Extensively Drug-Resistant Typhoid Outbreak in Pakistan, Experience at a Tertiary Care Hospital in Lahore; A Tip of An Iceberg

Extensively Drug-Resistant Typhoid Outbreak in Pakistan, Experience at a Tertiary Care Hospital in Lahore; A Tip of An Iceberg

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Objective: To provide a laboratory-based surveillance report of typhoid fever cases diagnosed at a tertiary care hospital in Lahore during the ongoing outbreak.Study Design: Cross-sectional study.Place and Duration of Study: Department of Microbiology, Combined Military Hospital, Lahore Pakistan, from Mar 2018 to Jun 2019.Methodology: All positive blood culture samples that yielded the growth of Salmonella Typhi were included in the study.The samples were dealt with L-TRYPTOPHAN according to standard microbiological procedures.

Antimicrobial susceptibility was performed using Clinical and Laboratory Standards Institute (CLSI) guidelines.Results: During the study period, (377) Typhoidal Salmonellae were isolated, of which 327 (86.7%) were Salmonella Typhi and 50 (13.3%) were Paratyphi A.The percentage of XDR Salmonella isolates was 41.

9%.Conclusion: Extensively drug-resistant typhoid fever cases reported in this SERENITY FORMULA study represent just the tip of an iceberg.Therefore, nationwide surveillance efforts must be undertaken along with implementing effective preventive measures.