ANTIBIOTIC SUSCEPTIBILITY PATTERN OF SALMONELLA TYPHI AND SALMONELLA PARATYPHI AT A TERTIARY CARE HOSPITAL IN PESHAWAR

Background: Salmonella typhi and Salmonella paratyphi are leading causes of enteric fever in endemic regions. The emergence of multidrug-resistant (MDR) and extensively drug-resistant (XDR) strains has limited therapeutic options, making surveillance of local resistance patterns crucial for guiding empirical therapy. Objective: To determine the antibiotic susceptibility pattern of Salmonella typhi and Salmonella paratyphi at a tertiary care hospital in Peshawar. Study Design: Cross-sectional study. Setting: Department of Microbiology, Rehman Medical Institute, Peshawar. Duration of Study: 24-November-2024 to 24-May 2025. Methods: A total of 139 patients with culture-proven Salmonella typhi or Salmonella paratyphi infection were included. Antibiotic susceptibility was assessed using the standard Kirby-Bauer disk diffusion method. MDR and XDR strains were identified according to established definitions. Potential confounders stratified frequencies, and post-stratification comparisons were performed using the Chi-square test. Results: The mean age of patients was 35.27 ± 9.90 years, with 98 (70.5%) males and 41 (29.5%) females. The mean BMI was 17.80 ± 1.89 kg/m², and the mean duration of fever was 5.16 ± 1.92 days. Of the isolates, 97 (69.8%) were S. typhi and 42 (30.2%) were S. paratyphi. MDR strains were identified in 25 (18.0%) cases and XDR strains in 61 (43.9%). The highest sensitivity was observed with meropenem (80.4%) and azithromycin (71.1%). Conclusion: Antibiotic resistance among Salmonella isolates was highly prevalent, with MDR and XDR strains observed in 18% and 43.9% of cases, respectively. Meropenem and azithromycin remain the most effective treatment options in this setting, emphasising the urgent need for antimicrobial stewardship and continuous resistance surveillance.