PROFILE OF CULTURE POSITIVE ENTERIC FEVER IN CHILDREN ADMITTED IN A TERTIARY CARE HOSPITAL
Journal Title: Journal of Evolution of Medical and Dental Sciences - Year 2017, Vol 6, Issue 88
Abstract
BACKGROUND According to literature, there are only few studies and also only one Indian prospective study from South India available on culture positive enteric fever, hence this study was undertaken to provide a data about entire profile of culture positive enteric fever in children from South India, particularly Puducherry. The aims of this study are to assessa) Proportion of culture positive enteric fever cases among children aged 6 months to 18 years, admitted with fever of ≥ 3 days in a tertiary care hospital, b) Their clinical and laboratory profile, c) Culture sensitivity pattern, d) Response to antibiotics, e) Complications. MATERIALS AND METHODS This was a prospective observational study done between June 2016 and May 2017 at SLIMS, Puducherry. Total study population was 51. They were included in the study after getting informed consent and the following data were collected: a) Age, sex and socioeconomic details; b) Symptoms; c) Signs; d) Laboratory parameters; e) Antibiotic sensitivity pattern; f) Treatment and clinical outcomes. All the data were statistically analysed by using SPSS software. RESULTS In our study, 58.82% were < 5 years. The predominant symptoms seen are high grade fever in 51 (100%), vomiting in 27 (52.94%), anorexia in 22 (43.14%) and diarrhoea in 20 (39.22%). The predominant signs seen are isolated hepatomegaly in 34 (66.66%), hepatosplenomegaly in 11 (21.57%) and coated tongue in 10 (19.61%). Majority of the population had normal total counts, high CRP and elevated SGOT and SGPT. Salmonella typhi was the major isolate in Blood Culture and Sensitivity and all strains were sensitive to ceftriaxone. Overall, Mean (SD) time for defervescence of fever was 3.86 (± 2.12) days and Mean (SD) hospital stay duration was 6.84 (± 2.09) days. Only one complication (consolidation) and no death were seen in our study. CONCLUSION Enteric fever should be suspected when there is high CRP, normal WBC and Platelet counts in a child with ≥ 3 days fever with isolated hepatomegaly/ hepatosplenomegaly. Blood culture is the gold standard diagnostic test. Antibiotic sensitivity pattern showed re-emergence of strains with high sensitivity to first line antibiotics like Ampicillin, Chloramphenicol and Cotrimoxazole. Nalidixic acid resistance was observed in all isolates. All the cultures were sensitive to Ceftriaxone and it was used as first line intravenous antibiotic for enteric fever with good outcome.
Authors and Affiliations
Mullainathan Sucindar, Seshanganur Sitaraman Kumaran
Keywords
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- EP ID EP277889
- DOI 10.14260/jemds/2017/1328
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