Ayaz Hussain Qureshi, Nuzhat Mushahid, Aamir Ijaz, Afzal Ahmad, Mohammad Ateque, Munawar Hussain Marri, Mohammad Ashraf Qamar, Nadir Ali.
Changing drug susceptibility pattern of Salmonellae Paratyphi A.
J Coll Physicians Surg Pak Jan ;11(7):449-51.

Objective: To know the change in susceptibility pattern of Salmonella paratyphi A, to conventional anti-typhoid drugs, if any, at Quetta, Balochistan. Design: An observational study. Place and Duration of Study: Pathology Laboratory, Combined Military Hospital, Quetta, during the period from April, 1996 to October, 2000. Subjects and Methods: About 161 blood culture strains of Sparatyphi A, were isolated from cases of febrile illness. The blood samples were taken in brain heart infusion (BH) broth in first week of illness and processed. The isolates were identified on morphological, biochemical and serological characteristics. These were subjected to disc diffusion susceptibility tests as per standard methods against chloramphenicol (CAP), ampicillin (AMP), trimethoprim sulphamethoxazole (TMP-SMX), ciprofloxacin (CIP) and ceftriaxone (CRO). Results: Out of 161 strains tested, 66 (40.9%) strains exhibited resistance to CAP, AMP and TMP-SMX, 3 (1.8%) isolates were resistant to CAP and AMP, 2 (1.2% ) strains each to CAP and TMP-SMX as well as AMP and TMPSMX. Single drug resistance was observed in 19 (11.8%) isolates against TMP-SMX, 6 (3.7%) strains revealed resistance to AMP and 2 (1.2% ) to CAP, none of the isolates was resistant to ciprofloxacin and ceftriaxone. However, 40.9% S.paratyphi A in our clinical practice were resistant to three conventional anti-typhoid drugs. Conclusion: There was an overall increased multi-drug resistance in S.paratyphi A` at Quetta from zero % in 1994 to 40.9 % in October, 2000. Three conventional first line drugs i.e., CAP, AMP and TMP-SMX were rather ineffective regimen in about 75 % cases of enteric fever due to S.paratyphi A in year 2000. This quantum of drug resistance against conventional anti-typhoid drugs is leaving us with limited choice of costly drug regimen to treat S.paratyphi A infections at Quetta.

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