Abstract

Typhoid fever continues to remain a health problem as the causative organismSalmonella typhi has developed resistance to many of the antibiotics used. This study was undertaken to determine the current pattern of resistance to antimicrobial agents of S. typhi isolates obtained in a tertiary Health care Hospital. 309 samples were taken. Sensitivity to ampicillin, chloramphenicol, cotrimoxazole, ciprofloxacin and ceftriaxone was determined by disc diffusion, and the minimum inhibitory concentration (MIC) was determined. Antibiotic sensitivity was carried out by Kirby-Bauer method. ESBL screening and phenotype confirmation were done following National Committee for Clinical Laboratory Standards (NCCLS) recommendations for Escherichia coli. Isolation rates of Salmonella typhi was prominent in 2002 - 2003 and have remained stable. S. paratyphi-A is showing an increasing trend. The 3 common antibiotics which were showing resistance earlier are now showing sensitivity. The study indicates that MDR S. typhi is on the rise. There is also re-emergence of chloramphenicol sensitivity. Sensitivity pattern of causative organism must be sought before instituting appropriate therapy to prevent further emergence of drug resistance. Indiscriminate use of ciprofloxacin or ceftriaxone should be strongly discouraged. They should be used as second line agents. Also, the treatment must not be completely dependent on the Widal test. Blood culture and clinical history must be taken into consideration for treatment.

Key words: Ciprofloxacin, ceftriaxone, enteric fever, multi-drug resistant (MDR)Salmonella, Minimum inhibitory concentration (MIC).