DOI: http://dx.doi.org/10.18203/2349-3291.ijcp20221372

A study of clinico-diagnostic profile and antibiogram in children with enteric fever in a tertiary care hospital

Bulbul Jain, Sanjay Mandot, Darshini Patel

Abstract


Background: Enteric fever remains a major concern in developing countries caused by Salmonella typhi. Recently, an upsurge in antimicrobial resistant strains has complicated the management. The present study was undertaken to evaluate the clinical profile, compare typhidot test with blood culture and determine antimicrobial susceptibility pattern.

Methods: Single centre descriptive study was conducted by enrolling children who presented with fever and who were either blood culture positive for S. typhi or typhidot positive. The clinico-laboratory data and antibiogram was studied.

Results: Out of 76 cases, blood culture was positive in 35 (46%) cases. Typhidot test showed 92.11% positivity. Abdominal pain (78%), vomiting (68%), hepatomegaly (68%) and splenomegaly (43%) were most commonly observed. The sensitivity for classical drugs chloramphenicol, ampicillin and cotrimoxazole was 88.57%, 74.28% and 77.14%. High susceptibility to ceftriaxone (97.14%) and high resistance to ciprofloxacin (55.14%) was observed.

Conclusions: Prompt diagnosis of enteric fever is essential for appropriate management therefore, important to have conventional tests like typhidot test. There is re-emergence of sensitivity to the classical drugs. Ceftriaxone as monotherapy is quite effective. Effective vaccination strategy and hygienic practices can decrease the burden of this disease.

 


Keywords


S. typhi, Blood culture, Typhidot test, Antibiotic susceptibility

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References


Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: Systematic review to estimate global morbidity and mortality for 2010. J Glob Health. 2012;2(1):010401.

Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ. 2004;82:346-53.

Arndt MB, Mosites EM, Tian M, Forouzanfar MH. Estimating the burden of paratyphoid A in Asia and Africa. PLoS Negl Trop Dis. 2014;8(6):e2925.

John J, Bavdekar A, Rongsen T, Dutta S, Kang G. Estimating the incidence of enteric fever in children in India: a multi-site, active fever surveillance of pediatric cohorts. BMC public health. 2018;18(1):1-6.

Ganesh R, Janakiraman L. Profile of Typhoid fever in children from a tertiary care hospital in Chennai-southern India. Indian J Pediatr. 2010;77:1089-92.

Jha G, Kumar A, Singh BK, Kejriwal M. Clinical and laboratory profile of typhoid fever inn children with special emphasis on drug resistance. J Dental Med Sci. 2019;18(6):1-7.

Jeeyani HN, Mod HK, Tolani JN. Current perspectives of enteric fever: a hospital-based study of 185 culture positive cases from Ahmedabad. Int J Contemp Pediatr. 2017;4:816-21.

Devaranavadagi RA, Srinivasa S. A study on clinical profile of typhoid fever in children. Int J Contemp Pediatr. 2017;4:1067-73.

Gautam S, Purushothaman S, Patel KP, Sankhe AP, Mahadik MR. Assessment of clinical profile, antibiotic sensitivity and prescription pattern in blood culture positive enteric fever among pediatric and adult patients admitted in a tertiary care hospital: a prospective study. Int J Res Med Sci. 2019;7.

Sarswat S, Kumar M, Gupta R. Pediatric Nature of Enteric Fever with Emerging Antibiogram: A Cross Sectional Study. Int J Pediatr Res. 2018;4:039.

Modi R. Clinical profile and treatment outcome of typhoid fever in children at a teaching hospital, Ahmedabad, Gujarat, India. Int J Med Sci Public Health. 2016;5:212-6.

Laishram N, Singh PA. Clinical profile of enteric fever in children. J Evolution Med Dent Sci. 2016;5(2):114-6.

Gavhane J, Yewale V, Weekey P, Dhanya, Warrior D. Enteric fever in children from Navi Mumbai-clinical profile, hematological features, sensitivity patterns and response to antimicrobials. Pediatr infect dis. 2010;11:05-9.

IAP task force report. Diagnosis of enteric fever in children. Indian Pediatr. 2006;43:875-83.

Iftikhar A, Bari A, Jabeen U, Bano I. Spectrum of complications in childhood Enteric Fever as reported in a Tertiary Care Hospital. Pak J Med Sci. 2018;34(5):1115-9.

Malini A, Barathy C, Madhusudan N S, Johnson C. Clinical and microbiological profile of enteric fever among pediatric patients in a tertiary care center in South India: A cross-sectional study. J Clin Sci. 2020;17:74-9.

Kundu R, Ganguly N. IAP task force report. Management of enteric fever in children. Indian pediatr. 2006;43:884-7.

Udayakumar S, Pushpalatha K, Naveen HM, Swathi PM, Yoganand R, Sushma C. Comparative study of Typhidot-M with Widal and blood culture in diagnosis of enteric fever. Indian J Child Health. 2017;4(1):64-7.

Dipankar De, Sunilbala K, Mondal AR. Evaluation of typhidot test in diagnosis of typhoid fever in children in RIMS hospital. J Dental Med Sci. 2016;15:19-21.

Sanjeev H, Sweetha N. A systematic evaluation of rapid dot-eia, blood culture and widal test in the diagnosis of typhoid fever. NUJHS. 2013;3:1.

Balakrishna TP, Sumathi S. A comparative study of typhidot and Widal test in the diagnosis of typhoid fever. J Evolution Med Dental Sci. 2013;2(21):3720-5.

Chitkara AJ, Chitkara S, Narang PS, Sundharam M, Goyal M. Clinico-bacteriological profile of typhoid fever in a private sector hospital in New Delhi. Indian pediatrics. 2019;56(12):1033-6.

Singh L, Cariappa MP. Blood culture isolates and antibiogram of Salmonella: Experience of a tertiary care hospital. Med J Armed Forces India. 2016;281-4.

Sharma P, Dahiya, Manral N. Changing trends of culture positive typhoid fever and antimicrobial susceptibility in a tertiary care North Indian hospital over the last decade. Indian J Med Microbiol. 2018;36:70-6.

Vala S, Shah U, Ahmad SA, Scolnik D, Glatstein M. Resistance Patterns of Typhoid Fever in Children: A Longitudinal Community-Based Study. Am J Ther. 2016;23(5):e1151-4.

Manchanda V, Bhalla P, Sethi M, Sharma VK. Treatment of enteric fever in children on the basis of current trends of antimicrobial susceptibility of Salmonella typhi. Indian J Med Microbiol. 2006;24(2):101-6.

Gosai MM, Hariyani HB, Purohit PH. A study of clinical profile of multidrug resistant typhoid fever in children. NJIRM. 2011;2(3):87-90.

Mishra SK, Sah JP, Shrestha R, Lakhey M. Emergence of Nalidixic acid resistant Salmonella: a confounding scene in antibiotic armamentarium. J Nepal Med Lab Sci. 2008;9(1):61-6.

Rai S, Jain S, Prasad KN, Ghoshal U, Dhole TN. Rationale of azithromycin prescribing practices for enteric fever in India. Indian J Med Microbiol. 2012;30:30-3.

Dahiya S, Malik R, Sharma P, Sashi A, Lodha R, Kabra SK et al. Current antibiotic use in the treatment of enteric fever in children. Indian J Med Res. 2019;149(2):263-9.