Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan

  • Muhammad Saeed Department of Microbiology, Government College University Faisalabad, Pakistan
  • Muhammad Hidayat Rasool Department of Microbiology, Government College University Faisalabad, Pakistan
  • Farhan Rasheed Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan
  • Muhammad Saqalein Department of Microbiology, Government College University Faisalabad, Pakistan
  • Muhammad Atif Nisar Department of Microbiology, Government College University Faisalabad, Pakistan
  • Ambreen Anwar Imran Department of Pathology, Allama Iqbal Medical College, Lahore, Pakistan
  • Saba Tariq Centre for Applied Molecular Biology, University of the Punjab, Lahore, Pakistan
  • Afreenish Amir National Institute of Health, Islamabad, Pakistan
  • Aamer Ikram National Institute of Health, Islamabad, Pakistan
  • Mohsin Khurshid Department of Microbiology, Government College University Faisalabad, Pakistan
Keywords: Salmonella, cephalosporins, ESBL, Typhoid

Abstract

Introduction: The multidrug-resistant (MDR) Salmonella enterica serovar Typhi isolates have been increasingly reported from the Asian and African countries. The emergence of isolates with decreased susceptibility to fluoroquinolones and cephalosporins has worsened the situation. Recently, an outbreak from Sindh, Pakistan was reported caused by extensively drug-resistant (XDR) S. Typhi strains.

Methodology: In the present study, a total of 82 cases of typhoid have been investigated during 2018 from the febrile children referred to a tertiary care hospital in the population-wise largest province (Punjab) of Pakistan. S. Typhi was identified by standard microbiological techniques and isolates were characterized for antimicrobial resistance profiling and minimum inhibitory concentrations were determined. The presence of various ESBL genes in S. Typhi was confirmed by the PCR.

Results: Out of the 82 isolates tested, 35 (43%) were found to be XDR; resistant to the first-line drugs. The resistance to third-generation cephalosporins was mainly mediated by extended-spectrum beta-lactamases i.e. blaTEM and blaCTX-M genes.

Conclusions: The higher prevalence of ESBL producing Salmonella typhi clinical strains raises the concern about transmission prevention and infection management in the community as well as clinical settings. Moreover, the study highlights the problem concerning the declining antibiotic arsenal for the therapeutic management of typhoid fever and the emergence and spread of XDR strains in Pakistan.

Author Biography

Mohsin Khurshid, Department of Microbiology, Government College University Faisalabad, Pakistan

Assistant Professor, Department of Microbiology, Government College University, Faisalabad, Pakistan

Published
2020-02-29
How to Cite
1.
Saeed M, Rasool MH, Rasheed F, Saqalein M, Nisar MA, Imran AA, Tariq S, Amir A, Ikram A, Khurshid M (2020) Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan. J Infect Dev Ctries 14:169-176. doi: 10.3855/jidc.12049
Section
Original Articles