Clinico-laboratory Profile of Enteric Fever and Antibiotic Sensitivity Pattern in Hospitalized Children

Abstract

Abstract:Background: Enteric fever is endemic in Bangladesh. This is an important cause of morbidity and mortality in developing countries. The aim of the study was to evaluate the clinical and laboratory profiles, culture positivity rate and sensitivity pattern of Salmonella enterica.Methodology: This was an observational study carried out in a tertiary care hospital in Dhaka, Bangladesh during the period from January to December, 2017. Total 120 children who had enteric fever diagnosed either by positive blood culture or widal test with significant titre for Salmonella Typhi or Paratyphi were enrolled in the study.Results: Fever and abdominal pain were the main presenting symptoms. Leucocyte and platelet count were normal whereas ALT and CRP found to be elevated. Culture positivity rate in our study was 43.33%. Of the culture positive isolates, 88.46% were Salmonella Typhi and 11.53% were Salmonella Paratyphi. All the isolates were sensitive to third and fourth generation cephalosporins while 79.54% showed intermediate sensitivity to ciprofloxacin. Conclusion:A good sensitivity to third and fourth generation cephalosporins against Salmonella was noted whereas ciprofloxacin found to be less sensitive. Ceftriaxone showed remarkable efficacy when used as monotherapy.

Study on the efficacy of ceftriaxone versus azithromycin for the treatment of uncomplicated enteric fever among the patients admitted in a tertiary level hospital

“…Out of 91 patients, 83 (91%) were culture positive for S. typhi and 8 (9%) were culture positive for S. paratyphi. These findings are consistent with some earlier studies by Saha et al and Rahat et al24,25 Only culture positive patients were evaluated. Out of 91 patients, 51 were receiving ceftriaxone and forty (40) were receiving azithromycin.…”

Detection of Salmonella species by Automated Blood Culture Method in Suspected Cases of Enteric Fever

“…20,21,22 Comparatively, a 2018 study in Bangladesh found an isolation rate of 63.33 percent, which was significantly higher than the present study. 23 This high rate of isolation may be due to the prevalence of automated blood culture techniques. Blood culture positivity rates among febrile cases have been reported to be 8.5%, 5%, and 4.2% in Vietnam, 5%, and 4.2% in Delhi, and 4% in Egypt, respectively, despite diverse population-based experiences of the occurrence of typhoid fever in these countries.…”