DOI: 10.36347/sjams.2020.v08i09.018

Pages: 2068-2072

Background: Typhoid remains a global public health problem with a higher burden in low- and middle-income countries (LMICs) due to poverty, limited access to safe water and unhygienic practices. The prevalence of Multidrug-resistant strains has been responsible for outbreaks in India. In recent years, there has been an increase in fluoroquinolones resistance because of which ciprofloxacin is no longer the empirical choice of treatment in our country. Objectives: The aim of the study is to know the prevalence of enteric fever associated with Salmonella enterica and determine its antimicrobial susceptibility in a tertiary care hospital. Methods: This is a retrospective study conducted in the Department of Microbiology, CMC and Hospital, Ludhiana for 6 years. All the culture positive enteric fever cases were included in the study. Antimicrobial susceptibility was done as per corresponding CLSI guidelines. Results: A total of 918 strains of Salmonella species- Salmonella typhi 802 (87.36%) and Salmonella paratyphi A 116 (12.63%) were isolated from the blood cultures. Antimicrobial susceptibility for chloramphenicol, ampicillin and co trimoxazole was found to be 94%, 97%, 100% for S. Typhi and 94.63%, 96.64% and 100% for S. Paratyphi A, respectively. There is a continuous increase in Ciprofloxacin minimum inhibitory concentration values over the time. Majority of Salmonella isolates were nalidixic acid resistant. Although the rate of MDR Salmonella strains was nil, their reduced susceptibility to fluoroquinolones has restricted their routine empirical use. Conclusions: Enteric fever continues to cause significant morbidity due to delayed diagnosis, inadequate treatment and worsening drug resistance in India and beyond. There has been a reported decline in MDR with a parallel increase in decreased ciprofloxacin susceptibility among S. Typhi. Third generation cephalosporins are the safest choice for empirical use as ampicillin, chloramphenicol or cotrimoxazole are ........