Minimal Inhibitory Concentrations Of Azithromycin In Typhoidal Salmonella Isolated In Tertiary Care Setting

Anam Tariq; Irfan Ali Mirza; Qanita Fahim; Ayesha Bashir; Shafqat hussain; Chahat Hussain

doi:10.51253/pafmj.v74i2.7999

Authors

Anam Tariq Department of Pathology, Combined Military Hospital Lahore/ National University of Medical Sciences (NUMS) Pakistan
Irfan Ali Mirza Department of Pathology, Armed Forces Institute of Pathology / National University of Medical Sciences (NUMS) Rawalpindi Pakistan
Qanita Fahim Department of Pathology, Combined Military Hospital Chunian / National University of Medical Sciences (NUMS) Pakistan
Ayesha Bashir Department of Pathology, Combined Military Hospital Lahore/ National University of Medical Sciences (NUMS) Pakistan
Shafqat hussain Department of Pathology, Combined Military Hospital Lahore/ National University of Medical Sciences (NUMS) Pakistan
Chahat Hussain Department of Pathology, Combined Military Hospital Lahore/ National University of Medical Sciences (NUMS) Pakistan

DOI:

https://doi.org/10.51253/pafmj.v74i2.7999

Keywords:

Azithromycin, Minimum inhibitory concentration, Salmonella typhi

Abstract

Objective: To determine the variations in minimal inhibitory concentrations (MIC) of Azithromycin amongst Salmonella typhi isolates.

Study Design: Cross-sectional study.

Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Jan to Dec 2020.

Methodology: Three hundred and eighty-four samples yielding the growth of Salmonella typhi were processed. Antibiotic susceptibility testing was done using the Kirby-Bauer Disk Diffusion technique, and the MIC of Azithromycin was determined using the E-strip method. Clinical and Laboratory Standards Institute (CLSI) recommended that MIC breakpoints be used for susceptibility testing of Azithromycin.

Results: Of 384 tested isolates, 103(26.8%) were multidrug-resistant (MDR). Resistance to Ciprofloxacin was as high as 367(95.6%) isolates, whereas extensively drug-resistant (XDR) isolates were calculated to be 204(53.1%). No resistance against Azithromycin was observed. All the isolates were in the susceptible MIC range of 0.5 and 8 μg/ml. The lowest MIC observed was 0.5 μg/ml by 12(5%) of the isolates. The highest MIC value of 8 μg/ml was observed in 6(1.5%) isolates, all of which were XDR. 231(60.2%) isolates had one μg/ml MIC, followed by MIC 4 μg/ml of 72(18.8%) isolates. The mean MIC value of all the isolates was calculated to be 1.82±1.3μg/ml.

Conclusion: The rise in XDR Salmonella typhi could lead to Azithromycin resistance. Antimicrobial stewardship is of prime importance, and Azithromycin MICs should be reported to keep the trends in check.

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