ABSTRACT

Aim: To study the trends of progression of Extensively Drug Resistant (XDR)Salmonella typhoid and identify the alarming emergence of Azithromycin Resistancein Lahore, Pakistan.

Methodology: In this multicentral study 400 Salmonella typhoidpositive blood cultures from January 1^st, 2017 to June 1st, 2019 from individuals of all ages were collected, from three major academic microbiology centres from Lahore, Pakistan. The entire culture reports from these centres were analysed including the drug sensitivity patterns and relevant demographic data. The case was further classified using the NIH guidelines into non-resistant, multidrug resistant (MDR), and extra drug resistant (XDR) typhoid and azithromycin resistance depending on antibiotic susceptibility patterns.

Results: In the study 300(75%)of samples were fulfils of the selection criteria. Among selected samples 22(7.3%) cases were azithromycin resistant XDR, 100(33.33%)were MDR, 56(18.67%) were non-resistant species of Salmonella.Alarmed to notice the emergence of azithromycin resistant XDR Salmonella in samples from 2019. Furthermore, there is a proportional progressive increase in the ratio of blood culture positive XDR salmonella in our region.

Conclusion:A progressive increase in the blood cultures positive for XDR salmonella is alarming as is the emergence of azithromycin resistant XDR Salmonella in samples from 2019. We would like to stress the need for substantive sustained & timely local and international interventions to curb this resistant organism and established menace.

Keywords: Azithromycin resistance, typhoid,XDR, Pakistan.