Reemergence of Chloramphenicol Sensitivity among Salmonella entericaserovarsTyphi and Paratyphi

Reemergence of Chloramphenicol Sensitivity among Salmonella enterica serovars Typhi and Paratyphi : a six year experience in a tertiary care hospital in Nepal.

Rajani Shrestha, Niranjan Nayak, Dharma Raj Bhatta, Deependra Hamal, Supram Hosuru Subramanya, Shishir Gokhale

Department of Microbiology, Manipal College of Medical Sciences, Pokhara, Nepal

Abstract

Background: Emerging drug resistance among Salmonella Typhi and Paratyphi has become challenging in the treatment of enteric fever. The objective of this study was to determine the antibiotic susceptibility pattern of Salmonella serotypes isolated from patients with enteric fever admitted to Manipal Teaching Hospital, Pokhara.

Methods: A total of 30 Salmonella enterica serovar Typhi, Paratyphi A, and Paratyphi B isolated from cases of typhoid and paratyphoid fever admitted to Manipal Teaching Hospital over a period from January 2012 to March 2018 were investigated. All strains were identified by standard microbiological method and tested for in vitro antibiotics susceptibility by the Kirby-Bauer disc diffusion method following the criteria designed by the Clinical and Laboratory Standards Institute (CLSI 2013).

Results: S Typhi was the most predominant amongst all the isolates (18 of 30 i.e.60%), followed by S Paratyphi A (33.3%, 10 out of 30) and S Paratyphi B (6.6%; 2 out of 30).  Overall, 91.3% of the isolates were susceptible to chloramphenicol. The percentage sensitivity towards ceftriaxone, ciprofloxacin, cotrimoxazole and ampicillin was 82.6%, 75.8%, 63% and 37% respectively. All the isolates were sensitive to imipenem and amikacin. 

Conclusion: These findings suggested that there were changing patterns of antibiotic resistance in enteric fever with reemergence of chloramphenicol sensitivity. This necessitates continuous surveillance of cases and re-evaluation of chloramphenicol therapy in Salmonella infections in Nepal.

Keywords: Enteric fever; Salmonella; Chloramphenicol; Re-emergence of chloramphenicol sensitivity.

Author(s): Rajani Shrestha

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