Typhoidal Salmonaelle in Holy Family Red Crescent Medical College Hospital, Dhaka, Bangladesh

Abstract

Enteric fever is still an important public health problem in many developing countries like Bangladesh. A changing antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi A and emergence of multidrug resistance has increased to a greater concern. The present study was undertaken to find out the rate of isolation of Salmonella from Blood samples and to compare the changing patterns of drug resistance at Holy Family Hospital and Medical College and Hospital over a two year study period from January 2013 to December 2014. During the period January 2013 to December 2013, total 31 Salmonella were isolated (14% of blood isolates) in which Salmonella typhi were 27 and Salmonella paratyphi were 4. Again, during the period January 2014 to December 2014, total 27 Salmonella were isolated (10% of blood isolates) in which Salmonella typhi were 23 and Salmonella paratyphi were 4. The rate of isolation of S. typhi was noted higher among pediatric group when compared to adult group in both study periods. The sensitivity of cotrimoxazole and chloramphenicol was increased which were (80-88)% & (79-93)% respectively in 2 year study period. Nalidixic acid resistant Salmonella typhi(NARST) was 88-89% and all of NARST showing good sensitivity to ciprofloxacin. In our study period, Azythromycin resistance rate is increasing from 30-35%. All the isolates were fully susceptible to 3rd generation of cephalosporin in both study periods. The rate of Multi drug resistant(MDR) was (6.5-7.4)%; which was low in 2 year period. The policy of empirical treatment of enteric fever needs to be rationalized and newer generation antibiotics should be restricted only for multi-resistant cases of enteric fever.

Pattern of Antimicrobial Susceptibility for Salmonella Typhi in Dhaka Medical College Hospital from 2013-2014

“…14,19,20 In our study azythromycin resistance is increasing (29%) and it also correlates with other study. 12,16 In the present study 100% Salmonella were sensitive to ceftriaxone which is the drug of choice in Dhaka Medical College and other parts of Bangladesh to treat typhoid fever. In Bangladesh so far no ceftriaxone resistant Salmonella has been identified.…”

“…In present study all of NARST had good sensitivity to ciprofloxacin which correlate with the data of another study. 12 Ciprofloxacin which showed good sensitivity in vitro was not effective in vivo if the isolate was nalidixic acid resistant. 9 It was advised to use nalidixic acid sensitivity testing for deciding treatment with fluroquinolones as the isolate that are nalidixic acid resistant may not show response in vivo with fluroquinolone even though the strain is sensitive to it in vitro.…”