A pattern of antibiotic drug resistance of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever in a tertiary care hospital in Lahore, Pakistan

Abstract

Aim To establish the pattern of antibiotic resistance and assess the frequency of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains of Salmonella Typhi and Salmonella Paratyphi among children with enteric fever. Methods This cross-sectional study was carried out in the Department of Pediatrics, Sharif Medical City Hospital, La-hore, from July 2020 to January 2021. The study involved patients aged between 0 to 15 years who attended our outpatient department or were admitted to the ward with the suspicion of typhoid fever. A convenience sample of patients with blood cultures positive for S. Typhi and S. Paratyphi was enrolled. Results Of the 105 participants, 70 (66.7%) were male. The mean age was 8.48 ± 4.18 years, and the most affected age group was 6-10 years (n = 46, 43.8%). Among the cultured organisms, 95 (90.5%) isolates were S. Typhi and 10 (9.5%) were S. Paratyphi A. Antibiotic resistance was highest against ampicillin (n = 91, 86.7%), and all of the isolates were sensitive to imipenem and meropenem. Twen-ty-three (21.9%) cultured organisms were MDR and 54 (56.8%) were XDR. Conclusion An alarming antibiotic drug resistance pattern was observed among children with enteric fever in Lahore. The lowest resistance was noted for azithromycin, meropenem, and imipenem. Our findings warrant the im-mediate implementation of tailored antibiotic stewardship and infection control strategies.