1 Department of Health Sciences, Africa University, Mutare, Zimbabwe
2 National Microbiology Reference Laboratory, Harare, Zimbabwe
3 Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe
Typhoid is a life-threatening infectious disease requiring the administration of antibiotics for treatment. Ciprofloxacin is the antibiotic of choice for diarrheal cases in Zimbabwe, adopted by the Ministry of Health and Child Care, from current World Health Organisation (WHO) guidelines. However, there has been an increase in the emergence and spread of multidrug resistance against ciprofloxacin and conventional drugs antibiotics for the treatment of typhoid.
This cross-sectional study aimed to determine the prevalence of ciprofloxacin-resistant Salmonella Typhi (S. Typhi) isolated in Harare for the first quarter of 2016.
This study was carried out at the National Microbiology Reference Laboratory (NMRL), located at Harare Central Hospital, in Zimbabwe. The NMRL carries out confirmatory tests and molecular typing of pathogens isolated at different national laboratories. The current study retrieved demographics, clinical data, and isolates for confirmed typhoid cases out of 402 suspected specimens. The isolates from Harare, confirmed as S. Typhi, between January and April 2016, were evaluated for ciprofloxacin resistance.
A total of 35 S. Typhi isolates were recovered for the period from January to April 2016. When the 35 isolates were characterised, nine (25.7%) were resistant to ciprofloxacin. The area with the highest recorded cases of typhoid fever was Budiriro High-Density Suburb in Harare. This area has been hit by other diarrheal outbreaks in the past, most likely due to the intermittent supply of safe water.
Most high-density areas, where S. Typhi positive specimens originated, are overpopulated and have regular water cuts, resulting in a decrease in hygiene. More than a quarter of isolates are resistant to ciprofloxacin, agreeing with other reports from Zimbabwe. The misuse of antibiotics could be associated with resistance, necessitating education on the correct use of antibiotics in the community and other preventive measures. Additionally, molecular research on geographic and phylogenetic relatedness of isolates and other holistic approaches for studying the development of antimicrobial resistance mutations, using whole-genome sequencing, in this setting, are warranted.
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* Address correspondence to this author at the Department of Medical Laboratory Sciences, University of Zimbabwe, Harare, Zimbabwe; Tel: +263772566214;