Antimicrobial Sensitivity Pattern of Salmonella Enterica Serovar Typhi and Paratyphi a Isolated from Blood Culture in a Tertiary Care Hospital, Bettiah, Bihar, India


Awadhesh Kumar Jha, Kali Charan Rajak, Imtiaz Ahmad, Shuvendu Das Gupta, Chandan Kumar Poddar, Ramannand Kumar Pappu, Maheshwar Narayan Singh, S. K. Shah

BACKGROUND Typhoid fever continues to remain a major public health problem, especially in Bihar, due to poor sanitation and personal hygiene. Typhoid fever continues to remain a health problem as the causative organism Salmonella Typhi has developed resistance to many of the antibiotics used. This study was done to evaluate status in antimicrobial susceptibility patterns of Salmonella enterica serovar Typhi (S. Typhi) and S. Paratyphi obtained from blood culture in a tertiary care hospital in Bettiah, Bihar, India. METHODS Blood samples were obtained from patients, suspected with enteric fever. Blood isolates of Salmonella species over a one year period between July 2018 and August 2019 were studied. 120 strains of S. Typhi were isolated. Sensitivity to ampicillin, chloramphenicol, gentamicin, ciprofloxacin and ceftriaxone were tested for antimicrobial susceptibility by Kirby-Bauer disc diffusion method. RESULTS Of the total 120 isolates studied, 68 (56.67%) were S. Typhi and 52 (43.33%) were S. Paratyphi A. Of these isolates, 104 (86.33%) were sensitive to ciprofloxacin (MIC<0.25 mg/ml), 110 (91.67%) were nalidixic acid resistant. Of the 110 nalidixic acid resistant isolates, 104 (86.33%) were susceptible to ciprofloxacin (MIC <0.25 mg/ml). All 120 isolates were sensitive to co-trimoxazole and ceftriaxone, 104 isolated (86.66%) were sensitive to amoxicillin and 110 (91.67%) were sensitive to chloramphenicol. CONCLUSIONS Nalidixic acid resistance screening is not a consistent surrogate indicator of ciprofloxacin resistance. Ciprofloxacin MIC should to be routinely done. The isolates showed a high degree of susceptibility to ampicillin, co-trimoxazole and chloramphenicol. Thus, antibiotics like amoxicillin, co-trimoxazole, and third generation Cephalosporins (Cefotaxime) may once again be useful for the management of enteric fever in tertiary care hospitals in Bettiah, Bihar, India.