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

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 outbre...

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Main Authors: Muhammad Saeed, Muhammad Hidayat Rasool, Farhan Rasheed, Muhammad Saqalein, Muhammad Atif Nisar, Ambreen Anwar Imran, Saba Tariq, Afreenish Amir, Aamer Ikram, Mohsin Khurshid
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2020-02-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/12049
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author Muhammad Saeed
Muhammad Hidayat Rasool
Farhan Rasheed
Muhammad Saqalein
Muhammad Atif Nisar
Ambreen Anwar Imran
Saba Tariq
Afreenish Amir
Aamer Ikram
Mohsin Khurshid
author_facet Muhammad Saeed
Muhammad Hidayat Rasool
Farhan Rasheed
Muhammad Saqalein
Muhammad Atif Nisar
Ambreen Anwar Imran
Saba Tariq
Afreenish Amir
Aamer Ikram
Mohsin Khurshid
author_sort Muhammad Saeed
collection DOAJ
description 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.
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institution Kabale University
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language English
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publisher The Journal of Infection in Developing Countries
record_format Article
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spelling doaj-art-9acd113016464374b7d59e52c63e9d442025-08-20T03:52:39ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802020-02-01140210.3855/jidc.12049Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, PakistanMuhammad Saeed0Muhammad Hidayat Rasool1Farhan Rasheed2Muhammad Saqalein3Muhammad Atif Nisar4Ambreen Anwar Imran5Saba Tariq6Afreenish Amir7Aamer Ikram8Mohsin Khurshid9Department of Microbiology, Government College University Faisalabad, PakistanDepartment of Microbiology, Government College University Faisalabad, PakistanDepartment of Pathology, Allama Iqbal Medical College, Lahore, PakistanDepartment of Microbiology, Government College University Faisalabad, PakistanDepartment of Microbiology, Government College University Faisalabad, PakistanDepartment of Pathology, Allama Iqbal Medical College, Lahore, PakistanCentre for Applied Molecular Biology, University of the Punjab, Lahore, PakistanNational Institute of Health, Islamabad, PakistanNational Institute of Health, Islamabad, PakistanDepartment of Microbiology, Government College University Faisalabad, Pakistan 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. https://jidc.org/index.php/journal/article/view/12049SalmonellacephalosporinsESBLTyphoid
spellingShingle Muhammad Saeed
Muhammad Hidayat Rasool
Farhan Rasheed
Muhammad Saqalein
Muhammad Atif Nisar
Ambreen Anwar Imran
Saba Tariq
Afreenish Amir
Aamer Ikram
Mohsin Khurshid
Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
Journal of Infection in Developing Countries
Salmonella
cephalosporins
ESBL
Typhoid
title Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
title_full Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
title_fullStr Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
title_full_unstemmed Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
title_short Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan
title_sort extended spectrum beta lactamases producing extensively drug resistant salmonella typhi in punjab pakistan
topic Salmonella
cephalosporins
ESBL
Typhoid
url https://jidc.org/index.php/journal/article/view/12049
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