Defining the concurrent pattern of antimicrobial sensitivity of Typhoidal Salmonella
Dipa Rani Bhowmik1, Bushra Jannat1, Md. Abu Zihad1, Kumkum Rahman Mouree 1*, Suvamoy Datta2
Journal of Primeasia 2(1) 1-7 https://doi.org/10.25163/primeasia.2120216
Submitted: 11 April 2021 Revised: 01 June 2021 Published: 11 June 2021
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
References
Afroj, S., Ilias, M., Islam, M., & Saha, S. K. (2011). Prevalence of ciprofloxacin and nalidixic acid resistant Salmonella enterica serovar Typhi in Bangladesh. Bangladesh Journal of Microbiology, 28(1), 7-11.
Afroz, H., Hossain, M. M., Fakruddin, M., Hossain, M. A., Khan, Z. U. M., & Datta, S. (2013). Prevalence and antibiotic susceptibility patterns of bloodstream Salmonella infections in a tertiary care hospital, Dhaka. Journal of Medical Sciences, 13(4), 360-366.
Aggarwal, A., Vij, A. S., & Oberoi, A. (2007). A three-year retrospective study on the prevalence, drug susceptibility pattern, and phage types of Salmonella enterica subspecies Typhi and Paratyphi in Christian Medical College and Hospital, Ludhiana, Punjab. Journal of the Indian Academy of Clinical Medicine, 8(1), 32-35.
Akinyemi, K. O., Oshundare, Y. O., Oyeyinka, O. G., & Coker, A. O. (2012). A retrospective study of community-acquired Salmonella infections in patients attending public hospitals in Lagos, Nigeria. Journal of Infection in Developing Countries, 5(5), 387-395.
Akter, L., Hassan, M., & Ahmed, Z. (2012). Present status and antibiotic sensitivity pattern of Salmonella Typhi and S. Paratyphi in different age group hospitalized patients in Dhaka City, Bangladesh. IOSR Journal of Pharmacy and Biological Sciences, 4(2), 27-30.
Akter, T., Hossain, M. J., Khan, M. S., Al Sanjee, S., Fatema, K., & Datta, S. (2016). Prevalence and antimicrobial susceptibility pattern of Salmonella spp. isolated from clinical samples of Bangladesh. American Journal of Pharmacy & Health Research, 4(3), 1-11.
Alam, A. S., Zaman, S., Chaiti, F., Sheikh, N., & Kundu, G. K. (2010). A reappraisal of clinical characteristics of typhoid fever. Bangladesh Journal of Child Health, 34(2), 80-85.
Bauer, A. W. (1966). Antibiotic susceptibility testing by a standardized single disc method. American Journal of Clinical Pathology, 45, 149-158.
Benschop, J., Hazelton, M. L., Stevenson, M. A., Dahl, J., Morris, R. S., & French, N. P. (2008). Descriptive spatial epidemiology of subclinical Salmonella infection in finisher pig herds: Application of a novel method of spatially adaptive smoothing. Veterinary Research, 39(1), 2.
Boni-Cissé, C., Meité, S., Faye-Ketté, H., Houedanou, C., Timité-Konan, M., Kalpi, C., et al. (2012). Serotypes and antibiotypes of Salmonella isolated at the University Teaching Hospital of Yopougon, Abidjan, Côte d’Ivoire from 2005 to 2009. Journal of Microbiology and Antimicrobials, 4(3), 40-44.
Clinical and Laboratory Standards Institute. (2006). Performance standards for antimicrobial disk susceptibility tests (9th Informational Supplement, CLSI document M2-A9). Wayne, PA: Clinical and Laboratory Standards Institute.
Dimitrov, T. S., Panigrahi, D., Emara, M., Al-Nakkas, A., Awni, F., & Passadilla, R. (2005). Incidence of bloodstream infections in a specialty hospital in Kuwait: 8-year experience. Medical Principles and Practice, 14(6), 417-421.
Djeghout, B., Saha, S., Sajib, M. S. I., Tanmoy, A. M., Islam, M., Kay, G. L., et al. (2018). Ceftriaxone-resistant Salmonella Typhi carries an IncI1-ST31 plasmid encoding CTX-M-15. Journal of Medical Microbiology, 67(5), 620-627.
Gautam, V., Gupta, N. K., Chaudhary, U., & Arora, D. R. (2002). Sensitivity pattern of Salmonella serotypes in Northern India. Brazilian Journal of Infectious Diseases, 6(6), 281-287.
Ghurnee, O., Ghosh, A. K., Abony, M., Aurin, S. A., Fatema, A. N., Banik, A., et al. (2021). Isolation of multi-drug resistant (MDR) and extensively drug resistant (XDR) Salmonella typhi from blood samples of patients attending tertiary medical centre in Dhaka City, Bangladesh. Advances in Microbiology, 11(9), 488-498.
