Antibiotic Resistance and Sensitivity Pattern in Cases of Blood Culture Proven Enteric Fever Visiting a Tertiary Care Hospital Abbottabad
DOI:
https://doi.org/10.70749/ijbr.v3i5.2905Keywords:
Anti-Bacterial Agents, Child, Drug Resistance Bacterial, Salmonella Typhi, Typhoid FeverAbstract
Background: Enteric fever is a common systemic infection in developing countries and mainly affect children due to poor sanitation and contaminated water. Increasing misuse and overuse of antibiotics has lead to rising antimicrobial resistance which is creating difficulty in proper treatment and empirical therapy selection. Objective: To determine the antibiotic resistance and sensitivity pattern in cases of blood culture proven enteric fever in children visiting a tertiary care hospital in Abbottabad. Study Design: Descriptive cross sectional study. Duration and Place of Study: Conducted from 5 July 2024 to 5 January 2025 at Combined Military Hospital Abbottabad. Methodology: A total of 184 children aged 1–15 years with positive blood culture for Salmonella Typhi or Salmonella Paratyphi A were included. Blood samples were processed on standard culture media and antibiotic susceptibility testing was done by disc diffusion method according to Clinical and Laboratory Standards Institute guidelines. Data were analyzed using Statistical Package for Social Sciences version 23. Results: Mean age was 8.20 ± 4.22 years and mean weight was 24.30 ± 8.63 kg. Majority were males 119 (64.7%) and from rural areas 104 (56.5%). High resistance was observed to ampicillin 167 (90.8%), chloramphenicol 164 (89.1%), trimethoprim sulfamethoxazole 148 (80.4%) and ciprofloxacin 158 (85.9%). Ceftriaxone resistance was 122 (66.3%) and cefixime 131 (71.2%). Azithromycin showed sensitivity in 163 (88.6%) cases. Imipenem and meropenem showed 100% sensitivity. Conclusion: Antibiotic resistance in enteric fever is very high against commonly used drugs.
Downloads
References
1. Chidambaram Y, Dhas CJ, Juhi R, Petchiappan V, Sujithkumar S. Tracking the shift in enteric fever trends and evolving antibiotic sensitivity patterns. Ghana Med J. 2024;58(1):86-90.
https://doi.org/10.4314/gmj.v58i1.12
2. Nakisuyi J, Bernis M, Ndamira A, Kayini V, Mulumba R, Theophilus P, et al. Prevalence and factors associated with malaria, typhoid, and co-infection among febrile children aged six months to twelve years at kampala international university teaching hospital in western Uganda. Heliyon. 2023;9(9):e19588. https://doi.org/10.1016/j.heliyon.2023.e19588
3. Chatterjee R, Chowdhury AR, Mukherjee D, Chakravortty D. From Eberthella typhi to Salmonella Typhi: the fascinating journey of the virulence and pathogenicity of Salmonella Typhi. ACS Omega. 2023;8(29):25674-25697.
https://doi.org/10.1021/acsomega.3c02386
4. Veronese P, Pappalardo M, Maffini V, Rubini M, Giacometti A, Ruozi MB, et al. Severe typhoid fever complicated by superior mesenteric and splenic vein thrombosis. Infect Dis Rep. 2023;15(4):377-385.
https://doi.org/10.3390/idr15040038
5. Rauniyar GP, Bhattacharya S, Chapagain K, Shah GS, Khanal B. Typhoid fever among admitted pediatric patients in a tertiary care center: a descriptive cross-sectional study. J Nepal Med Assoc. 2021;59(241):871-874.
https://doi.org/10.31729/jnma.6044
6. Marchello CS, Carr SD, Crump JA. A systematic review on antimicrobial resistance among Salmonella Typhi worldwide. Am J Trop Med Hyg. 2020;103(6):2518-2527.
https://doi.org/10.4269/ajtmh.20-0258
7. Parry CM, Qamar FN, Rijal S, McCann N, Baker S, Basnyat B. What should we be recommending for the treatment of enteric fever? Open Forum Infect Dis. 2023;10(Suppl1):S26-S31.
