Isolation of Multi-Drug Resistant (MDR) and Extensively Drug Resistant (XDR) &amp;lt;i&amp;gt;Salmonella typhi&amp;lt;/i&amp;gt; from Blood Samples of Patients Attending Tertiary Medical Centre in Dhaka City, Bangladesh

Ghurnee, Oshin; Ghosh, Amit; Abony, Maruf; Aurin, Shahrin Akhter; Fatema, Aneeka Nawar; Banik, Avijit; Ahmed, Z. S. A. Zaki

doi:10.4236/aim.2021.119036

Cited by 11 publications

(6 citation statements)

References 32 publications

(24 reference statements)

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“…12 Since the emergence of XDR typhoid fever in Karachi Sindh, Pakistan in 2016, there are increasing number of cases of drug resistant typhoid fever especially XDR typhoid documented by various studies. 13,14,15 Anwar T et al documented that majority of drug resistant typhoid fever cases in their study were of XDR typhoid and it was more common in males, younger age group (1-6 years), poor socioeconomic class and west district of Karachi. 16 Similarly, Zakir et al documented XDR typhoid fever cases to be more prevalent in their study with increased incidence in males and 0-10 year age group.…”

Section: Discussionmentioning

confidence: 92%

Drug resistant typhoid fever; its clinical spectrum and management in different age groups.

Sobia Ashfaq,

Asif Manzoor Basra,

Ammara Kaleem

et al. 2023

TPMJ

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Objective: To describe the clinical spectrum of MDR and XDR typhoid fever in different age groups of pediatric population as the disease is generally more common in children with higher rates of complications and mortality. Study Design: Prospective Cross-sectional study. Setting: Department of Pediatric, Government Teaching Hospital Shahdara, Lahore. Period: July 2020 to July 2021. Material & Methods: 211 patients with suspected/confirmed enteric fever between 6 months to 5 years were initially enrolled. Blood culture was performed in all cases. Only culture confirmed cases (143/211) were included. Data was entered and analyzed using SPSS version 23. Quantitative variables like age group, fever defervescence time and duration of hospital stay were calculated as mean and standard deviations while qualitative variables like gender, clinical symptoms and signs, types of typhoid and response to antibiotics were calculated as percentages. Chi-square test was used taking P value <0.05 as statistically significant. Results: Mean age of study population was 6.8 ± 3.1 years. Majority (44.1%) of patients belonged to age group >5-10 years and were males (54.5%). Anorexia, coated tongue and hepatomegaly was prevalent among all age groups. High grade fever, loose motions and splenomegaly were common in children <5 years as were anemia, leukocytosis and enteric hepatitis. Children >5-10 years of age had more frequency of abdominal pain (P value <0.03), toxic look (P value <0.04) and leucopenia. While vomiting and thrombocytopenia were common in children >10-15 years of age. MDR typhoid was common in young children (<5 years) while XDR typhoid was common in children of >5-15 years. All MDR patients responded to ceftriaxone while XDR patients responded to either monotherapy or a combination of drugs. Age and gender did not affect antibiotic resistance in both MDR and XDR typhoid (P value >0.05). Fever defervescence time (FDT) was 3-5 days in both MDR and XDR typhoid and it was not significantly different with either monotherapy or a combination of drugs (P value 0.40). Conclusion: There are age related differences in clinical spectrum and lab parameters of drug resistant typhoid fever (MDR & XDR). Resistance to antibiotics in both MDR and XDR typhoid was not significantly affected by age and gender.

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Section: Discussionmentioning

confidence: 92%

Drug resistant typhoid fever; its clinical spectrum and management in different age groups.

Sobia Ashfaq,

Asif Manzoor Basra,

Ammara Kaleem

et al. 2023

TPMJ

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“…S. typhi strains were resistant to macrolides, sulfonamides, penicillins, and cephalosporins. Ghurnee et al (2021) found that S. typhi was resistant to ciprofloxacin (99.52%) and nalidixic acid (81.60%). Farooq et al (2019) discovered S. typhi to be highly resistant to fluoroquinolones (ciprofloxacin and ofloxacin) at 84 and 87%, respectively, which agree with the findings of other studies that have reported high resistance from different regions of Pakistan.…”

Section: Resultsmentioning

confidence: 99%

Antibacterial Efficacy of Macro and Nano Achillea millefolium L. against Multidrug-resistant Salmonella typhi with Genotyping Analysis

Elkhateeb,

Mabrouk,

Othman

et al. 2023

Egypt. J. Bot.

