Molecular detection of extensively drug-resistant Salmonella Typhi and carbapenem-resistant pathogens in pediatric septicemia patients in Pakistan - a public health concern.

Aim: To determine the prevalence of multidrug (MDR) and extensively drug-resistant (XDR) pathogens from pediatric blood samples Methods: In total, 4543 children's blood samples were processed in the BacT/ALERT system. Confirmation of the isolates and MIC was determined in VITEK®  2 system. Molecular identification of bla IMP , bla VIM and bla OXA-48 was done by PCR. Results: Of 4543 blood cultures, 458 (10%) were positive for bacterial growth and Salmonella  Typhi (415; 90%) remained the primary pathogens. Antibiogram revealed 208 (50.1%) and 137 (33%) were MDR and XDR S . Typhi, respectively. Klebsiella pneumoniae displayed 46% resistance to imipenem. One hundred twelve (81.7%) XDR Typhi were positive for bla CTXM , whereas 14 (66.6%) bla VIM were found in carbapenem-resistant bacteria. Conclusion:  A high prevalence of MDR and XDR pathogens was found in peads blood culture.