Acute rise in Multiple Drug Resistance Typhoid fever in Children in Rural Sindh: an Alarming Situation

Abstract

Objective: Evaluation of the frequency of antimicrobial drug resistance in Salmonella typhiamong children of rural Sindh. Study Design: Cross sectional / observational study Place and Duration: At Department of Pediatric medicine Civil Hospital Mirpurkhas, Sindh from January 2019 to July 2019 Methodology: With approval of ethical committee and informed consent from parents/attendant blood samples (5ml) of 55 children with age between 0 to 15 years are obtained at outpatient department (OPD) or admitted in the ward with suspected enteric fever. The blood samples were used to obtain bacterial culture and antibiotic sensitivity was performed at diagnostic and research laboratory (DRC) of Liaquat University of Medical and Health Sciences (LUMHS). Blood culture and Antibiotic Susceptibility testing was performed according to standard protocol of Clinical Laboratory Standard Institute (CLSI) guidelines. Results: Among study population (n=55), 32 (58.2% were in age group 0 to 5 years, 20(36.4%) in age group of 6 to 10 years while only 3(5.5%) were in the age group of 11 to 15 years.While regarding gender,29(52.7%) were male while 26(36.4%) were females. S. typhi exhibited high resistance against ampicillin (93% n=51) and cotrimazole-trimethoprim (91%n= 50). About 82% (n=46) of culture was observed resistant to ciprofloxacin, whereas 84% (n=46) showed resistance to ceftriaxone, 84% (n=46) were resistant to cefixime. Out of these 55, 45(82%) showed antimicrobial sensitivity to meropenem, 34 (62%) to azithromycin, 10(18%) to ciprofloxacin, 09 (16%) to cefixime and ceftriaxone each, while only 05 patients showed sensitivity to (9%) to cotrimazole-trimethoprim and 04(7%) to Amoxicillin/clavulanic acid. Conclusion: Multiple drug resistance in S. typhiis high alert situation in our setup and needs prompt initiatives to combat.