Multi-drug resistant typhoid in adults

A total of 100 clinically suspected cases of typhoid fever were studied during the period January 1993 to December 1994. Blood and bone marrow cultures were done to find out the pattern of anti-microbial sensitivity of Salmonella; 44 cases were culture positive. Salmonella typhi was isolated in 81.8% of the cases [n=36] while Salmonella para typhi A was isolated in 18.1% of the cases [n=8]. Salmonella paratyphi B and C were not isolated. All isolates of Salmonella typhi were resistant to conventional anti-typhoid drugs i.e. chloramphenicol, amoxycillin and co-trimoxazole, and were sensitive to aminoglyco-sides-gentamycin, third generation cephalosporin cefexim, cefotaxime, ceftazidime and ceftriaxone and to quinolones i.e. ofloxacin and glomefloxacin. All isolated of Salmonella paratyphi A were sensitive to conventional as well as the newer antibiotics mentioned above. It is concluded that, in view of the alarming increase in the incidence of multi-drug resistant salmonella typhi to conventional antibiotics, typhoid fever must be treated very cautiously, and newer antibiotics must only be used when they are indicated so as to prevent the development of microbial resistance against them