Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India - a Seven Year Ambispective Study
Language English Country Czech Republic Media print
Document type Journal Article
PubMed
30664444
DOI
10.14712/18059694.2018.130
PII: am_2018061040125
Knihovny.cz E-resources
- Keywords
- antimicrobial resistance, enteric fever, multidrug-resistant Salmonella,
- MeSH
- Anti-Bacterial Agents therapeutic use MeSH
- Drug Resistance, Bacterial MeSH
- Typhoid Fever drug therapy epidemiology microbiology MeSH
- Tertiary Care Centers MeSH
- Disk Diffusion Antimicrobial Tests MeSH
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Microbial Sensitivity Tests MeSH
- Adolescent MeSH
- Child, Preschool MeSH
- Salmonella paratyphi A isolation & purification MeSH
- Salmonella paratyphi B isolation & purification MeSH
- Salmonella typhi isolation & purification MeSH
- Check Tag
- Child MeSH
- Adult MeSH
- Middle Aged MeSH
- Humans MeSH
- Adolescent MeSH
- Male MeSH
- Child, Preschool MeSH
- Female MeSH
- Publication type
- Journal Article MeSH
- Geographicals
- India epidemiology MeSH
- Names of Substances
- Anti-Bacterial Agents MeSH
INTRODUCTION: Enteric-fever is a major public-health problem in developing countries emerging as multidrug-resistant, Nalidixic-acid resistant and extremely drug-resistant Salmonella (Pakistan, 2016), has intensified the use of WHO watch/reserve group antimicrobials such as azithromycin and meropenem. METHODS: This ambispective-study was conducted on 782 non-repeat blood-culture isolates of S. Typhi, S. Paratyphi A and S. Paratyphi B obtained from 29,184 blood cultures received at a 1000-bedded tertiary-care hospital of North-India from 2011-2017. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer's disc diffusion with resistance to ampicillin, chloramphenicol and cotrimoxazole being labeled as multidrug-resistant. Decreased ciprofloxacin-susceptibility and ciprofloxacin-resistance were defined as MIC 0.125-0.5 and >1 μg/ml. RESULTS: S. Typhi and S. Paratyphi A in a ratio of 3.9:1 were seen between July-September predominantly distributed between 6-45 year age group. Resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 6.1%, 13.8%, 16.1 and 5.78% respectively. Multidrug-resistant S. typhi and S. paratyphi A were 2.73% and 1.91% respectively. CONCLUSION: Enteric-fever is a major public-health problem in India. Emergence of multidrug-resistant, Nalidixic-acid resistant and extremely-drug resistant Salmonella mandates ongoing surveillance for targeted empirical therapy and containment of spread. Repeated epidemics call for water, sanitation, hygiene and vaccination strategies to sustain herd-immunity.
Army College of Medical Sciences and Base Hospital New Delhi India
Army Hospital Research and Referral New Delhi 110010 India
Department of Microbiology MH Bhopal India
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