn and sent to the pathology department within 12 hours of the admission. Salmonella typhi was identified by biochemical testing of the suspicious non-lactose fermenting colonies. Mueller Hinton Agar medium was used for testing antibiotic sensitivity. The sensitivity of the drug was interpreted as Sensitive, Intermediate and Resistant based on inhibition zone size. Results: The average age of the children was 5.56±2.39 years. Sensitivity for meropenem, azithromycin was 100% and 93.3% respectively while the sensitivity of ciprofloxacin was 53.7%. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone were more than 80% resistant. Conclusion: Our study confirms the sensitivity for meropenem, azithromycin, ciprofloxacin. Ampicillin, Co-trimoxazole, Chloramphenicol and Ceftriaxone showed higher resistance. This study emphasizes the need for continuous evaluation and judicious use of antimicrobials, considering the ever-changing antibiogram.