FREQUENCY OF EXTENSIVELY DRUG RESISTANT (XDR) IN PATIENT WITH TYPHOID FEVER AT TERTIARY CARE TEACHING HOSPITAL SUKKUR

Abstract

BACKGROUND: Extensively drug-resistant (XDR) typhoid fever is an emerging public health threat in Pakistan, with rising resistance to multiple antibiotics. This study aimed to determine the frequency of extensively drug resistant (XDR) in patient with typhoid fever presented to a tertiary care teaching hospital in Sukkur.

METHODOLOGY: A cross-sectional study was conducted on 134 patients aged 18-60 years, diagnosed with typhoid fever. Antibiotic sensitivity testing was used to identify XDR typhoid, defined as resistance to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporins. Data on socio-demographic factors, comorbidities, vaccination status, and laboratory findings were collected. Chi-square and Fisher’s exact tests were applied to assess associations, with p ≤ 0.05 considered statistically significant.

RESULTS: XDR typhoid was identified in 80 patients (59.7%). Statistically significant associations were observed between XDR typhoid and urban residence (p=0.001), male gender (p=0.048), low educational status (p=0.003), hypertension (p=0.004), diabetes mellitus (p=0.001), obesity (p=0.001), smoking (p=0.002), low platelet count (p<0.001), anemia (p=0.010), vitamin D deficiency (p<0.001), and lack of typhoid vaccination (p<0.001). Age and marital status were not significantly associated with XDR typhoid.

CONCLUSION: The high burden of XDR typhoid underscores the urgent need for public health interventions, including rational antibiotic use, improved sanitation, health education, and widespread typhoid vaccination. Early identification of high-risk individuals and addressing modifiable risk factors can help curb the spread of drug-resistant Salmonella typhi strains.