Emerging Trends of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) Salmonella Typhi in a Tertiary Care Hospital of Lahore, Pakistan

• Published in: Microorganisms (Basel) 2021-11, Vol.9 (12), p.2484
• Main Authors: Zakir, Muhammad, Khan, Maryam, Umar, Muhammad Ihtisham, Murtaza, Ghulam, Ashraf, Muhammad, Shamim, Saba
• Format: Article
• Language: English
• Subjects: Age; Ampicillin; Antibiotics; Azithromycin; Chloramphenicol; Chloromycetin; Ciprofloxacin; Data analysis; Drug resistance; extensively drug-resistant; Fatalities; Fever; Gender; Health risks; Imipenem; Lahore; Meropenem; Multidrug resistance; multidrug-resistant; Pathogens; Patients; Pediatrics; Piperacillin; Salmonella; Salmonella enterica serovar Typhimurium; Salmonella Typhi; Statistical analysis; Statistical methods; Statistics; Strains (organisms); Tazobactam; Typhoid; typhoid fever; Waterborne diseases
• ISSN: 2076-2607; 2076-2607
• DOI: 10.3390/microorganisms9122484

Typhi is a Gram-negative pathogen that causes typhoid fever in humans. The use of antibiotics to treat typhoid has considerably mitigated its fatality risk, but rising multidrug-resistant (MDR) and extensively drug-resistant (XDR) resistance in Pakistan threatens effective treatment. This study determined the prevalence of MDR and XDR . Typhi at a local hospital in Lahore. Blood samples ( = 3000) were obtained and processed for bacterial identification. Antibiotic susceptibility test was performed using VITEK 2 Compound 30 System. Statistical data analysis was performed using a Mann-Whitney U and Kruskal-Wallis H test, respectively. The results revealed 600 positive cultures, of which the majority were found to be XDR . Typhi (46.1%) and MDR . Typhi (24.5%) strains. The disease burden of resistant strains was greater in males (60.67%) than females (39.33%), with the most affected age group being 0-10 years old (70.4 %). In both the outpatient department (OPD) and general ward, the prevalence of XDR . Typhi cases was found to be alarmingly high (48.24%), followed by MDR . Typhi (25.04 %). The results of the statistical analysis demonstrated that the incidence of resistance in MDR and XDR . Typhi strains was not affected by the age as well as the gender of patients ( > 0.05). The occurrence of resistant strains against four tested antibiotics (azithromycin, ciprofloxacin, imipenem, and meropenem) was found to be similar in different wards and among hospitalized and OPD patients ( > 0.05). Maximum resistance was observed against chloramphenicol and ampicillin in the OPD and pediatric ward. Piperacillin/Tazobactam was observed to be the most effective antibiotic, followed by co-amoxiclav ( < 0.001). This study is effective in validating the existence of MDR and XDR . Typhi in Lahore, where stringent methods should be applied for controlling its spread.