Solation, Identification and Antibioticsensitivity Testing of salmon ellaserovars From Enteric Fever Suspected Patientsvisitingbir Hospital

Abstract

The present study was carried out at Bir Hospital, Kathmandu from June 2008 to August2008 to study the Widal test and the antibiotic sensitivity pattern of the isolates.Alltogether 970 blood samples were collected from patients clinically suspected of entericfever,503 blood samples were tested for Widal test and 48 blood sampleswere testedforEnterocheck-Wb. All blood samples were cultured in 1% bile broth and sub cultured inblood agar and MacConkey agar plates.Of 503 blood samples,49.6% (247)had titer lessthan 1:80 in TO, TH, AH and BH.Even in culture proven cases nearly half of the sampleshad titer less than 1:80 in TO, TH, AHand BH. High titer of 1:320 was observed forculture proven cases.Of 48 blood samples tested for Enterocheck-Wb, 58% (28)werepositive of which 14 was culture positive forSalmonellaserovars.No blood sampleswereculture positive for SalmonellaTyphi but negative on Enterocheck-Wb. Of 970 bloodsamples, 631 were male. 68 (10%)ofmale and 29 (8.6%)offemale were infected. Therewas no significant association of enteric fever with gender of patients (p=0.27).Of970blood samples, 104 (10.72%) wereculturepositive, 97 (10%)wereSalmonella serovarsisolated after 7 days of incubation period. More than 90% of isolates were resistant toAmpicillin.SalmonellaParatyphi Awas 100%susceptible to Ceftriaxone, Ciprofloxacin,Ofloxacin and Chloramphenicol.SalmonellaTyphiwas98%sensitivetoCeftriaxone,96%to Ofloxacin and Chloramphenicol, 92.4% to Ciprofloxacin and 88.5% to Cotrimoxazole.Of total Salmonella Typhi isolated2 (3.9%)were MDR as well as Nalidixic acid resistantand 3 (5.76%)were resistant to Ciprofloxacin as well as Nalidixic acid.Since the antibodydevelops after second week of infection andWidal test can be diagnostic if interpretedconsidering the base line titer as well as clinical condition of the patient.Enterocheck-Wbis new diagnostic kitfor early detection of typhoid fever.Antibiotic resistance problems aregrowing rapidly and threaten our ability to treatthe infection. Key words: Enteric fever, Antibiograms, Multidrug resistance (MDR), Widal test,Enterocheck-wb