Trends in antibiotic susceptibility of enteric fever isolates among children attending a tertiary care hospital of Peshawar, KP

Abstract

Introduction: The rising trend of multi-drug resistance in bacteria has also been documented in the organism Salmonella enterica causing Typhoid or Enteric Fevers, and cases of multidrug and extended drug resistance are on the rise. Determining the trends of antibiotic susceptibility provides an important therapeutic aid to the practicing clinician.Objective: To evaluate the ten-year trends in antibiotic susceptibilities of Salmonella typhi and Salmonella paratyphi isolated from blood cultures in the paediatric patients of a tertiary care hospital of Peshawar, Khyber Pakhtunkhwa, Pakistan.Materials & Methods: A descriptive study was conducted in the department of Paediatrics, Rehman Medical Institute, Peshawar from June 2019 to May 2020 based on ten years retrospective data of children with positive blood culture for Salmonella spp. Data were analyzed using IBM SPSS Statistics for Windows, Version 20.0 (IBM Corp., Armonk, NY). The level of significance was set at p ≤0.05.
 Results: A total of 168 cases Salmonella enterica spp. were isolated over the 10-year study period, of which 97(64.88%) isolates were identified as Salmonella typhi and 71(42.26%) as Salmonella paratyphi A; 94(55.95%) patients were male and 74(44.04%) were female, with mean age of 4.76 ± 2.65 years (range 2 to 12 years); majority, 69(41.07%) of patients were of ages 5-8 years. S. typhi strains showed the highest sensitivity to Imipenem and Meropenem; the lowest sensitivity seen was to Ampicillin. Bacterial sensitivity to Ceftriaxone was 79.76% and to Ciprofloxacin 58.97%. In the S. typhi group, there were six (2.6%) cases of MDR typhoid and four (2.38%) cases of XDR typhoid which was only sensitive to Imipenem.
 Conclusion: Increased resistance to Ampicillin, Ciprofloxacin and Ceftriaxone was found, however complete sensitivity was found to Imipenem along with Meropenem.