https://doi.org/10.1093/ofid/ofad179
8. Kuehn R, Stoesser N, Eyre D, Darton TC, Basnyat B, Parry CM. Treatment of enteric fever (typhoid and paratyphoid fever) with cephalosporins. Cochrane Database Syst Rev. 2022;11(11):CD010452. https://doi.org/10.1002/14651858.CD010452.pub2
9. Musa DA, Majiya H, A U, Akor SE, Mambula-Machunga S, Aremu HK, et al. Sociodemographic and clinical factors influencing typhoid fever prevalence and multidrug resistance in Niger State, Nigeria. PLoS One. 2025;20(7):e0327740. https://doi.org/10.1371/journal.pone.0327740
10. Memon H, Saeed F, Iqbal M, Saboohi E, Hanif S, Mallick AHH. Association of extensively drug resistant salmonella infection in children with typhoid fever. Pak J Med Sci. 2022;38(7):1864-1869. https://doi.org/10.12669/pjms.38.7.5868
11. Tanmoy AM, Hooda Y, Sajib MSI, Rahman H, Sarkar A, Das D, et al. Trends in antimicrobial resistance amongst Salmonella Typhi in Bangladesh: a 24-year retrospective observational study (1999-2022). PLoS Negl Trop Dis. 2024;18(10):e0012558. https://doi.org/10.1371/journal.pntd.0012558
12. da Silva KE, Tanmoy AM, Pragasam AK, Iqbal J, Sajib MSI, Mutreja A, et al. The international and intercontinental spread and expansion of antimicrobial-resistant Salmonella Typhi: a genomic epidemiology study. Lancet Microbe. 2022;3(8):e567-e577.
https://doi.org/10.1016/S2666-5247(22)00093-3
13. Baig U, Mehdi SM, Iftikhar N. A pattern of antibiotic drug resistance of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever in a tertiary care hospital in Lahore, Pakistan. Croat Med J. 2023;64(4):256-264.
https://doi.org/10.3325/cmj.2023.64.256
14. Lail A, Bhanbhro BA, Khuhro AA, Kumar P, Haider I, Saleem S. Enteric fever in era of antibiotic resistance: a retrospective study. J Popul Ther Clin Pharmacol. 2024;31(1):1209-1214.
https://doi.org/10.53555/jptcp.v31i1.4152
15. Manzoor A, Batool ST, Ahmed T, Khalid J. Antibiotic sensitivity pattern in blood culture positive typhoid fever. Med Forum. 2023;34(7):188-192.
https://doi.org/10.60110/medforum.340744
16. Ahmad F, Ibrahim, Ghaffar MS, Bashir A, Shamim S, Mahmood T. Antibiotic sensitivity pattern in blood culture positive typhoid fever. Pak J Med Health Sci. 2022;16(1):855-857.
https://doi.org/10.53350/pjmhs22161855
17. Ahmad M, Shah N, Siddiqui MA. Frequency and antibiotics sensitivity pattern of culture-positive Salmonella typhi in children. J Coll Physicians Surg Pak. 2023;33(3):303-307.
https://doi.org/10.29271/jcpsp.2023.03.303
18. Jabeen B, Liaquat I, Zulfiqar S, Mumtaz N, Shabbir S. Antibiotic sensitivity pattern of Salmonella Typhi in paediatric population in a tertiary care hospital. Isra Med J. 2024;16(2):57-62.
https://doi.org/10.55282/imj.oa1416
19. Anjum M, Soomro S, Kulsoom S, Bibi S, Asim S, Riaz M. Pattern of enteric fever at a children hospital of Karachi: clinical spectrum, laboratory profile and antibiotic susceptibility pattern of children with enteric fever at a tertiary care hospital of Karachi. J Islamabad Med Dent Coll. 2021;16(1):4-9.
20. Javed MA, Javed S, Zulfqar R, Aslam S, Alizai SA, Naghmi N. Antimicrobial resistance patterns of Salmonella Typhi isolates among paediatric patients: a single-center study. Ann Pak Inst Med Sci. 2025;21(2):447-451.
https://doi.org/10.48036/apims.v20i2.1504
21. Muhammad R, Ali Z, Mehmood K, Ziauddin, Afridi AR, Bari F. Antibiotic sensitivity pattern of Salmonella serotypes in patients with enteric fever in a teaching hospital. J Postgrad Med Inst. 2013;27(4):397-402.
22. Afroze SR, Rahim MA, Hasan MM, Afroz F, Haque HF, Ahmed JU, et al. Pattern of antibiotic sensitivity in enteric fever: a tertiary care hospital experience. J Med. 2014;15(2):122-124.
https://doi.org/10.3329/jom.v15i2.20684
23. Sattar A, Kaleem F, Muhammad S, Iqbal F, Zia MQ, Anwar R. Current trends in antimicrobial susceptibility pattern of Salmonella typhi and paratyphi. Rawal Med J. 2020;45(2):291-294.
Downloads
Published
Issue
Section
License
Copyright (c) 2025 Indus Journal of Bioscience Research
This work is licensed under a Creative Commons Attribution 4.0 International License.
