Ashfaq Ahmad, Salman Mustaan, Fazal Wahab, Muhammad Ayyaz, Abubakar Sadiq, Sara, Ijaz Hussain.
Pattern of Antibiotic Resistance in Salmonella Typhi Isolates with Special Consideration to Extended Drug Resistant Typhoid.
J Saidu Med Col Jan ;11(2):103-7.

Background: Typhoid or enteric fever is potentially fatal multisystem illness caused by salmonella typhi and Para typhi transmitted through consumption of contaminated food and water. Salmonella behave in a wide spectrum of resistance from Multi Drug Resistant typhoid to now Extended Drug Resistant typhoid. Objective: To analyze the culture, sensitivity and resistance of salmonella typhi in patients with clinical suspicion of typhoid fever. Material and methods: A cross sectional study was performed on 624 clinically suspected cases of typhoid fever admitted to the st th inpatient ward facility of Pediatric unit STH Swat from 1 July 2019 to 30 June 2020. Data was analyzed using SPSS version 22. Results: Out of 624 clinically suspected cases of typhoid fever reported to the Pediatric unit of STH Swat, only 239 cases had a positive blood culture for salmonella typhi during the period of 1 year. Drug resistance pattern of salmonella typhi in our study was ceftriaxone 91.86%, chloramphenicol 83.72% ampicillin 75.58%, co-trimoxazole 72.09%, Quinolones 83.72% , azithromycin 55.81%, Cefoperazone/Sulbactum 77.9%, Piperacillin/Tazobactam 65.11%, and meropenem was low at 4.65% and no resistance was reported to imipenem. rd Conclusion: In the light of our study the highest resistance of salmonella specie and emergence of XDR typhoid to the i.e. 3 generation cephalosporins and Azithromycin, it is necessary to rationalize the use of antibiotics in acute febrile illness and to educate the community for vaccination against salmonella typhi, proper sanitation and use of safe water supply. Blood culture should be the gold standard test for diagnosis of enteric fever in the first week of illness.

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