Defining the concurrent pattern of antimicrobial sensitivity of Typhoidal Salmonella

Dipa Rani Bhowmik¹, Bushra Jannat¹, Md. Abu Zihad¹, Kumkum Rahman Mouree 1*, Suvamoy Datta²

High prevalence of multidrug-resistant Salmonella Typhi in Dhaka demonstrated urgent need for tailored antibiotic guidelines and novel treatment strategies.

Abstract

Objective: Salmonella-associated typhoidal fever presents a significant public health challenge in Bangladesh. Factors such as limited access to safe water, inadequate sanitation, low awareness of infection control measures among the general population, and inappropriate use of antibiotics contribute to the high incidence of Salmonella typhi infections. Moreover, the emergence of resistance to multiple advanced antibiotics complicates treatment options. Methods:  monitor the prevalence and drug resistance patterns of Salmonella typhi among patients across northern and southern Dhaka. Blood samples were collected aseptically from febrile patients, identifying Salmonella typhi as the causative agent. These isolates were then tested against twelve commonly prescribed antibiotics across eight different classes to assess their resistance profiles. Results: Among the 200 blood samples tested from suspected typhoid patients, 28% tested positive for Salmonella typhi. Distribution was skewed, with 43% of cases from northern Dhaka and 57% from southern Dhaka. Antibiotic resistance analysis revealed high resistance rates to first-line antibiotics and fluoroquinolones. However, susceptibility was retained against third-generation cephalosporins and carbapenems. Azithromycin showed moderate sensitivity, but the rapid emergence of resistance is concerning, limiting treatment options primarily to injectable carbapenems. Conclusion: The findings underscore the urgent need for tailored antibiotic prescribing guidelines and the development of novel therapeutic agents to address these healthcare challenges in tropical developing countries like Bangladesh. Effective strategies are essential to combat rising antibiotic resistance and ensure effective treatment outcomes for typhoid fever.

Keywords: Typhoid fever, Salmonella typhi, Antibiotic resistance, Bangladesh, Public health

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