Enteric susceptibility profile: Finding hope amidst despair

Area of Science:

• Infectious Diseases
• Microbiology
• Public Health

Background:

• Enteric fever, primarily caused by Salmonella Typhi, poses a significant global health burden.
• Antimicrobial resistance is a growing concern, complicating treatment and increasing morbidity and mortality.
• Tertiary care settings often manage complex cases with resistant pathogens.

Purpose of the Study:

• To determine the antimicrobial susceptibility profile of enteric fever patients.
• To assess the prevalence of multidrug resistance (MDR), extensive drug resistance (XDR), and extended-spectrum beta-lactamase (ESBL) production in Salmonella Typhi.
• To evaluate resistance patterns against first-, second-, and third-line antimicrobial agents.

Main Methods:

• A retrospective study was conducted at Pakistan Institute of Medical Sciences, Islamabad.
• Data from January 2019 to April 2023 included patients over 12 years old with blood culture-confirmed Salmonella Typhi.
• Antimicrobial susceptibility testing results, including MDR, XDR, and ESBL status, were analyzed.

Main Results:

• Out of 734 patients, 11.98% exhibited multidrug resistance, and 24.25% showed extensive drug resistance.
• Extended-spectrum beta-lactamase production was detected in 6.81% of cases.
• While sensitivity to third-line drugs was high (99.2%), significant resistance was noted against first-line (37.4%) and second-line (30.5%) agents.

Conclusions:

• The study reveals an alarming level of antimicrobial drug resistance in enteric fever patients.
• High rates of MDR and XDR necessitate urgent attention and potential revision of treatment protocols.
• Continued surveillance of antimicrobial susceptibility is crucial for effective management of enteric fever.