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Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever

Received: 13 February 2021     Accepted: 26 February 2021     Published: 1 April 2021
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Abstract

Background and objective: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the tertiary care hospitals in Dhaka. Materials & Methods: This was a cross sectional study conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and SSMCH – Sir Salimullah Medical College & Hospital (SSMCH), Dhaka, Bangladesh for a period of one year from July 2015 to June 2016. A total number of 100 children with enteric fever were studied and diagnose were based on clinical features, Wedel test and blood culture. Results: Out of 100 diagnosed enteric fever children, 60 (60%) were male and 40 (40%) were female. Fever was present in all patients. Other most common manifestation are loss of appetite, vomiting, diarrhea, headache and constipation. Coated tongue was the predominant examination finding followed by hepatomegaly, splenomegaly and abdominal tenderness. Sensitivity to ceftriaxone was 100% in our study while resistance to nalidixic acid was 90%. MDR S.typhi is still a threat but there was re-emergence of sensitivity to Cotrimoxazole and Chloramphenicol. Conclusion: The study concluded that clinical pattern of typhoid fever conforms well to that of known pattern of the disease in children. Blood culture profile shows widespread emergence of nalidixic acid related resistant strains and the sporadic occurrence of cephalosporin resistant strains of S. Typhi. However, the first line antibiotics such as chloramphenicol and cotrimoxazole still have a role to play in the treatment of typhoid due to re-emergence of sensitivity.

Published in American Journal of Pediatrics (Volume 7, Issue 2)
DOI 10.11648/j.ajp.20210702.11
Page(s) 44-48
Creative Commons

This is an Open Access article, distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution and reproduction in any medium or format, provided the original work is properly cited.

Copyright

Copyright © The Author(s), 2021. Published by Science Publishing Group

Keywords

Typhoid Fever, Antimicrobial, Sensitivity, Isolated, Salmonella Typhi, Pediatrics, Cotrimoxazole

References
[1] Chand HJ, Rijal KR, Neupane B, Sharma VK, Jha B 2014, ‘Re-emergence of susceptibility to conventional first line drugs in Salmonella isolates from enteric fever patients in Nepal’. J Infect Dev Ctries; vol. 8, pp. 1483-1487.
[2] Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA 2006, Typhoid fever in children: Some epidemiological considerations from Karachi, Pakistan. International J Infectious Diseases; vol. 10, pp. 215-22. (Kothari, 2008 and Cho, 19)
[3] Bhan MK, Bahl R, Bhatnagar S 2005, ‘Typhoid and paratyphoid fever’. Lancet; vol. 366, pp. 749-762.
[4] Arora D, Singh R, Kaur M, Ahi RS 2010, ‘A changing pattern in antimicrobial susceptibility of Salmonella enterica serotype isolated in north India’. Afr J Microbiol Re; vol. 4, pp. 197-203.
[5] Muthu G, Suresh A, Sumathy G, Srivani R 2011, ‘Studies on antimicrobial susceptibility pattern of Salmonella isolates from Chennai, India’. Int J Pharma Bio Sci; vol. 2, pp. 435-442.
[6] World Health Organization 2003. ‘Background document: the diagnosis, treatment and prevention of typhoid fever’. Geneva: WHO 2003.
[7] 1m F, Sayeed MA, Choudhury FK, Sheikh A, Ahmed D, Goswami D, et al., 2015, Typhoid Fever in Young Children in Bangladesh: Clinical Findings, Antibiotic Susceptibility Pattern and Immune Responses. PLoS Negl Trop Dis; vol. 9, pp. 3619.
[8] Kumar S, Rizvit M, and Berry N. 2008, Rising prevalence of enteric fever due to multidrug resistant salmonella: an epidemiological study. J. Of medical microbiology; vol. 57, pp. 1247-50.
[9] Abdullah FE, Haider F, Fatima K, Irfan S, Iqbal MS 2012, Enteric Fever in Karachi: Current Antibiotic Susceptibility of Salmonellae Isolates. Journal of the College of Physicians and Surgeons Pakistan; vol. 22, pp. 147-150.
[10] Shah G, Ghimire A, Shrestha S 2014, Clinical profile of culture proven enteric fever in children at university teaching hospital, Nepal. Journal of Patan Academy of Health Sciences; vol. 1, pp. 42-45.
[11] Alam ABMS, Zaman S, Chaiti F, Sheikh N, Kundu GK 2010, A Reappraisal of Clinical Characteristics of Typhoid Fever. Bang J Child Health; vol. 34, pp. 80-85.
[12] Chowdhury MAJ, Shumy F, Anam, AM, Chowdhury, MK 2014, Current status of typhoid fever: a review. Bangladesh Med J; vol. 43, pp. 106-111.
[13] Chiou SC, Lauderdale TL, Phung DC et al, 2014 ‘Antimicrobial Resistance in Salmonella enteric Serovar Typhi Isolates from Bangladesh, Indonesia, Taiwan, and Vietnam.’ Antimicrobial Agents and Chemotherapy; vol. 58, no. 11, pp. 6501-6507.
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  • APA Style

