Enteric fever is a systemic infection caused by Salmonella Typhi (S.Typhi), Salmonella Paratyphi A (S.Paratyphi A), Salmonella Paratyphi B and Salmonella Paratyphi C. It is endemic in India and is a major public health problem in the country. Treatment with Ciprofloxacin which was considered the drug of choice for multi drug resistant Salmonellae, is now showing high rates of failure clinically. A total of 33 isolates obtained from blood and bone marrow were tested for antimicrobial susceptibility by Kirby Bauer disc diffusion method. The minimum inhibitory concentrations of Ciprofloxacin & Ceftriaxone were determined by broth dilution method. Majority of the patients were young adults falling in the age group 16-35 years (57.7%).Only 2 isolates of S.Typhi were resistant to all three first line drugs (Ampicillin, Cotrimoxazole and Chloramphenicol) and classified as multi drug resistant S.Typhi (MDRST). One strain of S.Paratyphi A was resistant to Ampicillin. 90.9% of isolates were susceptible to Azithromycin. None of the isolates showed full susceptibility to Ciprofloxacin. 7 isolates showed intermediate susceptibility with an MIC of 0.5µg/mL. The MIC of Ceftriaxone showed an upward trend though still within the susceptible limits. 69.7% of the 33 isolates had an MIC of 0.06 µg/mL and 30.3% of isolates had an MIC of 0.12µg/mL. There is reemergence of susceptibility to the first line drugs. Presence of fluoroquinolone resistance and the rise in MIC of Ceftriaxone is a concern. Antibiotic stewardship has to be implemented urgently.
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