EMERGENCE OF EXTENSIVE DRUG RESISTANCE TYPHOID IN HOSPITALIZED COVID-19 PATIENTS IN SOUTH PUNJAB, PAKISTAN
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Keywords
XDR, COVID-19, typhoid, Salmonella typhi, S. Typhi, MDR
Abstract
Introduction: In Pakistan, one of the main causes of mortality and morbidity is typhoid fever. Notably, extended drug-resistant (XDR) typhoid has been misdiagnosed widely due to many physicians continued use of Widal and Typhi-dot as serological tests for diagnosis during the COVID-19 pandemic. There were increased cases of extensively drug-resistant typhoid due to the use of extended drugs during the COVID-19 pandemic without confirming the antimicrobial susceptibility of Salmonella typhi.
Methodology: In this study, 118 patient blood samples after the COVID-19 pandemic was analyzed by automated blood culture through BacT/ALERT 3D, and antimicrobials susceptibility was performed. And compared with the antimicrobial susceptibility before the COVID-19 pandemic samples of the same patients.
Results: Out of 118 blood cultures of Post-COVID-19 isolates, 34 cultures were positive for Salmonella typhi. On antibiotic susceptibility test profiling of these 34 isolates, 44.12% were extensive drug-resistant (XDR), 38.24% were multidrug-resistant (MDR), 8.82% were non-MDR, non-XDR and 8.82% were resistant to all antibiotics. While in Pre-COVID-19 isolates 21.74% were XDR, 60.87% were MDR, 17.39% were non-MDR, non-XDR and 0.0% were resistant to all antibiotics. There were an increased XDR typhoid ratio as compared to MDR typhoid in Post-COVID-19 isolates.
Conclusions: There is an increased emergence of XDR typhoid cases in Post-COVID-19 isolates of Salmonella typhi as compared to the Pre-COVID-19 Salmonella typhi isolates. Moreover, implementing antimicrobial susceptibility profiling and proper diagnosis before using any antibiotic against Salmonella typhi prevent the XDR typhoid outbreak in the near future.
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Safdar Ali
Department of Microbiology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
Muhammad Moazam Jalees
Assistant Professor, Department of Microbiology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
Waqas Ashraf
Assistant Professor, Department of Microbiology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
Maimona Sadia
Department of Microbiology, Government College University Faisalabad, Pakistan
Rafia Anwar
Department of Microbiology, Government College University Faisalabad, Pakistan
Saleha Zafar
Consultant Pathologist, Department of Pathology, Quaid-e-Azam Medical College, Bahawalpur, Pakistan
Muhammad Tariq Mahmood
Assistant Professor, Department of Zoology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
Muhammad Rizwan
Department of Microbiology, Cholistan University of Veterinary and Animal Sciences, Bahawalpur, Pakistan
Abdul Mannan
The Aga Khan University Hospital and Medical College Foundation, Pakistan