Department of Microbiology, KIST Medical College and Teaching Hospital, Lalitpur, Nepal.
JNMA J Nepal Med Assoc. 2021 Mar 31;59(235):256-262. doi: 10.31729/jnma.5748.
Typhoid fever and paratyphoid fever commonly called as enteric fever is a life-threatening illness caused by Salmonella serotype Typhi and Salmonella serotype Paratyphi, respectively. It is a major public health issue in underdeveloped and developing countries. The aim of the study is to find out the prevalence of enteric fever pathogens in blood culture of patients attending a tertiary care centre.
A descriptive cross-sectional study was conducted in 3483 blood samples of patients attending a tertiary care centre, with the history and symptoms suspicious of enteric fever during one year period from mid-September 2019 to mid-September 2020 after ethical approval from the institutional review committee. Isolates were identified by standard microbiological methods and tested for in vitro antibiotic susceptibility by modified kirby-bauer disc diffusion method. The obtained data was entered and analyzed in WHONET 5.6 program, point estimate at 95% was calculated along with frequency and proportion for binary data.
In our study, enteric fever pathogens were isolated from 18 (0.51%) blood samples. Out of which, Salmonella Paratyphi A was isolated from 10 (8.19%) and Salmonella Typhi was isolated from 8 (6.55%) blood samples. Other serotypes were not isolated. Antimicrobial susceptibility test showed that salmonella species that was isolated were sensitive to most of the drugs.
Prevalence of enteric fever pathogens was lesser compared to other studies. Varying degrees of antibiotic resistance among isolated enteric fever pathogens necessitates continuous surveillance of the susceptibility patterns. Prudent use of antimicrobials, active infection control practices and stringent antibiotic policy should be implemented to prevent emergence of antibiotic resistance and future outbreaks.
伤寒和副伤寒通常被称为肠热病，是由伤寒沙门氏菌和副伤寒沙门氏菌分别引起的危及生命的疾病。它是不发达和发展中国家的一个主要公共卫生问题。本研究的目的是确定在一家三级保健中心就诊的患者的血培养中肠热病病原体的流行情况。
在经过机构审查委员会的伦理批准后，对 2019 年 9 月中旬至 2020 年 9 月中旬期间，一家三级保健中心的 3483 名有肠热病病史和症状可疑的患者的 3483 份血液样本进行了一项描述性的横断面研究。通过标准的微生物学方法鉴定分离株，并采用改良的 kirby-bauer 碟扩散法对体外抗生素敏感性进行测试。将获得的数据输入到 WHONET 5.6 程序中进行分析，计算 95%点估计值，以及二元数据的频率和比例。
在我们的研究中，从 18 份（0.51%）血液样本中分离出肠热病病原体。其中，从 10 份（8.19%）和 8 份（6.55%）血液样本中分离出甲型副伤寒沙门氏菌和伤寒沙门氏菌。未分离出其他血清型。药敏试验表明，分离出的沙门氏菌对大多数药物敏感。
肠热病病原体的流行率低于其他研究。分离出的肠热病病原体存在不同程度的抗生素耐药性，需要持续监测药敏模式。应实施谨慎使用抗生素、积极的感染控制措施和严格的抗生素政策，以防止抗生素耐药性的出现和未来的爆发。
