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Category: Volume 07 Issue 01 January 2019
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Title: Recent trends of drug susceptibility of salmonella isolates in tertiary health care hospital at Patna Bihar

Authors: Chandan Kumar, Sunil Kumar, H.L. Mahto

 DOI: https://dx.doi.org/10.18535/jmscr/v7i1.167

Abstract

Introduction: Typhoid or enteric fever is a major health problem in India. It is caused by Salmonella entreica var typhi and it is endemic in India. Its transmission occurs through feco-oral rout; poor hygiene and bad sanitation are main cause of its occurrence. Antibiotics resistance and development of MDR S.typhi is a big problem in treatment of typhoid. Chloramphenicol, Fluoroquinlones, Azithromycin and Cephalosporins are the major antibiotics for the treatment of enteric fever. Therefore this study is performed to determine the recent trend of antibiotics susceptibility among Salmonella typhi isolates in tertiary health care hospital in Patna, Bihar.

Material and Methods: present study is done in the department of Microbiology, Paediatrics, and Medicine at NMCH, Patna. Total 3940 provisionally diagnosed cases of typhoid or enteric fever is included in this study. Venous blood samples were used for the blood culture and blood culture is done on Brain-Heart infusion broth. Further subculture is done on Blood agar, MacConkey agar, and S-S agar media. Antibiotic sensitivity is done through Kirby-Bauer disc diffusion method. Antibiotic discs used are ampicillin, ciprofloxacin, oflaxacin, nalidixic acid, ceftriaxone, imipenem, meropenem etc supplied by Hi-media laboratory, Mumbai.

Results: Total no. of 3940 blood samples were collected for blood cultures. From these 228 salmonella isolates were isolated. Out of these 206 (90.3%) were S. typhi, 21 (9.21%) isolates were S.paratyphi A and 1 isolates (0.44%) was S.paratyphi B. Antibiotic susceptibility testing is done for ampicillin, cotrimoxazole, chloramphenicol, ciprofloxacin, ceftriaxone, amikacin, cefixime, meropenem, imipenem, aztreonam etc. Among these antibiotics maximum isolates (188) were resistant against ampicillin and cotrimoxazole and sensitive against azithromycin, meropenem and aztreonam.

Discussion: Enteric fever is endemic disease in India. Its incidence and prevalence is high in India due to poor sanitation and unhygienic food and water condition. Among infected persons males were more affected than females. Male female ratio was 1.7:1. Children were more affected than adults; this is due to unhygienic food habit of children and more exposure of males to the external environment than females. Antibiotic resistance and development of MDR Salmonella enterica is the major problem in the treatment of enteric fever. However some antibiotics like ceftriaxone, cefixime, azithromycin, meropenem, imipenem, aztreonam and some fluoroquinolones have good sensitivity against Salmonella species and are the drug of choice now a days.

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Corresponding Author

Sunil Kumar

Tutor, Department of Microbiology, Nalanda Medical College, Kankarbagh main Road, near Bhutnath Road,  Patna-800026, India

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