{"title":"Clinical and microbiological profile of enteric fever among pediatric patients in a tertiary care center in South India: A cross-sectional study","authors":"A. Malini, C. Barathy, N. Madhusudan, C. Johnson","doi":"10.4103/jcls.jcls_17_20","DOIUrl":null,"url":null,"abstract":"Introduction: Enteric fever, which is endemic in India, is a significant cause for morbidity, particularly among young children. Enteric fever is associated with high fever, abdominal pain, diarrhea, and splenomegaly. Recently, there have been increasing reports of enteric fever due to Salmonella enterica serovar Paratyphi A and multidrug resistance among Salmonella species. Objectives: The objective of this study was to know the relative occurrence of Salmonella Typhi and Salmonella Paratyphi A from blood cultures of enteric fever cases, to study the sensitivity pattern of Salmonella species isolated, to compare the clinical profiles in typhoid and paratyphoid fever, and to know their treatment outcome. Materials and Methods: It was a prospective hospital-based cross-sectional study. The demographic, clinical, and laboratory data were recorded for all cases included in the study. All clinically suspected cases of enteric fever were confirmed by blood culture and/or the Widal test. Antibiotic sensitivity was tested by the Kirby–Bauer disc diffusion method. Results were analyzed using SPSS version 21. Results: One hundred and nineteen cases were confirmed enteric fever. Their clinical profile is discussed. Out of 119 cases, 24 showed blood culture positivity. Salmonella Paratyphi A and Salmonella Typhi were isolated in the ratio of 3:1. The isolates were sensitive to ampicillin, co-trimoxazole, ceftriaxone, and azithromycin. Ceftriaxone was the most commonly used antibiotic for treatment. All patients recovered, and no mortality was encountered. Complications were seen in 33 children (27.7%), which included subclinical hepatitis, bronchitis, and pneumonia. Conclusion: Considering the blood culture results, enteric fever due to S. Paratyphi A was more common in our study. Multidrug resistance was not seen among Salmonella species. The duration of illness and complications were more with typhoid than paratyphoid cases.","PeriodicalId":15490,"journal":{"name":"Journal of Clinical Sciences","volume":null,"pages":null},"PeriodicalIF":0.2000,"publicationDate":"2020-07-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":"2","resultStr":null,"platform":"Semanticscholar","paperid":null,"PeriodicalName":"Journal of Clinical Sciences","FirstCategoryId":"1085","ListUrlMain":"https://doi.org/10.4103/jcls.jcls_17_20","RegionNum":0,"RegionCategory":null,"ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"","PubModel":"","JCR":"Q4","JCRName":"MEDICINE, GENERAL & INTERNAL","Score":null,"Total":0}
引用次数: 2
Abstract
Introduction: Enteric fever, which is endemic in India, is a significant cause for morbidity, particularly among young children. Enteric fever is associated with high fever, abdominal pain, diarrhea, and splenomegaly. Recently, there have been increasing reports of enteric fever due to Salmonella enterica serovar Paratyphi A and multidrug resistance among Salmonella species. Objectives: The objective of this study was to know the relative occurrence of Salmonella Typhi and Salmonella Paratyphi A from blood cultures of enteric fever cases, to study the sensitivity pattern of Salmonella species isolated, to compare the clinical profiles in typhoid and paratyphoid fever, and to know their treatment outcome. Materials and Methods: It was a prospective hospital-based cross-sectional study. The demographic, clinical, and laboratory data were recorded for all cases included in the study. All clinically suspected cases of enteric fever were confirmed by blood culture and/or the Widal test. Antibiotic sensitivity was tested by the Kirby–Bauer disc diffusion method. Results were analyzed using SPSS version 21. Results: One hundred and nineteen cases were confirmed enteric fever. Their clinical profile is discussed. Out of 119 cases, 24 showed blood culture positivity. Salmonella Paratyphi A and Salmonella Typhi were isolated in the ratio of 3:1. The isolates were sensitive to ampicillin, co-trimoxazole, ceftriaxone, and azithromycin. Ceftriaxone was the most commonly used antibiotic for treatment. All patients recovered, and no mortality was encountered. Complications were seen in 33 children (27.7%), which included subclinical hepatitis, bronchitis, and pneumonia. Conclusion: Considering the blood culture results, enteric fever due to S. Paratyphi A was more common in our study. Multidrug resistance was not seen among Salmonella species. The duration of illness and complications were more with typhoid than paratyphoid cases.
导言:肠热病是印度的一种地方病,是发病的重要原因,特别是在幼儿中。肠热伴有高热、腹痛、腹泻和脾肿大。最近,有越来越多的报告,由于肠炎沙门氏菌血清型副伤寒和多种沙门氏菌耐药引起的肠热。目的:了解伤寒和副伤寒沙门氏菌在肠热患者血培养中的相对发生率,研究分离沙门氏菌的敏感性,比较伤寒和副伤寒的临床特点,了解其治疗效果。材料和方法:这是一项前瞻性的以医院为基础的横断面研究。记录研究中所有病例的人口学、临床和实验室数据。所有临床疑似肠热病例均经血培养和/或维达尔试验证实。采用Kirby-Bauer圆盘扩散法检测抗生素敏感性。使用SPSS version 21对结果进行分析。结果:确诊肠热119例。讨论了他们的临床表现。119例中,24例血培养阳性。甲型副伤寒沙门菌和伤寒沙门菌的分离比例为3:1。该菌株对氨苄西林、复方新诺明、头孢曲松和阿奇霉素敏感。头孢曲松是最常用的抗生素。所有患者均康复,无死亡病例。并发症33例(27.7%),包括亚临床肝炎、支气管炎和肺炎。结论:从血培养结果来看,副伤寒沙门氏菌引起的肠热在本研究中更为常见。沙门氏菌未见多药耐药。伤寒病例的病程和并发症多于副伤寒病例。