    Sk. Mohammad Ali Rashed, Murshida Akhter, Md. Ruhul Amin, Mahbub Mutanabbi, Choudhury Ali Kawser. (2021). Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever. American Journal of Pediatrics, 7(2), 44-48. https://doi.org/10.11648/j.ajp.20210702.11

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    ACS Style

    Sk. Mohammad Ali Rashed; Murshida Akhter; Md. Ruhul Amin; Mahbub Mutanabbi; Choudhury Ali Kawser. Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever. Am. J. Pediatr. 2021, 7(2), 44-48. doi: 10.11648/j.ajp.20210702.11

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    AMA Style

    Sk. Mohammad Ali Rashed, Murshida Akhter, Md. Ruhul Amin, Mahbub Mutanabbi, Choudhury Ali Kawser. Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever. Am J Pediatr. 2021;7(2):44-48. doi: 10.11648/j.ajp.20210702.11

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  • @article{10.11648/j.ajp.20210702.11,
      author = {Sk. Mohammad Ali Rashed and Murshida Akhter and Md. Ruhul Amin and Mahbub Mutanabbi and Choudhury Ali Kawser},
      title = {Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever},
      journal = {American Journal of Pediatrics},
      volume = {7},
      number = {2},
      pages = {44-48},
      doi = {10.11648/j.ajp.20210702.11},
      url = {https://doi.org/10.11648/j.ajp.20210702.11},
      eprint = {https://article.sciencepublishinggroup.com/pdf/10.11648.j.ajp.20210702.11},
      abstract = {Background and objective: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the tertiary care hospitals in Dhaka. Materials & Methods: This was a cross sectional study conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and SSMCH – Sir Salimullah Medical College & Hospital (SSMCH), Dhaka, Bangladesh for a period of one year from July 2015 to June 2016. A total number of 100 children with enteric fever were studied and diagnose were based on clinical features, Wedel test and blood culture. Results: Out of 100 diagnosed enteric fever children, 60 (60%) were male and 40 (40%) were female. Fever was present in all patients. Other most common manifestation are loss of appetite, vomiting, diarrhea, headache and constipation. Coated tongue was the predominant examination finding followed by hepatomegaly, splenomegaly and abdominal tenderness. Sensitivity to ceftriaxone was 100% in our study while resistance to nalidixic acid was 90%. MDR S.typhi is still a threat but there was re-emergence of sensitivity to Cotrimoxazole and Chloramphenicol. Conclusion: The study concluded that clinical pattern of typhoid fever conforms well to that of known pattern of the disease in children. Blood culture profile shows widespread emergence of nalidixic acid related resistant strains and the sporadic occurrence of cephalosporin resistant strains of S. Typhi. However, the first line antibiotics such as chloramphenicol and cotrimoxazole still have a role to play in the treatment of typhoid due to re-emergence of sensitivity.},
     year = {2021}
    }
    

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  • TY  - JOUR
    T1  - Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever
    AU  - Sk. Mohammad Ali Rashed
    AU  - Murshida Akhter
    AU  - Md. Ruhul Amin
    AU  - Mahbub Mutanabbi
    AU  - Choudhury Ali Kawser
    Y1  - 2021/04/01
    PY  - 2021
    N1  - https://doi.org/10.11648/j.ajp.20210702.11
    DO  - 10.11648/j.ajp.20210702.11
    T2  - American Journal of Pediatrics
    JF  - American Journal of Pediatrics
    JO  - American Journal of Pediatrics
    SP  - 44
    EP  - 48
    PB  - Science Publishing Group
    SN  - 2472-0909
    UR  - https://doi.org/10.11648/j.ajp.20210702.11
    AB  - Background and objective: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the tertiary care hospitals in Dhaka. Materials & Methods: This was a cross sectional study conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and SSMCH – Sir Salimullah Medical College & Hospital (SSMCH), Dhaka, Bangladesh for a period of one year from July 2015 to June 2016. A total number of 100 children with enteric fever were studied and diagnose were based on clinical features, Wedel test and blood culture. Results: Out of 100 diagnosed enteric fever children, 60 (60%) were male and 40 (40%) were female. Fever was present in all patients. Other most common manifestation are loss of appetite, vomiting, diarrhea, headache and constipation. Coated tongue was the predominant examination finding followed by hepatomegaly, splenomegaly and abdominal tenderness. Sensitivity to ceftriaxone was 100% in our study while resistance to nalidixic acid was 90%. MDR S.typhi is still a threat but there was re-emergence of sensitivity to Cotrimoxazole and Chloramphenicol. Conclusion: The study concluded that clinical pattern of typhoid fever conforms well to that of known pattern of the disease in children. Blood culture profile shows widespread emergence of nalidixic acid related resistant strains and the sporadic occurrence of cephalosporin resistant strains of S. Typhi. However, the first line antibiotics such as chloramphenicol and cotrimoxazole still have a role to play in the treatment of typhoid due to re-emergence of sensitivity.
    VL  - 7
    IS  - 2
    ER  - 

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Author Information
  • Department of Pediatrics, Upazila Health Complex, Charghat, Rajshahi, Bangladesh

  • Sir Salimullah Medical College & Mitford Hospital, Dhaka, Bangladesh

  • Department of Pediatrics, Rajshahi Medical College Hospital, Rajshahi, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

  • Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka, Bangladesh

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