Abstract :
Aims: The disease burden of enteric fever has increased due to overwhelming resistance of Salmonella. The objectives of this study were to assess different clinico-epidemiological factors and biochemical profiles of blood-culture positive cases as well as to detect the antibiogram for its treatment.
Materials & Methods: Based on inclusion and exclusion criteria, 50 children of age 1-12 years out of 239 screened were culture positive and constituted the study group. Across-sectional observational study was conducted for a period of one year. A detailed clinical examination, blood culture and antibiogram were performed. The total duration of treatment with antibiotics was two weeks. The clinical course was monitored and the period of defervescence noted in the study subjects.
Results: School-going children (56%) were mainly affected though incidence is increasing in under-5 age group (24%). The pattern of fever was predominantly continuous (48%) and high grade. Prior exposure to antibiotics was statistically significantly (p=0.03) in the cases < 5 years. S. typhi was 92% and 89.5% sensitive to Azithromycin and Cefixime while in S. paratyphi the sensitivity was 91.7% and 100% respectively. Occurrence of S. paratyphi Ainfection and early defervescence was statistically significant (p=0.03).
Conclusion: Lower socioeconomic status was responsible for higher incidence rate. Widal test with moderate sensitivity and specificity is still a useful diagnostic tool. It was re-established that Ceftriaxone, Cefixime and Azithromycin were the most effective anti-salmonella agents.Re-emergence of chloramphenicol susceptibility and resistance to ciprofloxacin was observed, thereby emphasizing rational drug use in enteric fever
Keyword :
enteric fever, anti-salmonella agents, antibiogram, Kirby-Bauer Disc Diffusion technique, Widal test