Abstract

CLINICAL PROFILE AND ANTIBIOTIC SENSITIVITY PATTERN OF TYPHOID FEVER IN PATIENTS ADMITTED TO PEDIATRIC WARD IN A RURAL TEACHING HOSPITAL

Introduction: Typhoid is a major endemic health problem among children in India. The last two decades have witnessed the emergence and spread of multidrug resistance against conventional anti typhoid drugs (Ampicillin, chloramphenicol and trimethoprim – sulfamethoxazole) especially in the South and South-East Asia. Materials and Methods: Children under twelve years of age with signs and symptoms suggestive of enteric fever were included in this study. Blood cultures were carried by collecting aseptically 5ml of blood and inoculating into bile broth and subcultured onto blood agar and Mac Conkey agar. Antimicrobial sensitivity performed according to CLSI guidelines. Widal test was performed. Other investigations like haemoglobin, total count and differential count of WBC, ESR were carried out. Results: The incidence of enteric fever in this study was 3%. The maximum children were in age group more than 5 years. Maximum cases were admitted during June-September. The most common symptoms were fever, anorexia, vomiting, and pain abdomen. The culture positivity of Salmonella typhi (S.typhi) was 35.4%. The overall positivity of Widal test was 89.8%. Multidrug resistant isolates in this study was 53.6%. Conclusion: Majority of the children were greater than 8 years old. Fever (intermittent type), anorexia, vomiting were the three major symptoms. Among the signs spleenomegaly, hepatomegaly, coated tongue and toxemia were common. Relative bradycardia was not seen. Widal test was found positive in the majority of cases. Blood cultures were positive mainly in the first week of illness. The sensitivity pattern of S.typhi revealed significant proportion of multidrug resistant strains and simultaneous presence of chloramphenicol sensitive and resistant strains in the study.

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