Emerging Trends of Resistance of Typhoid Fever in Paediatric Population: A Hospital Based Study

Abstract

OBJECTIVE: To evaluate the current trends of typhoid fever resistance in the local community. METHODOLOGY: This descriptive cross-sectional study, conducted at UMDC/ Creek General Hospital from February to August 2019. Patients of Korangi and Landhi included. A total of 68 patients included, diagnosed clinically and positive blood cultures. The data was analyzed on SPSS 20.0. RESULTS: The average age of patients in this study was 5.16±3.449 years and weight of about 15.88±7.77 Kg. M:F ratio was approximately 1:1. Outpatient admissions were 49(72.1%) and emergency admissions were 19 (27.9%). The duration of symptoms was about 10.91±5.092 days. Out of these 68 patients, 57 (83.8%) had a history of medication for the same disease. The most common co-morbid was un-boiled water intake (66%), followed by malaria (12%). The most common clinical presentations were persistent fever (100%), anorexia (83.8%) and abdominal pain (80.9%). Blood culture and sensitivity showed that MDR/XDR is present in 60 (88.2%) patients. Sensitivity to first-line drugs was found in 1/10th of the study population while sensitivity to Meropenem and Azithromycin was approximately 90%. The complication occurred only in 2 patients (2.9%). Almost all patients recovered and there is no recurrence of symptoms in any of the patients following treatment with fever clearance time of 5.26±1.32 days only. CONCLUSION: This study revealed extensive drug resistance strains of Salmonella typhi in the studied population. This study reported increased use of unhealthy drinking water intake and prior medication which is one of the causes of this emerging resistance.

Keywords

• typhoid fever
• enteric fever
• resistance