Antimicrobial Sensitivity Trend in Blood Culture Positive Enteric Fever

  • Rajesh Dhoj Joshi Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal
  • Sachin Khadka Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal
  • Deepak Man Joshi Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal
  • Basudha Shrestha Department of Microbiology, Kathmandu Model Hospital, Kathmandu, Nepal
  • Ganesh Dangal Department of Obstetrics and Gynecology, Kathmandu Model Hospital, Kathmandu, Nepal
  • Kiran Prasad Acharya Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal
  • Sanjit Shrestha Department of Microbiology, Kathmandu Model Hospital, Kathmandu, Nepal
  • Yashad Dongol Department of Biochemistry, KIST Medical College, Lalitpur, Nepal

Abstract

Background: 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.
Methods: 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.
Results: 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.
Conclusions: 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.
Keywords: Cephalosporin; enteric fever; sensitivity.

Author Biography

Rajesh Dhoj Joshi, Department of Medicine, Kathmandu Model Hospital, Kathmandu, Nepal

MBBS,MD,Chief  Department of Medicine , kathmandu Model Hospital

Published
2018-07-03
How to Cite
JOSHI, Rajesh Dhoj et al. Antimicrobial Sensitivity Trend in Blood Culture Positive Enteric Fever. Journal of Nepal Health Research Council, [S.l.], v. 16, n. 2, p. 228-232, july 2018. ISSN 1999-6217. Available at: <http://jnhrc.com.np/index.php/jnhrc/article/view/1377>. Date accessed: 17 aug. 2018.