Prevalence and Antibiotic Sensitivity test of Salmonella Serovars from Enteric Fever Suspected Patients Visiting Alka Hospital, Lalitpur

Abstract

Enteric fever is still an important public health problem in developing countries including Nepal. A changing antibiotic susceptibility pattern of Salmonella Typhi and Salmonella Paratyphi A has increased to a great concern. To determine the prevalence and antibiotic sensitivity pattern of S. enteric serovars Typhi and Paratyphi from blood specimen in enteric fever suspected culture positive cases. A cross-sectional study was carried out at Alka hospital, lalitpur. Blood culture samples were collected from suspected enteric fever patient and tested microbiologically by standard procedure. AST was based on Kirby disc diffusion method and results were interpreted according to Clinical Laboratory Standards Institute (CLSI) guidelines. Of total 37 (6.10%) Salmonella serotype isolated from 604 blood culture samples, 25 (67.57%) were S. Typhi and 12 (32.43%) were S. Paratyphi A. Among the culture positive cases, the incidence rate was high in male 70.27% and the age group of 21-30 years showed maximum number of growth i.e., 14 (37.8%). Among the tested antibiotics S. Typhi was fully susceptible towards Ceftriaxone. In case of S. Paratyphi A Ciprofloxacin, Cefriaxone and Cefixime showed 100% susceptibility. Resistant pattern of Salmonella serovars was seen in higher number 34 (91.9%) in the case of Nalidixic acid. Among 37 Salmonella serovars isolated six were found to be Multidrug Resistance (MDR) where four were Salmonella Typhi and two were Salmonella Paratyphi A. Ceftriaxone and Cefixime was the most effective drugs as no isolates were resistant. Ceftriaxone and Cefixime can be the better choice of antibiotic for Salmonella isolates and remains the last drug of choice for S. Typhi and S. Paratyphi A which are also resistant to the first line agents.