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T YPHOID fever is one of many illnesses caused by Salmonella typhi (S. typhi), especially multidrug-resistant (MDR) S. typhi. This research aimed to isolate and quantify MDR S. typhi by detecting specific genes responsible for MDR S. typhi and the use of Achillea millefolium leaves (A. millefolium L.) essential oil, extract, and nanoparticles separately as all-natural remedies for MDR S. typhi strains. S. typhi was discovered in 52/84 (61.90%) of the collected specimens from Abbassia Fever Hospital, Egypt. 24/52 samples were multidrugresistant. However, men were likely more susceptible to infection than women. The findings showed that 91.66% of S. typhi isolates harboured the blaCMY-2 gene, 87.50% harboured the DHFR gene and 50.0% harboured the acrB gene, while 33.33% of them carried the three genes. Gas chromatography-mass spectrometry (GC-MS) exhibited that the cyclohexane,1methylene-4-(1-methylethyl) compound was the most popular component, with a percentage of 44.5% in A. millefolium L. essential oil. 30µg/mL of A. millefolium L. nanoparticles was found to be the minimal bactericidal concentration (MBC) and the minimal inhibitory concentration (MIC) was 20µg/ml. Consequently, as detected by transmission electron microscopy (TEM), A. millefolium L. nanoparticles damaged the cell wall and cytoplasmic structures of MDR S. typhi. The IC50 of A. millefolium L. nanoparticles against human gastric epithelial cell line (GES1) was 552.023±32.7ug/ml, and the meropenem drug was 151.386±8.32ug/mL, showing that meropenem was more cytotoxic on GES1 normal cells than A. millefolium L. nanoparticles. A. millefolium L. nanoparticles have high effect against MDR S. typhi and more safe than using meropenem drug.

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“…Progressing to the more common use of azithromycin and meropenem will result in developing resistance against these antibiotics in near future, for the treatment of these XDR strains will accelerate the rise of azithromycin-resistant strains as well in the coming days. The XDR cases from Sindh especially Karachi, Pakistan highlight the rise of extensive cephalosporins resistance among Salmonella typhi strains, which demands the implication of a vital action plan before such strains become the usual phenotypes that will ultimately lead to treatment failure for typhoid fever with the available antimicrobial agents 23 .…”

Section: Discussionmentioning

confidence: 99%

Extensively Drug-Resistant Typhoid: Antibiotic Susceptibility Pattern of an Emerging Menace in Karachi

2023

PJMD

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Background: Salmonella typhi, a rod-shaped Gram-negative bacterium that stands responsible for causing typhoid fever, in places with poor sanitation and polluted water. Injudicious antibiotic practices have significantly added to the rise of multidrug-resistant (MDR) and extensively drug-resistant (XDR) Salmonella typhi. This study aimed to determine the frequency and antibiotic susceptibility pattern of Salmonella typhi in blood cultures of patients with fever. Methods: This cross-sectional retrospective study was conducted from November 2018 to November 2019 at Tahir Laboratory, Karachi. All clinically suspected typhoid fever cases were cultured and Salmonella typhi was identified by traditional methods using standard microbiological procedures. Antibiotic susceptibility testing was done by the Kirby-Bauer disk diffusion method and a combined disc test was done to detect Extended Spectrum β-Lactamase production in XDR cases. Results: Out of 394 samples received for blood culture, 99(25.12%) were gram-positive, 158(40.10%) were gram-negative and 137 (34.7%) showed no growth. In 158 gram-negative samples, 92(58.22%) were of Salmonella typhi, consisting of 40(43.47%) cases of children aged 0-10 years. MDR and XDR Salmonella typhi isolates were 25(27.2%) and 8(8.7%) respectively, showing a male preponderance of 20 (60.60%). Both the MDR and XDR strains were sensitive to Meropenem and Azithromycin. Extended Spectrum β-Lactamase production was confirmed by combined disc test in all the XDR cases. Conclusion: The emergence of multidrug-resistant and extensively drug-resistant Salmonella typhi requires surveillance to see antibiogram trends for empirical therapy and to facilitate the prevention of the spread of the disease. Keywords: Salmonella typhi; Antibiotic Susceptibility Test; Extensively Drug-Resistant; Multidrug-Resistant.

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Isolation of Multi-Drug Resistant (MDR) and Extensively Drug Resistant (XDR) <i>Salmonella typhi</i> from Blood Samples of Patients Attending Tertiary Medical Centre in Dhaka City, Bangladesh

Cited by 11 publications

References 32 publications

Drug resistant typhoid fever; its clinical spectrum and management in different age groups.

Drug resistant typhoid fever; its clinical spectrum and management in different age groups.

Antibacterial Efficacy of Macro and Nano Achillea millefolium L. against Multidrug-resistant Salmonella typhi with Genotyping Analysis

Extensively Drug-Resistant Typhoid: Antibiotic Susceptibility Pattern of an Emerging Menace in Karachi

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