Clinico-immunological profile and antibiogram of Salmonella species causing enteric fever at a tertiary care hospital in Bihar: A hospital-based cross-sectional study.

Priyanka R K; Randhir Kumar; Archana; Amit Mishra; Rakesh Kumar; Namrata Kumari

doi:10.51168/83df2v31

Autori

Priyanka R K Senior Resident, Department of Microbiology, IGIMS, Patna, Bihar, India
Randhir Kumar Associate Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.
Archana Assistant Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.
Amit Mishra Additional Professor, Department of General Medicine, IGIMS, Patna, Bihar, India.
Rakesh Kumar Additional Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.
Namrata Kumari Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.

DOI:

https://doi.org/10.51168/83df2v31

Cuvinte cheie:

Blood culture, serological testing, enteric fever, antimicrobial resistance, antibiotic utilisation, Salmonella typhi

Rezumat

Background:

Enteric fever continues to pose a significant public health challenge in Bihar, attributed to inadequate sanitation, restricted diagnostic capabilities, and the escalating risk of antibiotic resistance (AMR). Traditional diagnostic techniques, including blood culture and serological assays, have limitations in sensitivity and specificity, hence requiring enhanced diagnostic methodologies.

Objective:

To assess the clinico-immunological characteristics and antibiogram of Salmonella species responsible for enteric fever in a tertiary care facility in Bihar.

Methods:

This hospital-based cross-sectional observational study was performed at IGIMS, Patna, over a duration of 12 months. A total of 163 individuals, aged 12 years and older, with clinically suspected enteric fever were included. Blood specimens were obtained for culture and antibiotic susceptibility analysis. Immunological assays, specifically Widal and Typhidot, were conducted. Statistical analysis was conducted with Epi Info, with a p-value of less than 0.05 being significant.

Results:

Blood culture positivity was noted in 30.7% of instances. The Widal and Typhidot tests showed high positivity rates but low specificity. A notable correlation was identified between Widal test outcomes and blood culture results (p < 0.05). Multidrug-resistant (MDR) Salmonella strains were discovered, demonstrating a substantial association between culture-positive and resistance patterns (p < 0.05).

Conclusion:

Enteric fever is a major contributor to acute illness in Bihar. The restricted specificity of serological assays and the rise of multidrug-resistant bacteria underscore the necessity for shifting serology to automated identification and AST systems. Enhancing surveillance, advocating for judicious antibiotic utilisation, and using automated diagnostics are crucial for improving patient outcomes and managing antimicrobial resistance.

Recommendation:

Blood culture should be the principal diagnostic method, supplemented by serological testing. The implementation of rapid automated diagnostics and regular antibiogram testing is crucial. Prudent antibiotic utilisation, enhanced surveillance, and superior cleanliness are essential for managing enteric fever and addressing escalating antimicrobial resistance.

Biografii autori

Priyanka R K, Senior Resident, Department of Microbiology, IGIMS, Patna, Bihar, India

is a Senior Resident in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India.
Randhir Kumar, Associate Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.

is an Associate Professor in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India.
Archana, Assistant Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.

is an Assistant Professor in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India.
Amit Mishra, Additional Professor, Department of General Medicine, IGIMS, Patna, Bihar, India.

is an Additional Professor in the Department of General Medicine at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India
Rakesh Kumar, Additional Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.

is an Additional Professor in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India.
Namrata Kumari, Professor, Department of Microbiology, IGIMS, Patna, Bihar, India.

is a Professor in the Department of Microbiology at Indira Gandhi Institute of Medical Sciences (IGIMS), Patna, Bihar, India.

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