Joshi Rajesh Dhoj, Khadka Sachin, Joshi Deepak Man, Shrestha Basudha, Dangal Ganesh, Acharya Kiran Prasad, Shrestha Sanjit, Dongol Yashad
Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal.
Department of Microbiology, Kathmandu Model Hospital, Kathmandu, Nepal.
J Nepal Health Res Counc. 2018 Jul 3;16(2):228-232.
For diagnosis of enteric fever, the culture of the organism from different body fluids is the gold standard. After diagnosis, it is important to treat with the right antibiotic before any complications can occur. The retrospective study is designed to explore the antibiotic sensitivity trend in blood culture positive typhoid fever cases and the extent of drug resistance before treatment is administered.
A retrospective study was carried out for culture isolated enteric fever patients admitted in Kathmandu Model Hospital. The discharged records from January 2012 to December 2016 were analyzed. The patients above 15 years and with culture isolated enteric fever were included in the study.
One hundred fifty-nine strains of Salmonella typhi and paratyphi were isolated from Jan 2012 to Dec 2016 at Kathmandu Model Hospital. Out of 159 isolated, 125 (78.6%) were Salmonella typhi and 34 (21.4%) were paratyphi. Among them co-trimoxazole, chloramphenicol, ceftriaxone, cefotaxime, cefixime, and ofloxacin demonstrated 100% sensitivity. Similarly, amoxicillin sensitivity was 98.1% (n=156) while ciprofloxacin was sensitive in 6.3% (n=10), intermediately sensitive in 49.1% (n=78) and resistance in 44.7% (n=71).The newer quinolone levofloxacin showed 78.5% (n=11) sensitivity. Azithromycin was sensitive in 99.2% (n=132) of total isolated Salmonella species both typhi and paratyphi.
A high degree of sensitivity was noted to chloramphenicol and co-trimoxazole, showing sensitivity has returned to conventional antibiotics. The drug-like ofloxacin is still the best responding drug in our contest whereas ciprofloxacin resistance is still high, but five years patterns show a trend of rollback of sensitivity.
对于肠热病的诊断，从不同体液中培养出病原体是金标准。确诊后，在任何并发症发生之前用正确的抗生素进行治疗很重要。这项回顾性研究旨在探讨血培养阳性伤寒热病例的抗生素敏感性趋势以及治疗前的耐药程度。
对加德满都模范医院收治的培养分离出的肠热病患者进行回顾性研究。分析了2012年1月至2016年12月的出院记录。纳入研究的患者年龄在15岁以上且培养分离出肠热病。
2012年1月至2016年期间，加德满都模范医院共分离出159株伤寒沙门氏菌和副伤寒沙门氏菌。在这159株分离菌中，125株（78.6%）为伤寒沙门氏菌，34株（21.4%）为副伤寒沙门氏菌。其中，复方新诺明、氯霉素、头孢曲松、头孢噻肟、头孢克肟和氧氟沙星显示出100%的敏感性。同样，阿莫西林的敏感性为98.1%（n = 156），而环丙沙星的敏感性为6.3%（n = 10），中度敏感性为49.1%（n = 78），耐药性为44.7%（n = 71）。新型喹诺酮类药物左氧氟沙星的敏感性为78.5%（n = 11）。阿奇霉素对所有分离出的伤寒沙门氏菌和副伤寒沙门氏菌的敏感性为99.2%（n = 132）。
氯霉素和复方新诺明显示出高度敏感性，表明敏感性已恢复到传统抗生素。在我们的研究中，像氧氟沙星这样的药物仍然是反应最好的药物，而环丙沙星的耐药性仍然很高，但五年的模式显示出敏感性回升的趋势。
