Enteric Fever in Sulaimani Pediatric Teaching Hospital: Risk Factors, Presentation, and Drug Susceptibility

Mohammed, Mohammed S; Hussain, Sherko A Omer; Rashid, Bakir R

doi:10.17656/jsmc.10049

JSMC

2014

DOI: 10.17656/jsmc.10049

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Enteric Fever in Sulaimani Pediatric Teaching Hospital: Risk Factors, Presentation, and Drug Susceptibility

Mohammed S Mohammed¹,

Sherko A Omer Hussain²,

Bakir R Rashid³

Abstract: Background Enteric fever is a severe systemic illness characterized by fever and abdominal pain that is caused by dissemination of typhoid Salmonella serovar, Typhi and Paratyphi. These organisms have no known hosts other than humans. Most commonly, foodborne or waterborne transmission occurs as a result of faecal contamination by ill or asymptomatic chronic carriers. Objectives The aim of this study was to determine the risk factors, clinical features in paediatric enteric fever infections a… Show more

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Cited by 3 publications

References 17 publications

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Bacterial Isolates From Pediatric Blood Culture and Their Response to Antimicrobial Agents

Omer¹

2015

JSMC

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Background The blood stream can be invaded by many bacteria in the course of many infections resulting in bacteremia or septicemia. Objectives The aim of this study was to identify the frequency and the types of bacteria isolated form pediatric blood cultures and identify their susceptibility to antimicrobial agents. Patients and Methods A retrospective study on the laboratory reports of blood cultures from pediatric patients attended Sulaimani Pediatric Teaching Hospital during 18 months period. Results From 6024 processed blood cultures, 512 cultures yielded positive for growth of bacteria (8.4%). Staphylococcus aureus was the commonest microorganism isolated from both Neonatal Intensive Care Unit (NICU) and other hospital units. This was followed by Enterobacter spp. and Escherichia coli in NICU, while in other hospital units Staphylococcus aureus was followed by E. coli and Enterobacter spp.. Salmonella Typhi was isolated from 5.8% of blood cultures. The isolates mostly were resistant to many antimicrobial drugs. Certain antimicrobial agents showed to be more effective such as vancomycin, amikacin and cefaclor while more than 80% of the isolates were resistant to other agents such as ampicillin, oxacillin, carbincillin and ceftriaxone. Conclusion Staphylococcus aureus was the commonest bacteria isolated from blood cultures followed by Gram negative Enterobacteriaceae. The isolated bacteria were resistant to many antimicrobial agents while vancomycin andamikacin were found to be more effective than other agents.

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Bacterial Isolates From Pediatric Blood Culture and Their Response to Antimicrobial Agents

Omer¹

2015

JSMC

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Intravenous Line Colonization in Patients Receiving Cytotoxic Drugs

Rahim¹,

Omer²

2017

JSMC

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Background Hospital acquired infections are infections that develop during the hospital stay; they mainly include urinary tract, respiratory tract or blood stream infections. Objectives To investigate microbial colonization of intravenous cannula of cancers patients receiving cytotoxic drugs. Materials and Methods Colonization of intravenous cannulas was investigated by cultivation of the device surface and lumen on different culture media under aerobic incubation. The isolates were identified based on cultural, morphological and biochemical activities. The susceptibility of the isolates to antimicrobial drugs was investigated using Bauer-Kirby disk diffusion method and the bacterial isolates were further investigated for their ability to form biofilm. Results From 200 cultivated intravenous cannulas, microbial colonization was detected among 26% and 11% of intravenous cannulas from cancer and non-cancer patients respectively; Out of 37 isolates, 34 (91.9 %) were Gram-positive bacteria, 2 (5.4 %) Gram-negative bacteria and one (2.7 %) was a Candida species. The main bacterial isolates were bacteria belonging to different coagulase negative staphylococci species such as Staphylococcus epidermidis, S. hominis and others. Few faecal organisms were isolated including a single isolate of each Klebsiella pneumoniae and Escherichia coli. All bacterial isolates were able to form biofilm and most showed to have biofilm-related icaA and icaD genes. Conclusion We detected microbial colonization of intravenous cannulas in 18.5% of all cultivated devices. We observed more colonization in cancer patients (26%) in comparison to the control group (11%). Most of the isolates were species of CoNS that were able to form biofilm.

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Characteristic Features of Culture Positive Enteric Fever in Pediatric Teaching Hospital in Sulaimani Governorate

Tyib¹,

Fakhir²

2017

JSMC

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Background Typhoid fever is still common disease in our country, and at the present time we are facing resistant cases to usual antibiotics. Objectives This study has been carried out to identify the clinical and laboratory characteristics of these microorganisms. Materials and Methods This is a prospective study done from October 2008 to October 2009, in Sulaimani Pediatric Teaching hospital. Blood cultures were taken from patients suspected of having Typhoid fever ,only patients with positive cultures were included in this study. Data regarding age, sex, residency, clinical presentation, duration of fever at presentation, response to treatment and antibiotic susceptibility were all analyzed by SPSS version 16.0. Results Ninety six patients whom with culture proved cases of Enteric fever, 55 males and 41 females. The age of the patients were from 1 month -14 years with an average of 6.8 years. The duration of fever before attendance to medical care was (2-19) days with a mean of 7 days. Mean days needed for subsidence of fever was 5 days ranging from 2-10 days. Mean duration of admission was about 8.5 days, while mean duration of treatment was 14 days. Headache was the most common symptom (67.7%) followed by abdominal pain in 56.6%, diarrhea in 31.2%, While the symptoms least encountered were confusion 5.2% and constipation 1%. Splenomeagly was the commonest sign (56.2%) followed by hepatomegaly (35.4%) and neck stiffness was positive in (3.1%)of the patients whom had normal CSF examination. The mean WBC count was 5.378 109/l, with 61% of the patients having neutrophilia and 20.7% having lymphocytosis and 18.3% having equal distribution. Most of the isolates were sensitive to amikacin 87%, followed by doxycycline 85.7%, ciprofloxacin 81.5%, azithromycin 60%. Cefotaxime and ceftriaxone had sensitivities of about 52-54%, while there was 75% resistance to chloramphenicol and nearly 99% resistance to ampicillin. All cases were culture positive; 99% for Salmonella typhi and only 1% grew Salmonella para typhi A and B. The incidence of complications was about 10.4%,GIT bleeding being the most common 4.2% followed by renal failure and hepatitis 2% and ataxia 1.1%. Mortality rate was (1.1%). Conclusion Typhoid fever has different presentations according to the locality and also may change its presentation in form of outbreaks in a specific locality. The disease was multidrug resistant, this may be due to previous misuse of antibiotics.

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Enteric Fever in Sulaimani Pediatric Teaching Hospital: Risk Factors, Presentation, and Drug Susceptibility

Cited by 3 publications

References 17 publications

Bacterial Isolates From Pediatric Blood Culture and Their Response to Antimicrobial Agents

Bacterial Isolates From Pediatric Blood Culture and Their Response to Antimicrobial Agents

Intravenous Line Colonization in Patients Receiving Cytotoxic Drugs

Characteristic Features of Culture Positive Enteric Fever in Pediatric Teaching Hospital in Sulaimani Governorate

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