Resistance Patterns of Microorganisms in Enteric Fever in Malakand Division, Pakistan

Abstract

Abdul Jabbar, Taj Akbar, Sadique Ullah, Amin ul Haq, Sabir Rehman and Amjad Ali

Objective: To determine the prevalence and antibiotic resistance patterns among patients with enteric fever in the Malakand Division of Pakistan.

Methodology: This cross-sectional study was conducted at the Department of Medicine, Saidu Group of Teaching Hospitals, Swat, Pakistan, from March 2023 to September 2023. A total of 305 patients aged 15–60 years with suspected enteric fever were enrolled through non- probability consecutive sampling. Patients presenting with fever of ≥38°C for at least three days along with gastrointestinal symptoms were evaluated using Typhidot IgM/IgG testing and blood culture where indicated. Antibiotic resistance patterns were assessed among laboratory-confirmed Salmonella isolates using culture and sensitivity testing.

Results: The mean age of the participants was 24.9 ± 8.05 years, and 174 (57%) were male. Overall, antibiotic resistance was observed in 157 (51.5%) patients. High resistance rates were noted for cefotaxime (83.7%), ampicillin (81.5%), and chloramphenicol (78.1%). Resistance to cefixime and ciprofloxacin was 67.4% and 42.9%, respectively. Lower resistance rates were observed for ceftriaxone (12.9%), azithromycin (7.7%), and meropenem (5.6%), indicating retained effectiveness of these agents against enteric fever isolates.

Conclusion: A high burden of antimicrobial-resistant enteric fever was observed in the Malakand Division, with substantial resistance to commonly used first-line antibiotics. Continuous surveillance, rational antibiotic prescribing, and regular revision of treatment guidelines are essential to limit the spread of drug-resistant enteric fever.

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