Prevalence, Risk Factors and Antimicrobial Resistance Pattern of Salmonella Isolates among Patients Attending Abubakar Tafawa Balewa University Teaching Hospital

Abstract

Salmonella enterica serovar Typhi (Salmonella typhi) remains an important cause of enteric fever, particularly in low-resource settings where poor sanitation and antimicrobial resistance complicate disease control. This study investigated the prevalence, associated risk factors, clinical characteristics and antimicrobial susceptibility pattern of S. typhi among patients. A cross-sectional study was conducted on 138 patients whose blood and stool specimens were cultured using standard bacteriological methods. Isolates were identified by conventional microbiological techniques and antimicrobial susceptibility testing was performed using the Kirby–Bauer disk diffusion method. Associations between S. typhi isolation and demographic, environmental, behavioural and clinical variables were determined using the Fisher’s Exact Test. Five S. typhi isolates were recovered, giving an overall prevalence of 3.62%, with stool specimens (4.17%) yielding slightly more isolates than blood specimens (3.03%). Salmonella typhi represented 4.0% of all bacterial isolates, while Escherichia coli and Staphylococcus aureus were the predominant pathogens. Demographic characteristics were not significantly associated with S. typhi isolation P > 0.05). However, the use of untreated river water, open defecation, overcrowding, poor hand hygiene, failure to wash fruits and vegetables and frequent consumption of roadside foods were significantly associated with infection (P < 0.05). All isolates were resistant to nalidixic acid, while high resistance was observed to cefixime and imipenem. Levofloxacin, ofloxacin and nitrofurantoin showed the highest susceptibility (60%). Salmonella typhi prevalence was low, but its occurrence was strongly associated with poor environmental sanitation and hygiene. The detection of multidrug-resistant isolates underscores the need for routine microbiological surveillance, antimicrobial stewardship and improved water sanitation and hygiene interventions to support effective typhoid fever control.