Clinical profile and drug resistance patterns of typhoid fever in children: A prospective hospital-based study
Keywords:Antibiotic resistance, burden, children, typhoid fever
Background: Salmonella typhi and Salmonella paratyphi are important causes of bacteremia in children, especially those from the developing world. The present study is undertaken to study the pattern of antimicrobial resistance of S. typhi in culture positive cases of enteric fever. Materials and Methods: This prospective non-randomized study was conducted in the Department of Pharmacology, J. N. Medical College, AMU, Aligarh, in association with the Department of Paediatrics and Department of Microbiology, J. N. Medical College, on pediatric patients attending the Outpatient/Inpatient Department of Paediatrics, over a period of 1 year and 11 months from September 2005 to August 2006. For all patients with suspected enteric fever, the following investigations were sent for complete hemogram, blood culture, and sensitivity test and Widal test. Results: About 114 randomly selected children having clinical features strongly suggestive of uncomplicated enteric fever with either culture positive or serology positive or both were entered in the study. Fever was the most common clinical presentation and was present in 94.7%. Only 25% of patients attended the hospital within the 1st week of illness, while maximum (54.6%) patients came to the hospital in the 2nd week of illness. Hepatomegaly was more common (43.8%) as compared to splenomegaly (27.1%). The characteristic rose spots of enteric fever were a rare finding in children. Conclusion: Burden of typhoid fever in endemic areas of India underscores the importance of evidence on disease burden in making policy decisions about interventions to control this disease. Our antimicrobial susceptibility data suggest that quinolones and third-generation cefalosporins should be used as first-line antimicrobials in enteric fever. A careful consideration should be given before deciding the antibiotic for treatment to prevent the emergence of antibiotic resistance. Key words: ,,,
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