“ANTIBIOTIC SENSITIVITY PATTERNS IN ENTERIC FEVER PT E POSITIVE BLOOD CULTURE”
Main Article Content
Keywords
Enteric fever; Salmonella Typhi; Salmonella Paratyphi; Blood culture; Antibiotic susceptibility; Antimicrobial resistance; Ceftriaxone; Azithromycin; Department of Medicine, Qazi Hussain Ahmed Medical Complex Nowshera, Pakistan.
Abstract
Background: Enteric fever is one of the key health problems facing Pakistan, and the increasing antimicrobial resistance has diminished the efficacy of some of the widely used antibiotic drugs. Empirical therapy and antibiotic stewardship are required to be guided by local, culture-based antibiograms.
Objective: To learn the sensitivity pattern of the antibiotic Salmonella Typhi and Salmonella Paratyphi to positive blood cultures of enteric fever patients in Department of Medicine, Qazi Hussain Ahmed Medical Complex Nowshera.
Methods: The study was a descriptive cross-sectional study in the Department of Medicine, Qazi Hussain Ahmed Medical Complex Nowshera, between May, 2025 and October, 2025. Standard microbiological procedures were applied to blood cultures of clinically suspected cases of enteric fevers. Biochemical tests and serotyping were used to identify isolates as S. Typhi or S. Paratyphi. The Kirby-Bauer disk diffusion test on Mueller-Hinton agar was used to perform the antimicrobial susceptibility test, and the results were interpreted based on CLSI 2025 breakpoints of the antibiotics tested.
Results: Out of 200 cases which had been culture-confirmed, S. Typhi was identified in 152 (76.0%), S. Paratyphi A was identified in 36 (18.0%), and S. Paratyphi B was identified in 12 (6.0%). Ampicillin (61.9% in S. Typhi) and chloramphenicol (57.2%) were seen to be the least susceptible, and ciprofloxacin (50.0% sensitive) was the least susceptible. Now, ceftriaxone (84.2%), cefixime (86.8%), and azithromycin (90.8%) were kept at high sensitivity. Meropenem was still very effective (98.7% sensitive). The same tendencies were observed in the S. Paratyphi isolates.
Conclusion: The first-line agents and fluoroquinolones used in the traditional approach were not very reliable, whereas the third-generation cephalosporins and azithromycin were still effective. Regular updates of institution-specific antibiograms and frequent culture-based recommendations are essential to maximize treatment, as well as prevent the further increase of resistance.
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Dr. AurangZeb
1Medical Officer, Department of Medicine, King Abdullah Teaching Hospital Mansehra
Dr. Abdul Jabbar
Senior Registrar, Department of Medicine, Qazi Hussain Ahmed Medical Complex Nowshera
Dr. Atta Ur Rehman
Public Health Coordinator, District Health Officer Office, Kohistan Lower, Khyber Pakhtunkhwa
Health Department Khyber Pakhtunkhwa, District Health Officer Office Kohistan Lower, Khyber Pakhtunkhwa
Dr Abdul Waris Khan
Medical Specialist/Consultant Physician and Rheumatologist, Senior Registrar, Department of Medicine, Khalifa Gulnawaz Teaching Hospital Bannu, Khyber Pakhtunkhwa
