XDR and MDR S. Typhi: An investigation of prevalence and risk factors | [Rawal Medical Journal • 2025]

Author(s):

1. Om Parkash: Department of Pathology, Chandka Medical College Sindh, Pakistan

2. Umair Farooqi: Institute of Pharmacy, Shaheed Mohtarma Benazir Bhutto Medical University, Pakistan

3. Sham Lal: Institute of Microbiology, Shah Abdul Latif University, Khairpur, Pakistan

4. Dayali Gul: Institute of Microbiology, Shah Abdul Latif University, Khairpur, Pakistan

Abstract:

Objective: To investigate the prevalence, antibiotic susceptibility patterns of multidrug-resistant (MDR) and extensively drug-resistant (XDR) S. Typhi strains and identify risk factors associated with typhoid fever transmission in Khairpur, Sindh, Pakistan. Methodology: This cross-sectional study was conducted from July to December 2019 at Kausar Hospital, Khairpur, Mir's, involving 150 clinical specimens. Initial screening used the Widal test, followed by confirmation through cell culture and biochemical testing. Data for demographic analysis was obtained using a structured questionnaire. Antibiotic susceptibility testing was performed using the Kirby-Bauer disk diffusion method, adhering to CLSI guidelines for accuracy. Results: Preliminary screening using the Widal test identified 85 potential cases, but only 26 were confirmed through cell culture and biochemical testing. The study found that 30.7% of the isolates were MDR, resistant to first-line antibiotics such as ampicillin, chlo-ramphenicol, and co-trimoxazole, while 7.7% were XDR, additionally resistant to fluoroquinolones and thi-rd generation cephalosporins. All isolates were sensi-tive to azithromycin. Demographic analysis showed that children aged 5-10 years in rural areas with limited access to clean water and poor sanitation were dispro-portionately affected. Conclusion: The study found that like other parts of Sindh, XDR and MDR S. typhi also present in the Khai-rpur and left very limited choices for antibacterial the-rapy and that is very concerning. Therefore, this region needs enhanced surveillance, improved diagnostic me-thods, and targeted public health interventions for com-bating the spread of resistant S. Typhi strains in Sindh.

Page(s): 592-595

DOI: DOI not available

Published: Journal: Rawal Medical Journal, Volume: 50, Issue: 3, Year: 2025

Keywords:

Salmonella Typhi , Antibiotic resistance , Risk factors , Typhoid fever , MDR Salmonella Typhi

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