Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India – a Seven Year Ambispective Study

Makkar, Anuradha; Gupta, Shilpi; Khan, Inam Danish; Gupta, Rajiv Mohan; Rajmohan, KS; Chopra, Harleen; Gupta, Manisha; Bansal, Sachin; Poonia, Bindu; Malik, Muqtadir; Panda, Pragyan Swagatika

doi:10.14712/18059694.2018.130

Acta Medica > Archive > 2018, Vol. 61 > Issue 4 > Epidemiological Profile and…

Acta Med. 2018, 61: 125-130

https://doi.org/10.14712/18059694.2018.130

Epidemiological Profile and Antimicrobial Resistance Pattern of Enteric Fever in a Tertiary Care Hospital of North India – a Seven Year Ambispective Study

Anuradha Makkar^a, Shilpi Gupta^b, Inam Danish Khan^a, Rajiv Mohan Gupta^c, KS Rajmohan^a, Harleen Chopra^a, Manisha Gupta^d, Sachin Bansal^e, Bindu Poonia^a, Muqtadir Malik^c, Pragyan Swagatika Panda^a

^aArmy College of Medical Sciences and Base Hospital, New Delhi, India
^bDepartment of Microbiology, MH Bhopal, India
^cArmy Hospital Research and Referral, New Delhi 110010, India
^dSanjay Gandhi Post-Graduate Institute, Lucknow, India
^eDr Lal Path Labs, Tilak nagar, New Delhi, India

Received August 9, 2018
Accepted November 14, 2018

Introduction: Enteric-fever is a major public-health problem in developing countries emerging as multidrug-resistant, Nalidixic-acid resistant and extremely drug-resistant Salmonella (Pakistan, 2016), has intensified the use of WHO watch/reserve group antimicrobials such as azithromycin and meropenem. Methods: This ambispective-study was conducted on 782 non-repeat blood-culture isolates of S. Typhi, S. Paratyphi A and S. Paratyphi B obtained from 29,184 blood cultures received at a 1000-bedded tertiary-care hospital of North-India from 2011–2017. Identification and antibiograms were obtained by Vitek-2 compact and Kirby-Bauer’s disc diffusion with resistance to ampicillin, chloramphenicol and cotrimoxazole being labeled as multidrug-resistant. Decreased ciprofloxacin-susceptibility and ciprofloxacin-resistance were defined as MIC 0.125–0.5 and >1 μg/ml. Results: S. Typhi and S. Paratyphi A in a ratio of 3.9:1 were seen between July–September predominantly distributed between 6–45 year age group. Resistance to co-trimoxazole, chloramphenicol, ceftriaxone and azithromycin was 6.1%, 13.8%, 16.1 and 5.78% respectively. Multidrug-resistant S. typhi and S. paratyphi A were 2.73% and 1.91% respectively. Conclusion: Enteric-fever is a major public-health problem in India. Emergence of multidrug-resistant, Nalidixic-acid resistant and extremely-drug resistant Salmonella mandates ongoing surveillance for targeted empirical therapy and containment of spread. Repeated epidemics call for water, sanitation, hygiene and vaccination strategies to sustain herd-immunity.