Extensively Drug-Resistant Typhoid Outbreak in Pakistan, Experience at a  Tertiary Care Hospital in Lahore; A Tip of An Iceberg

Anam Imtiaz; Irfan Ali Mirza; Qanita Fahim; Nargis Sabir; Ayesha Bashir; Salman Saleem

doi:10.51253/pafmj.v72i4.3703

Authors

Anam Imtiaz Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Irfan Ali Mirza Armed Forces Institute of Pathology/National University of Medical Sciences (NUMS), Rawalpindi Pakistan
Qanita Fahim Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS), Pakistan
Nargis Sabir Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS), Pakistan
Ayesha Bashir Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS), Pakistan
Salman Saleem Combined Military Hospital, Lahore/National University of Medical Sciences (NUMS), Pakistan

DOI:

https://doi.org/10.51253/pafmj.v72i4.3703

Keywords:

Extensively drug-resistant (XDR), Salmonella typhi, Outbreak, Typhoid fever

Abstract

Objective: To provide a laboratory-based surveillance report of typhoid fever cases diagnosed at a tertiary care hospital in Lahore during the ongoing outbreak.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Mar 2018 to Jun 2019.

Methodology: All positive blood culture samples that yielded the growth of Salmonella Typhi were included in the study. The samples were dealt with according to standard microbiological procedures. Antimicrobial susceptibility was performed using Clinical and Laboratory Standards Institute (CLSI) guidelines.

Results: During the study period, (377) Typhoidal Salmonellae were isolated, of which 327 (86.7%) were Salmonella Typhi and 50 (13.3%) were Paratyphi A. The percentage of XDR Salmonella isolates was 41.9%.

Conclusion: Extensively drug-resistant typhoid fever cases reported in this study represent just the tip of an iceberg. Therefore, nationwide surveillance efforts must be undertaken along with implementing effective preventive measures.