Heading towards threat of resistant super bug…. current pattern of antimicrobial sensitivity to salmonella typhi in Karachi.

Abstract

Objectives: The present study was aimed to find out the prevalence of MDR and XDR Typhoid and the remaining or alternate treatment options here in Karachi. Study Design: Descriptive retrospective analytical study. Setting: Department of Medicine, at Mamji Hospital Karachi. Period: From Jan 2019 till July 2019. Material & Methods: The medical records of all the patient admitted, were reviewed by the department of Medicine, at Mamjee Hospital Karachi specifically diagnosed to have Typhoid fever during the period between Jan 2019 till July 2019. A total of 72 patients were included in this study. Chart reviews were used to obtain and later collect the data. Typhoid was confirmed over Blood culture yielding Salmonella typhi. Demographic data and pattern of antibiotic sensitivity were collected. Statistical analysis was performed on SPSS version 17. Continuous variables were expressed as mean ± SD. Discrete variables were expressed as percentages and proportions. Results: From January 2019 till July 2019, 72 patients were diagnosed to have Typhoid fever (Salmonella Typhi culture positive) of which 43(60%) were male and majority of the patients were aged between 18 to 40 years 37(51%). Out of 14 antibiotics checked for sensitivity to Salmonella Typhi the Quinolones were the most resistant (85%) antibiotics followed by Ampicillin (83%) and Trimethoprim-sulfamethoxazole (82%). 48(66%) among 72 patients had extended drug resistant typhoid, 14(19%) were multidrug resistant typhoid while 11(15%) were pan sensitive. Conclusion: Majority of the patients had extended drug resistant typhoid, whereas quite a few had multidrug resistant typhoid. Most sensitive drugs were Imipenem, meropenem and Azithromycin whereas Quinolones along with other agents were found to have most resistance against Salmonella Typhi.