RESUMEN
Enteric fever, a potentially fatal multisystem disease that is caused by Salmonella enterica serovar Typhi and Paratyphi, poses a significant risk in low- and middle-income countries. A retrospective study to understand the prevalence and evolving patterns of antibiotic resistance in Salmonella Typhi and Paratyphi was undertaken from June 2017 to June 2022. A total of 4051 blood samples were collected from patients attending inpatient and outpatient departments of the School of Tropical Medicine (Kolkata, India) hospital. Blood samples were cultured, and culture positive samples were further processed for identification using conventional and automated systems. Antibiotic susceptibility test was performed using both the Kirby-Bauer disc diffusion method and VITEK2 (bioMerieux). Forty-five (1.1%) Salmonella species were isolated among the number of total (n = 4051) samples that were tested. Out of the 45 Salmonella isolates, 35 were Salmonella Typhi (77.77%) and 10 were Salmonella Paratyphi A (22.23%). We found pronounced fluoroquinolone resistance of 100% in the recent years (2019-2022) in both of the S. Typhi and S. Paratyphi A isolates. We found that 1 Salmonella Typhi and 2 Salmonella Paratyphi A isolates were resistant against multiple antibiotics (cefixime, ceftriaxone, ciprofloxacin and nalidixic acid), and 1 multidrug-resistant (MDR) Salmonella Paratyphi A isolate was found in a recent study year (2020) and it showed resistance against different classes of antibiotics (cephalosporins, fluoroquinolones and carbapenems). There was no resistance that was detected to the 3rd generation cephalosporins in the final years of the study. The emergence of Salmonella isolates that are resistant to multiple antibiotics poses a serious health problem. The antimicrobial resistance patterns that were detected in the study thus warrant further studies to understand the antibiotic susceptibility and resistance pattern of Salmonella against the major classes of antibiotics.
RESUMEN
CONTEXT: Both malaria and lymphatic filariasis (LF) are mosquito-borne diseases caused by protozoal and nematode parasites, respectively, and are serious public health problem in India. Although the vectors of the diseases are different, they can coexist in favorable conditions. Fever is the common symptom for both the diseases, but the emphasis is given for diagnosis and treatment of malaria due to its life-threatening severity, LF remained neglected. Detection and management of microfilaria are equally important. During the diagnosis of malaria, a few microfilaria were detected, which prompted us to undertake this study with following objectives. OBJECTIVES: The objective of the study was to determine the incidence of microfilaremia among the febrile patients attending for malaria diagnosis. SUBJECTS AND METHODS: Thick and thin peripheral blood smears from all patients attended were examined following Giemsa staining. Different malarial indexes were analyzed. RESULTS: Out of 8681 patients examined, 1778 were positive for Plasmodium vivax and 328 for Plasmodium falciparum with a slide positivity rate 20.48%. Twenty-six patients were positive for microfilaria of Wuchereria bancroftii among which five were coinfected with P. vivax and one with P. falciparum. Most of the microfilaria-positive patients were adult and originally from northern districts of Bihar. CONCLUSIONS: High incidence of microfilaria among febrile patients attending for malaria is alarming for urban Kolkata. Although the patients were originally from Bihar, they are staying in Kolkata for a long time, might be a source for transmission. Epidemiological study by collecting night blood samples and entomological survey is highly suggestive to explore local transmission if any.