enteric fever: in era of antibiotic resistance. a retrospective study

Abstract

Objective

 To study clinical, laboratory features, culture and sensitivities of uncomplicated enteric fever in children and their response to the treatment.

Study design   Retrospective study

Place & duration of study Pediatrics department of Railway General Hospital, Rawalpindi from March 2019 to February 2020

Material & methods

 108 children from 1 to 13 years with clinically suspected enteric fever were included in the study. Data was collected in terms of clinical features, blood culture & sensitivities and treatment responses on a study Performa and analyzed on SPSS version 23.

Results

The average age was 6.4 years with 59.3% male & 40.7% females. The average temperature observed was 101.5° F with an average fever duration of 9.7 days. Predominant features were abdominal pain (28.7%), anorexia (22 %), vomiting (18.5%) & coated tongue (59.3%). 23 % had thrombocytopenia and 25.9% had leucopenia. CRP was positive in 49% of cases. The blood culture positivity rate was 57.4%. Out of culture-positive cases, 27.4% cases were XDR, 27.4% cases were sensitive only to carbapenem and 17.7% were MDR, the remaining were sensitive to all drugs. High resistance to ceftriaxone (52%), ciprofloxacin (75%) chloramphenicol (82.4%) and azithromycin (57.4%) was observed.

Conclusion

This study reveals emerging resistance to all the antibiotics presently used for the treatment of enteric fever which is alarming as we are heading towards a desperate era in which lethal infections will become incurable. So there is a need to make proper policies at the national as well as the global level to improve the preventive strategies and irrational use of antibiotics.