Holt, K. E., Phan, M. D., Baker, S., Duy, P. T., Nga, T. V. T., Nair, S., et al. (2011). Emergence of a globally dominant IncHI1 plasmid type associated with multiple drug resistant typhoid. PLoS Neglected Tropical Diseases, 5(7), e1245.
Islam, M. A., Faisal Ahmed, M. U. S., Ahmed, S., Afroze, T., & Chowdhury, N. B. (2019). Drug resistance patterns of Salmonella in enteric fever in the. Journal of Sylhet Women's Medical College, 9(2), 1-8.
Islam, M. N., Rahman, M. E., Rouf, M. A., Islam, M. N., Khaleque, M. A., Siddika, M., et al. (2007). Efficacy of azithromycin in the treatment of childhood typhoid fever. Mymensingh Medical Journal, 16(2), 149-153.
Khan, M. R., & Hoque, S. S. (1992). Emergence of multi-drug resistant Salmonella Typhi: A need for therapeutic reappraisal. Bangladesh Journal of Child Health, 16(1), 1-3.
Kidgell, C., Reichard, U., Wain, J., Linz, B., Torpdahl, M., Dougan, G., et al. (2002). Salmonella typhi, the causative agent of typhoid fever, is approximately 50,000 years old. Infection, Genetics and Evolution, 2(1), 39-45.
Klemm, E. J., Shakoor, S., Page, A. J., Qamar, F. N., Judge, K., Saeed, D. K., et al. (2018). Emergence of an extensively drug-resistant Salmonella enterica serovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third-generation cephalosporins. MBio, 9(1), e00105-00118.
Kumar, M. S., Lakshmi, V., & Rajagopalan, R. (2006). Occurrence of extended-spectrum beta-lactamases among Enterobacteriaceae spp. isolated at a tertiary care institute. Indian Journal of Medical Microbiology, 24(3), 208-211.
Mannan, A., Shohel, M., Rajia, S., Mahmud, N. U., Kabir, S., & Hasan, I. (2014). A cross-sectional study on antibiotic resistance pattern of Salmonella typhi clinical isolates from Bangladesh. Asian Pacific Journal of Tropical Biomedicine, 4(4), 306-311.
Mbatchou, V., Ayebila, A., & Apea, O. (2011). Salmonella typhi. Journal of Animal & Plant Sciences, 10(1), 1248-1258.
Mohammad Mizanur Rahman, Maruf Abony et al., (2020). Isolation, Identification and Antibiotic Sensitivity Pattern of Salmonella typhi Isolated from Blood Samples of Patients, Journal of Primeasia, 1(1), 1-5, 560014
Pourakbari, B., Sadr, A., Ashtiani, M. T., Mamishi, S., Dehghani, M., Mahmoudi, S., et al. (2012). Five-year evaluation of the antimicrobial susceptibility patterns of bacteria causing bloodstream infections in Iran. Journal of Infection in Developing Countries, 6(2), 120-125.
Rahman, M., Siddique, A. K., Shoma, S., Rashid, H., Salam, M. A., Ahmed, Q. S., et al. (2005). Emergence of multidrug-resistant Salmonella enterica serotype Typhi with decreased ciprofloxacin susceptibility in Bangladesh. Epidemiology and Infection, 134(2), 433-438.
Rowe, B., Ward, L. R., & Threlfall, E. J. (1997). Multidrug-resistant Salmonella typhi: A worldwide epidemic. Clinical Infectious Diseases, 24(1), S106-S109.
Saha, S. K., Talukder, S. Y., Islam, M., & Saha, S. (1999). A highly ceftriaxone-resistant Salmonella typhi in Bangladesh. The Pediatric Infectious Disease Journal, 18(4), 387.
Saha, S., Sajib, M. S. I., Garrett, D., & Qamar, F. N. (2020). Antimicrobial resistance in typhoidal salmonella: Around the world in 3 days. Clinical Infectious Diseases, 71(2), S91-S95.
Shahriar, M., & Kabir, S. (2010). Status of antibiotic-resistant Salmonella Typhi strains from clinical isolates in Dhaka. Dhaka University Journal of Biological Sciences, 19(2), 207-209.
White, N. J., Dung, N. M., Vinh, H., Bethell, D., & Hien, T. I. (1996). Fluoroquinolone antibiotics in children with multidrug resistant typhoid. The Lancet, 348(9026), 547.
World Health Organization. (2018). Typhoid. Available from https://www.who.int/news-room/fact-sheets/detail/typhoid [Retrieved March 19, 2019].
View Dimensions
View Altmetric
Save
Citation
View
Share