Journal of Research and Education(JRE)
ISSN: 2996-2544 | DOI: 10.33140/JRE
Breaking Barriers: Investigating the Potential of Ceftazidime-Avibactam in the Treatment of Salmonella Typhi Bacteremia through In-vitro Susceptibility Testing
Abstract
Nazia Khursheed, Moiz Ahmed Khan, Qurat-ul-Ain Zahid and Fareeha Adnan
Introduction: The prevalence of typhoid fever has been rising steadily in Pakistan with extensively drug-resistant (XDR) cases posing a major challenge to the national health care system. Physicians are hence, pushed towards prescribing last resort antibiotics which have concerns of cost-effectiveness, frequent in-patient monitoring and growing drug resistance. Hence, we evaluated susceptibility of Ceftazidime-avibactam (CAZ-AVI) against Salmonella typhi isolates from cases of bacteremia.
Methods: This was a cross-sectional study conducted at the Clinical Microbiology Laboratory of The Indus Hospital Karachi, Pakistan from 1st May to 31st October 2023. Two hundred and eighty-nine blood culture isolates identified as S. typhi were included in the study and were tested for CAZ-AVI susceptibility by Disc diffusion method. Interpretation of zone diameters was done using antimicrobial susceptibility breakpoints mentioned in Clinical & Laboratory Standards Institute (CLSI) M100. A zone diameter of ≥ 21 mm was considered as sensitive and ≤ 20 mm was considered resistant.
Results: Of the 289 isolates, 59.9% (n=173) were from male patients and 40.1% (n=116) from females. Patients mostly belonged to ≤ 18 years age group (n=249; 86.2%). Majority of the S. typhi isolates were characterized as XDR (n=171; 59.2%) followed by non-drug-resistant isolates (n=90; 31.1%) whereas, least were characterized as multi drug-resistant (MDR) strains (n=28; 9.7%). All the isolates tested for CAZ-AVI susceptibility were found to be sensitive.
Conclusion: We report 100% susceptibility of CAZ-AVI in our set of S. typhi bacteremia isolates. The findings of this study provide valuable data to physicians for exploring other treatment options for typhoid as well as guiding further multi-center in-vitro studies and clinical trials.