Khattak Zainab, Aala Roohul, Sani Nimra, Khan Sher A, Khan Sana, Shah Syed A, Ansar Rubina, Riaz Mohsin, Ahmed Hasnat
Gajju Khan Medical College, Swabi, Pakistan.
Lab Line Diagnostic and Research Center, Mardan, Pakistan.
J Infect Dev Ctries. 2025 Jun 30;19(6):904-912. doi: 10.3855/jidc.20373.
Typhoid fever, caused by Salmonella Typhi, is a serious health problem, especially in developing countries like Pakistan where antibiotics are usually prescribed without susceptibility testing or epidemiological surveillance. Consequently, antibiotic-resistant typhoid bacteria appear, but are not reported to the authorities. There is limited research on the prevalence and antibiotic susceptibility patterns of S. Typhi among febrile patients in Swabi, Pakistan. This study aimed to address this gap at the Bacha Khan Medical Complex in Swabi.
Laboratory records of hospitalized patients who received a blood culture from September 2022 to August 2023 were reviewed in this retrospective, cross-sectional study. Every isolate of S. Typhi underwent antibiotic susceptibility test using modified Kirby-Bauer disk diffusion and agar-dilution methods to measure the isolates' minimum inhibitory concentration (MIC) for ciprofloxacin and azithromycin. The data were analyzed using SPSS version 24.0.
4.85% of febrile patients were positive for S. Typhi, with a higher prevalence in the 0-14 years age group. Male gender and seasonal variation were significant factors. The isolates were resistant to ampicillin, amoxicillin, cefotaxime, and ciprofloxacin; and sensitive to azithromycin, and carbapenems. The MICs for ciprofloxacin were between 0.06 to 16 µg/mL. Among the isolates, 1.094% were sensitive and 98.90% were resistant to ciprofloxacin; and 100% isolates were susceptible to azithromycin.
Azithromycin and carbapenem were a suitable empirical therapy choice. However, the isolates were highly resistant to conventional first-line antibiotics (ampicillin, amoxicillin), second generation fluoroquinolones (ciprofloxacin), and third-generation cephalosporins (ceftriaxone, cefotaxime), that are considered vital in typhoid treatment.
伤寒热由伤寒沙门氏菌引起，是一个严重的健康问题，尤其在巴基斯坦等发展中国家，抗生素通常在未进行药敏试验或流行病学监测的情况下就被开具。因此，出现了耐抗生素的伤寒细菌，但未向当局报告。关于巴基斯坦斯瓦比发热患者中伤寒沙门氏菌的流行情况和抗生素敏感性模式的研究有限。本研究旨在填补斯瓦比巴查汗医疗中心的这一空白。
在这项回顾性横断面研究中，对2022年9月至2023年8月期间接受血培养的住院患者的实验室记录进行了审查。每株伤寒沙门氏菌都使用改良的 Kirby-Bauer 纸片扩散法和琼脂稀释法进行抗生素敏感性试验，以测量分离株对环丙沙星和阿奇霉素的最低抑菌浓度（MIC）。使用SPSS 24.0版对数据进行分析。
4.85%的发热患者伤寒沙门氏菌呈阳性，在0至14岁年龄组中患病率更高。男性性别和季节变化是重要因素。分离株对氨苄西林、阿莫西林、头孢噻肟和环丙沙星耐药；对阿奇霉素和碳青霉烯类敏感。环丙沙星的MIC在0.06至16μg/mL之间。在分离株中，1.094%对环丙沙星敏感，98.90%耐药；100%的分离株对阿奇霉素敏感。
阿奇霉素和碳青霉烯类是合适的经验性治疗选择。然而，分离株对传统一线抗生素（氨苄西林、阿莫西林）、第二代氟喹诺酮类（环丙沙星）和第三代头孢菌素（头孢曲松、头孢噻肟）高度耐药，而这些抗生素在伤寒治疗中被认为至关重要。
