TMSS Medical College Journal

Enteric fever is a systemic infection that evolved about 50,000 years ago. The organism classically responsible for the enteric fever syndrome is S. Typhi & S. paratyphi. Treatment of typhoid fever has been complicated by the development and rapid dissemination of typhoidal organisms resistant to ampicillin , cotrimoxazole , and chloramphenicol. In recent years, development of creeping resistance to fluoroquinolones has resulted in more challenges. Multidrug-resistant (MDR) strains have caused numerous outbreaks in the Indian subcontinent, Southeast Asia, Mexico, the Arabian Gulf, and Africa. Antimicrobial sensitivity of salmonella varies among different places & countries. So it is very important to know the local Antimicrobial sensitivity & resistance patterns for a appropriate treatment of enteric fever as like all other infectious disease. So the present study was designed to analyze the antibiotic sensitivity pattern in the cases of culture positive enteric fever in Bogra, Bangladesh. A total of 36 cases of blood culture proved enteric fever were studied for antibiotic sensitivity pattern. The study was conducted over a period of 6 months. Total of 36 culture positive cases of enteric fever were included in the study. The sensitivity pattern of isolates from blood culture was recorded. Out of 36 cases, 21 (58.3%) were males and 15 (41.7%) were females. Average age of presentation was 26.17 years. Out of 36 Salmonella strains isolated, S. Typhi was found in 25% cases & S. Paratyphi A was found in 75% cases. All S typhi isolates were sensitive in vitro to ciprofloxacin, Levofloxacin, ceftriaxone, Ceftazidime & Meropenem (100%) while sensitivity to Amikacin, Nitrofurantoin & Cefepime was 67%. Cotrimoxazole, Cefixime, Chloramphenicol, Amoxicillin, Azithromycin is sensitive in only 33%. AIL'S paratyphi isolates were sensitive in vitro to ciprofloxacin, Levofloxacin, cefiriaxone, Cotrimoxazole, Azithromycin, Amikacin & Gentamicin,

Enteric fever is a systemic infection that evolved about 50,000 years ago’. The organism classically responsible for the enteric fever syndrome is S. enterica serotype Typhi (formerly S. typhi). Other Salmonella serotypes, particularly S. enterica serotype paratyphi A, B, or C, can cause a similar syndrome; however, it is usually not clinically useful or possible to reliably predict the causative organism based on clinical findings’. The term “enteric fever” is a collective term that refers to both typhoid and paratyphoid fever. It occurs in all parts of the world where there is substandard water supply and sanitation’. Typhoid fever is more common in children and young adults than in older patients’. The disease remains a serious public-health problem in the developing countries’. The advent of chloramphenicol treatment changed the perception of typhoid fever from a severe to a readily manageable infection’. Outbreaks of chloramphenicol-resistant typhoid was reported in 1972. In the late 1980s and 1990s, outbreaks of typhoid caused by organisms resistant to chloramphenicol, cotrimoxazole, ampicillin and amoxicillin were reported’. Currently, decreased susceptibility has also been reported to fluoroquinolones and third-generation  cephalosporins™!®. With this background in mind, it becomes imperative to assess the extent of drug resistance before treatment is administered. Therefore, this study aimed to study the antibiotic sensitivity pattern among typhoid fever cases in a tertiary care setting, which most often caters to referred cases unsuccessfully treated elsewhere.