Patterns of Antibiotic Drug Resistance among Salmonella Typhi Isolates of Enteric Fever in Pediatric Population at a Tertiary Care Hospital

Abstract

Objective: To determine patterns of antibiotic drug resistance among Salmonella typhi isolates of enteric fever in pediatric population at a tertiary care hospital. Material and methods: Consecutive 161 children with enteric fever were included in this study. This cross – sectional study was done at Department of Pediatric Medicine, Nishtar Medical University and Hospital, Multan from June 2015 to December 2016. Venous blood sample (3-5 ml) was drawn and it was immediately transported to Microbiology laboratory of Pathology Department, Nishtar Hospital Multan for blood culture and sensitivity test. Antibiotic drug resistance was determined after measuring diameter of zone of inhibition of a specific drug on Salmonella isolates on Mueller Hinton agar plates by modified Kirby baur disc diffusion method. Coated tongue, pain abdomen, anorexia and headache was assessed clinically. All the data were entered and analyzed using SPSS-11. Results: Of these 161 study cases, 91 (56.5%) were boys and 70 (43.5%) were girls. Mean age of our study cases was 5.79 ± 2.45 years (with minim age was 2 years while 12 years was maximum age). Previous history of use of antibiotics before 48 hours of the culture and sensitivity test was present in 93 (57.8%) of our study cases. Majority of our study cases having enteric fever presented with abdominal pain 65 (40.4%), headache 28 (17.4%) and diarrhea 17.4 % of our study cases. Chloramphenicol was sensitive in 40 (24.8%) of the Salmonella typhi isolates, Ampicillin was sensitive in 20 (12.4%), Co-trimoxazole in 20 (12.4%), Ciprofloxacin was sensitive in 88 (54.7%) isolates, Ofloxacin was sensitive in 101 (62.7%), Gentamycin was sensitive in 28 (17.4 %), Amoxycillin was sensitive in 36 (22.4 %). Conclusion: Our study results have indicated that S. typhi isolates of enteric fever showed higher degree of antibiotic drug resistance. Multidrug resistant strains were more prevalent in our study which points towards well directed efforts of our health policy makers to adopt certain guidelines regarding use of these drugs in our population.

Keywords: Enteric fever, drug resistance, children.