Evaluating the Rising Incidence of Multidrug-Resistant and Extensively Drug-Resistant Salmonella typhi and Salmonella paratyphi in Sialkot City

Drug-Resistant Salmonella typhi in Sialkot

Authors

  • Umair Zaman Department of Pathology, Khawaja Muhammad Safdar Medical College, Sialkot, Pakistan
  • Shua Nasir Department of Emergency Medicine, Ziauddin University and Hospital, Karachi, Pakistan
  • Shazia Asim Department of Pharmacology, Lahore Medical and Dental College, Lahore, Pakistan
  • Junaid Azmat Department of Pathology, Sialkot Medical College, Sialkot, Pakistan
  • Rana Muhammad Asad Khan Department of Pathology, Islam Medical and Dental College, Sialkot, Pakistan
  • Abdul Karim Soomro Department of Pathology, Bilawal Medical College, Jamshoro, Pakistan

DOI:

https://doi.org/10.54393/pjhs.v6i1.2446

Keywords:

Salmonella typhi, Multi-Drug Resistance, Extensive Drug Resistance, Antimicrobial Resistance

Abstract

In the Developing countries, Typhoid is one of the major health concerns. Most importantly the disease management is getting complicated due to multi and extensive drug resistance incidence. Objective: To investigate the incidence of causative agent’s salmonella typhi and para-typhi in the affected patients of Sialkot who were either multi drug resistant or extensive drug resistant. Methods: This descriptive cross-sectional study was conducted at the department of microbiology, Khawaja Muhammad Safdar medical college, Sialkot from January, 2024 to July, 2024. A total of 2000 patients with febrile illness were examined for the study, 500 samples of neonates were excluded and blood samples of remaining 1500 patients were collected. The blood samples were cultured on MacConkey agar and blood agar. Among the 1500 patients, only 73 were found to be infected with either Salmonella typhi or Salmonella paratyphi according to CLSI criteria. Antibiotic sensitivity was investigated and resistant to trimethoprim-sulfamethoxazole (septran), chloramphenicol, and ampicillin were labeled as multi drug resistant while resistant to ciprofloxacin and third generation cephalosporins in addition to aforementioned antibiotics were labeled as extensively drug resistant. Results: From a total of 1500 samples, n=73 salmonella positive samples were included in this research. Incidence of extensively drug resistant Salmonella was 23(32%) and multidrug drug resistant Salmonella was 7 (10%). Conclusion: This study highlighted significant resistance rates, emphasizing the need for sensible antibiotic prescriptions and judicious antimicrobial use to combat rising multidrug and extensive resistance.

References

Fatima S, Ishaq Z, Irfan M, AlAsmari AF, Achakzai JK, Zaheer T et al. Whole-genome sequencing of multidrug resistance Salmonella Typhi clinical strains isolated from Balochistan, Pakistan. Frontiers in Public Health. 2023 May; 11: 1151805. doi: 10.3389/fpubh.2023.1151805. DOI: https://doi.org/10.3389/fpubh.2023.1151805

Tristianti IZ and Dewi LM. Comparison of Sensitivity and Resistance to Ceftriaxone with Chloramphenicol in the Treatment of Salmonella typhi Infection: Literature Review. Proceeding ISETH (International Summit on Science, Technology, and Humanity). 2021 Jul: 62-71.

Chang MS, Woo JH, Kim S. Management of Typhoid Fever-Clinical and Historical Perspectives in Korea. Infection & Chemotherapy. 2019 Sep; 51(3): 330-5. doi: 10.3947/ic.2019.51.3.330. DOI: https://doi.org/10.3947/ic.2019.51.3.330

Khan A, Khan I, Babar AN, Khan Y, Shah G, Khan MI. Effectiveness of Oral Azithromycin in Treating Enteric Fever: A Hospital-Based Study on Pediatric Patients. Cureus. 2024 Aug; 16(8): e67024. doi: 10.7759/cureus.67024. DOI: https://doi.org/10.7759/cureus.67024

Kumar A and Kumar A. Antibiotic resistome of Salmonella typhi: molecular determinants for the emergence of drug resistance. Frontiers of Medicine. 2021 Oct; 15(5): 693-703. doi: 10.1007/s11684-020-0777-6. DOI: https://doi.org/10.1007/s11684-020-0777-6

Manesh A, Meltzer E, Jin C, Britto C, Deodhar D, Radha S et al. Typhoid and paratyphoid fever: a clinical seminar. Journal of Travel Medicine. 2021 Apr; 28(3): taab012. doi: 10.1093/jtm/taab012. DOI: https://doi.org/10.1093/jtm/taab012

