Antibiogram Of Salmonella serovars From The Blood of Clinically Suspected Enteric Fever Patients Visiting Alka Hospital

Abstract

Enteric fever is endemic in Nepal having a significant public health burden and includes typhoid fever caused by Salmonella sero type Typhi and paratyphoid fever caused by Salmonell a sero types Paratyphi A, B, and C. Across sectional study was carried out in clinically suspected enteric fever patients visiting Alka Hospital during July 2011 to February 2012 to determine the prevalence of enteric fever and antibiogram pattern of Salmonella isolates. Out of 1202 blood samples collected, only 86 (7.2%) showed positive blood culture result amongwhich56(65.1%) isolates were Salmonella Typhi and 30(34.9%) isolates were Salmonella Paratyphi A. Prevalence of enteric fever was higher in female patients (40/542;7.4%) than in male patients (46/660;7.0%), in age group 11-21years (28/220; 12.7%), and in the months of July and August.Salmonella Typhi isolates were 100% sensitive to chloramphenicol, cotrimoxazole, cefixime, ceftriaxone, ciprofloxacin and gentamicin followed by98.2%sensitive to amoxycillin,ofloxacinand89.3%sensitive to azithromycin. Similarly Salmonella Paratyphi A isolates were100%sensitive to amoxycillin, cotrimoxazole, ceftriaxone and gentamicin followed by 96.7% sensitive to chloramphenicol, ciprofloxacin, ofloxacin, cefixime and 86.7% sensitive to azithromycin.None of the Salmonella isolates were multi drug resistant(MDR).About91.1% S. Typhi and90.0% S. Paratyphi A isolates were nalidixic acid resistant(NAR).None of the nalidixic acid resistant S.Typhi were ciprofloxacin resistant whereas 1 (3.7%) nalidixic acid resistant S. Paratyphi A isolate was resistant to ciprofloxacin. This study revealed the increasing frequency ofnalidixic acid resistant Salmonella isolates andre-emergence of susceptibility to conventionalfirst linedrugs. Keywords: Enteric fever, Multi drug resistant (MDR), Nalidixic acid resistant,Salmonella