Multicentric Evaluation of Antimicrobial Sensitivity Profile of Typhoidal Salmonella

Abstract Introduction: In India, typhoid or enteric fever caused by Salmonella enterica serovar Typhi and Paratyphi (A, B, and C) is a major public health problem. The causative agents are spread by contaminated food and water. Over the past few years, a steady rise in the number of cases of enteric fever has been observed, making India, a country with the highest burden, globally. An early and accurate diagnosis of enteric fever is essential to differentiate it from other causes of tropical fever. Surveillance of antimicrobial resistance in typhoidal salmonella is also a priority. Thus, the primary aim of this study is to ascertain antimicrobial-resistant profile of typhoidal Salmonella isolated at tertiary care hospital of western India over the past 1 year. Materials and Methods: This cross-sectional study was conducted at two tertiary care teaching hospitals of Delhi Cantonment region (Hospital A, the primary study center and Hospital B, the secondary study center) following approval from the Institutional Ethics Committee. Microbiological culture and antibiotic sensitivity testing data, specific to Salmonella isolates, were retrieved for the blood culture samples submitted between June 2023 and May 2024 from individuals presenting with undiagnosed fever. The corresponding hematological and biochemical profile of patients with blood culture-confirmed diagnosis of enteric fever was retrieved and tabulated. Results: Overall, 108 and 91 Salmonella isolates were recovered from hospital A and B, respectively, during the study period. The ratio of Salmonella Typhi and Salmonella Paratyphi A isolation rate was 3:1. Sensitivity to cotrimoxazole, amoxycillin-clavulanic acid, third/fourth generation cephalosporins, azithromycin, and carbapenem was fairly preserved (range; 93%–100%). The data showed 74% and 89% of all Salmonella isolates from hospital A and B, respectively, were resistant to quinolones. Conclusion: The study indicated preserved sensitivity to macrolides, cotrimoxazole, amoxycillin-clavulanic acid, third and fourth-generation cephalosporins in S . Typhi and S . Paratyphi A. Anti-typhoid vaccination drive, improvement in sanitation practices and provision of safe water is essential to halt the spread of enteric fever in community.