Trends, Associations, and Antimicrobial Resistance of Salmonella Typhi and Paratyphi in Pakistan

Jahan

2019

AJRID

Introduction: Typhoid fever is a major public health issue in Pakistan. Variations in clinical manifestations make diagnosis a challenging task. Over use of antibiotics make the organism resistant. Antibiotic resistance is currently the most threatening issue as regards to infection control and our study would be helpful in the understanding of this feature of the microbes. The main purpose of this study was to determine the antimicrobial drug resistance and sensitivity pattern in Salmonella typhi and S. paratyphi. Methods: This is a descriptive study carried out in a private hospital in Karachi, Pakistan. One hundred consecutive patients, children from age one day till 12 years admitted in the hospital with the history of fever and had positive blood culture for Salmonella typhi and S.paratyphi were included, 9 antimicrobial drugs were taken into account to check their sensitivity. Statistical analysis was performed using SPSS (IBM SPSS Statistics 20.0). Data was expressed in frequencies and percentages. Results: Most of the children belong to middle class 58% with 62% male and common age group (40%) was 1 day to 4 years. Nearly half of them drinking un-boiled water and had ladder pattern of high grade fever. Most pronounced symptoms were abdominal pain, nausea and anorexia. Resistance pattern was ciprofloxacin 100%, chloramphenicol 89.1%, Ampicillin 87.1% Ceftriaxone 76.2%, Cefixime 75.2%, Amoxicillin 65.3%. Conclusion: Typhoid fever is most commonly observed with unhygienic practices, eating of unhealthy outside food and contaminated water. Pattern of anti microbial resistance gives us a little choice to select antibiotic for typhoid fever. Typhoid fever still remains the commonest bacteraemic illness in Pakistan with children being especially susceptible. Antimicrobial non-susceptibility continues to complicate management.

Section: Discussionmentioning

confidence: 99%

Pattern of Anti-microbial Drug Resistance in Childhood Typhoid Fever in a Selected Hospital in Karachi, Pakistan

Jahan

2019

AJRID

The American Journal of Tropical Medicine and Hygiene

“…These countries included Vietnam, 15 Thailand, 14 Chile, 9 and South Africa. 13 In other settings where typhoid fever trends were more uncertain, such as Pakistan, 12 India, 10 Bangladesh, 8 and Nigeria, 11 we obtained time trend information from large reference laboratories with standardized methods and documented denominators and relevant test volumes over time.…”

Section: Methodsmentioning

confidence: 99%

Typhoid Fever: Way Forward

Bhutta

Gaffey

Crump

et al. 2018

Self Cite

Abstract.The Tackling Typhoid supplement shows that typhoid fever continues to be a problem globally despite socioeconomic gains in certain settings. Morbidity remains high in many endemic countries, notably in sub-Saharan Africa and South Asia. In addition, antimicrobial resistance is a growing issue that poses a challenge for clinical management. The findings from this supplement revealed that outside of high-income countries, there were few reliable population-based estimates of typhoid and paratyphoid fever derived from surveillance systems. This indicates the need for monitoring systems that can also characterize the effectiveness of interventions, particularly in low- and middle-income settings. The country case studies indicated that gains in economic conditions, education, and environmental health may be associated with reductions in typhoid fever burden. Over the study period, the effect is mainly notable in countries with higher baseline levels of economic development, female literacy, and investments in public sanitation. High burden countries must continue to invest in strategies at the local level to address environmental factors such as access to safe drinking water and improved public sanitation that are known to interrupt transmission or diminish the risk of acquiring typhoid. Developing more effective vaccines and incorporating appropriate immunization strategies that target populations with the greatest risk could potentially alleviate disease burden.

Jundishapur J Microbiol

“…For this purpose, we explore and distinguish the variation in immunity to S. typhi infection in Sudanese and Chinese populations using an artificial neural network. Salmonella typhi is the etiologic agent of typhoid fever, which is exclusively a human systemic disease and still endemic in many parts of the world, where it is a causative agent of febrile illness in crowded and lowincome settings (1)(2)(3).…”

Section: Introductionmentioning

confidence: 99%

Quantitative Assessment of an Artificial Neural Network for the Variation in Immunity to Salmonella Infection Among Sudanese and Chinese Populations and the Relationship Between HLA-DQB1 and Antibody: A Preliminary Study

Tamomh

Liu

2020

Background: Salmonella enterica serovar typhi infection is a worldwide bacterial disease still remains a public health problem and the resistance to the infection and clearance of the bacteria may differ between Sudanese and Chinese populations. Objectives: We aimed to evaluate the difference in immunity to Salmonella infection and the relationship of HLA-DQB1 and antibody in the two populations using an artificial neural network (ANN). Methods: An ANN was constructed by data collected from resolved Salmonella-infected patients. The variation in immunity to Salmonella in the two groups was compared using the Mann-Whitney U test. The relationship between human leukocyte antigen (HLA) gene and the antibody was assessed by Spearman correlation. Binary Logistic regression assessed whether variables were independent in the two groups. The quantitative variations in immunity to S. typhi in the two groups were assessed by ANN using SPSS software version 21.0. Results: A high variation in immunity to S. typhi between Sudanese and Chinese in affinity (P < 0.05), and no differences in other antibody parameters (P > 0.05). There was a high variation in HLA-DQB1*03 (P < 0.05), and no differences with other HLA-DQB1 alleles (P > 0.05). A clear correlation was observed between HLA-DQB1*05 and the antibody (P < 0.05). The standardized percentage of the effect of HLA-DQB1 gene on the variation of immunity in the two groups for HLA-DQB1*06 (100%) was much higher than the other HLA-DQB1 alleles. Conclusions: A high variation in the HLA-DQB1 gene between Sudanese and Chinese populations may be associated with the difference in immunity against S. typhi infection.