Bisola Bello A, Olamilekan Adesola R, Idris I, Yawson Scott G, Alfa S, Akinfemi Ajibade F. Combatting extensively drug-resistant Salmonella: a global perspective on outbreaks, impacts, and control strategies. Pathogens and Global Health. 2024 Nov: 1-5. doi: 10.1080/20477724.2024.2416864. DOI: https://doi.org/10.1080/20477724.2024.2416864

Imran H, Saleem F, Gull S, Khan Z. Uncovering the growing burden of enteric fever: A molecular analysis of Salmonella Typhi antimicrobial resistance. Microbial Pathogenesis. 2024 Jun; 191: 106676. doi: 10.1016/j.micpath.2024.106676. DOI: https://doi.org/10.1016/j.micpath.2024.106676

Carey ME, Dyson ZA, Ingle DJ, Amir A, Aworh MK, Chattaway MA et al. Global diversity and antimicrobial resistance of typhoid fever pathogens: insights from 13,000 Salmonella Typhi genomes. medRxiv. 2022 Dec: 2022-12: e85867. doi: 10.7554/eLife.85867. DOI: https://doi.org/10.7554/eLife.85867

Riaz U, Qayyum Z, Sattar A, Riaz Z. Fighting XDR Typhoid: A Hospital Based Study on Clinical Aspects and Treatment Outcome in Tertiary Care Hospital. Annals of PIMS-Shaheed Zulfiqar Ali Bhutto Medical University. 2024 Jul; 20(SUPPL-1): 546-9. doi: 10.48036/apims.v20iSUPPL-1.1142. DOI: https://doi.org/10.48036/apims.v20iSUPPL-1.1142

Saeed N, Usman M, Khan EA. An overview of extensively drug-resistant Salmonella Typhi from a tertiary care hospital in Pakistan. Cureus. 2019 Sep; 11(9). doi: 10.7759/cureus.5663. DOI: https://doi.org/10.7759/cureus.5663

Yousafzai MT, Qamar FN, Shakoor S, Saleem K, Lohana H, Karim S et al. Ceftriaxone-resistant Salmonella Typhi outbreak in Hyderabad City of Sindh, Pakistan: high time for the introduction of typhoid conjugate vaccine. Clinical Infectious Diseases. 2019 Feb; 68(Supplement_1): S16-21. doi: 10.1093/cid/ciy877. DOI: https://doi.org/10.1093/cid/ciy877

Zakir M, Khan M, Umar MI, Murtaza G, Ashraf M, Shamim S. Emerging trends of Multidrug-Resistant (MDR) and Extensively Drug-Resistant (XDR) Salmonella Typhi in a tertiary care Hospital of Lahore, Pakistan. Microorganisms. 2021 Nov; 9(12): 2484. doi: 10.3390/microorganisms9122484. DOI: https://doi.org/10.3390/microorganisms9122484

Asghar M, Khan TA, Séraphin MN, Schimke LF, Cabral-Marques O, Haq IU et al. Exploring the antimicrobial resistance profile of Salmonella Typhi and its clinical burden. Antibiotics. 2024 Aug; 13(8): 765. doi: 10.3390/antibiotics13080765. DOI: https://doi.org/10.3390/antibiotics13080765

Jabeen K, Saleem S, Jahan S, Nizamudin S, Arshad F, Huma ZE et al. Molecular characterization of extensively drug resistant Salmonella enterica Serovar Typhi clinical isolates from Lahore, Pakistan. Infection and Drug Resistance. 2023 Dec: 2987-3001. doi: 10.2147/IDR.S406253. DOI: https://doi.org/10.2147/IDR.S406253

Walker J, Chaguza C, Grubaugh ND, Carey M, Baker S, Khan K et al. Assessing the global risk of typhoid outbreaks caused by extensively drug resistant Salmonella Typhi. Nature Communications. 2023 Oct; 14(1): 6502. doi: 10.1038/s41467-023-42353-9. DOI: https://doi.org/10.1038/s41467-023-42353-9

Sparrow A, Smith-Torino M, Shamamba SM, Chirakarhula B, Lwaboshi MA, Benn CS et al. A Risk Management Approach to Global Pandemics of Infectious Disease and Anti-Microbial Resistance. Tropical Medicine and Infectious Disease. 2024 Nov; 9(11): 280. doi: 10.3390/tropicalmed9110280. DOI: https://doi.org/10.3390/tropicalmed9110280

