Prevalence of Multi-Drug Resistant and Extensively Drug-Resistant Salmonella enterica Serovar Typhi Recovered from Pediatrics' Septicemia Patients in Lahore

Background: Increasing antimicrobial resistance to enteric pathogens like SalmonellaTyphi is an important public health issue. Aim: To report the prevalence of MDR and XDR S.Typhi in the pediatrics population. Methods: This retrospective study on blood cultures provided an insight into the frequency and drug susceptibility of S.Typhi at Fatima Memorial Hospital, Lahore. Blood samples (1-4ml) were drawn from suspected septicemia children's patients (n=2575) aseptically. Blood was inoculated in BacT/Alert peads bottles and processed in an automated BacT/Alert system. Positive samples were further sub-cultured on blood and MacConkey agar. Isolates confirmation and antibiogram were performed by VITEK 2 compact system. Results: Out of 2575, 292 (11.3%) blood cultures yielded bacterial growth. Among these, S. Typhi(170; 58.2%) and Salmonella paratyphiA(12; 4.1%) were isolated. S.Typhi(43%) was mostly isolated in the age group of 1-5 years. The majority of the S. Typhi and S.paratyphi A were isolated from peads OPD (55; 30.1%) and peads emergency wards (49; 26.7%). Overall, 23.5% and 54% were MDR and XDR S. Typhi respectively, and were sensitive to azithromycin and carbapenems. S. Typhi displayed resistance to chloramphenicol (72%), ampicillin (78%), co-trimoxazole (78%), ciprofloxacin (59%), and ceftriaxone (56%). Conclusion: A strict surveillance plan is mandatory for the containment of the MDR and XDR spread. Public awareness, improved sanitation, safe water supply, and vaccination can play a major role in the prevention of outbreaks.