Crabtrey SD. Honey's Influence on the Antibiotic Susceptibility and Virulence Factory Activity of Seven Pathogenic Bacteria Species. University of Central Arkansas; 2021 Dec; 17(6): 375-9. doi: 10.1016/j.anaerobe.2011.03.012. DOI: https://doi.org/10.1016/j.anaerobe.2011.03.012

Terreni M, Taccani M, Pregnolato M. New antibiotics for multidrug-resistant bacterial strains: latest research developments and future perspectives. Molecules. 2021 May; 26(9): 2671. doi: 10.3390/molecules26092671. DOI: https://doi.org/10.3390/molecules26092671

Uddin TM, Chakraborty AJ, Khusro A, Zidan BR, Mitra S, Emran TB et al. Antibiotic resistance in microbes: History, mechanisms, therapeutic strategies and future prospects. Journal of Infection and Public Health. 2021 Dec; 14(12): 1750-66. doi: 10.1016/j.jiph.2021.10.020. DOI: https://doi.org/10.1016/j.jiph.2021.10.020

Nisa I, Haroon M, Driessen A, Nijland J, Rahman H, Yasin N et al. Antimicrobial resistance of Shigella flexneri in Pakistani pediatric population reveals an increased trend of third-generation cephalosporin resistance. Current Microbiology. 2022 Apr; 79(4): 118. doi: 10.1007/s00284-022-02805-9. DOI: https://doi.org/10.1007/s00284-022-02805-9

Gao Q, Liu Z, Xiang J, Zhang Y, Tong MX, Wang S et al. Impact of temperature and rainfall on typhoid/paratyphoid fever in Taizhou, China: effect estimation and vulnerable group identification. The American Journal of Tropical Medicine and Hygiene. 2021 Dec; 106(2): 532. doi: 10.4269/ajtmh.20-1457. DOI: https://doi.org/10.4269/ajtmh.20-1457

Amsalu T, Genet C, Adem Siraj Y. Salmonella Typhi and S almonella Paratyphi prevalence, antimicrobial susceptibility profile and factors associated with enteric fever infection in Bahir Dar, Ethiopia. Scientific Reports. 2021 Apr; 11(1): 7359. doi: 10.1038/s41598-021-86743-9. DOI: https://doi.org/10.1038/s41598-021-86743-9

Shaikh OA, Asghar Z, Aftab RM, Amin S, Shaikh G, Nashwan AJ. Antimicrobial resistant strains of Salmonella typhi: The role of illicit antibiotics sales, misuse, and self-medication practices in Pakistan. Journal of Infection and Public Health. 2023 Oct; 16(10): 1591-7. doi: 10.1016/j.jiph.2023.08.003. DOI: https://doi.org/10.1016/j.jiph.2023.08.003

Hafeez S, Din M, Zia F, Ali M, Shinwari ZK. Emerging concerns regarding COVID‐19; second wave and new variant. Journal of Medical Virology. 2021 Jul; 93(7): 4108. doi: 10.1002/jmv.26979. DOI: https://doi.org/10.1002/jmv.26979

Ahmad S, Tsagkaris C, Aborode AT, Haque MT, Khan SI, Khawaja UA et al. A skeleton in the closet: the implications of COVID-19 on XDR strain of typhoid in Pakistan. Public Health in Practice. 2021 Nov; 2: 100084. doi: 10.1016/j.puhip.2021.100084. DOI: https://doi.org/10.1016/j.puhip.2021.100084

Batool R, Qureshi S, Haq Z, Yousafzai MT, Salam RA, Ali R et al. Coverage survey of typhoid conjugate vaccine among children aged 6 months to 15 years in an urban slum settlement of Lyari Town Karachi, Pakistan. Plos One. 2023 Aug; 18(8): e0289582. doi: 10.1371/journal.pone.0289582. DOI: https://doi.org/10.1371/journal.pone.0289582

Downloads

Published

2025-01-31
CITATION
DOI: 10.54393/pjhs.v6i1.2446
Published: 2025-01-31

How to Cite

Zaman, U., Nasir, S., Asim, S., Azmat, J., Khan, R. M. A., & Soomro, A. K. (2025). Evaluating the Rising Incidence of Multidrug-Resistant and Extensively Drug-Resistant Salmonella typhi and Salmonella paratyphi in Sialkot City : Drug-Resistant Salmonella typhi in Sialkot. Pakistan Journal of Health Sciences, 6(1), 319–324. https://doi.org/10.54393/pjhs.v6i1.2446

Issue

Section

Original Article

Plaudit