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Multidrug-resistant typhoid fever
Insights
This study on Salmonella typhi in children found high resistance to common antibiotics. Ciprofloxacin and ceftriaxone were effective against multidrug-resistant typhoid, leading to faster recovery and fewer complications.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Typhoid fever, caused by Salmonella Typhi, remains a significant pediatric health concern globally.
- Emerging antibiotic resistance poses a therapeutic challenge in managing typhoid fever.
Purpose of the Study:
- To investigate the clinical profile and complications of Salmonella Typhi infections in children.
- To evaluate antibiotic susceptibility patterns and treatment outcomes in pediatric typhoid fever.
Main Methods:
- A prospective study of 100 children with confirmed Salmonella Typhi bacteremia.
- Clinical data collection, Widal testing, antibiotic susceptibility testing, and complication monitoring were performed.
Main Results:
- Fever, vomiting, and abdominal pain were the most common clinical features.
- High resistance rates (80%) were observed for amoxicillin, chloramphenicol, and co-trimoxazole.
- Ciprofloxacin and ceftriaxone demonstrated excellent sensitivity.
- Complications, including encephalopathy and gastrointestinal bleeding, were more frequent with multidrug-resistant strains.
- Ciprofloxacin and ceftriaxone led to the shortest defervescence times.
Conclusions:
- Multidrug-resistant Salmonella Typhi is prevalent in pediatric cases.
- Ciprofloxacin and ceftriaxone are effective treatment options for pediatric typhoid fever.
- Prompt and appropriate antibiotic selection is crucial for managing complications and improving outcomes.
Abstract:
One hundred children (consecutive) with positive blood culture for Salmonella typhi were studied for clinical profile and complications. The common clinical features were fever (100%), vomiting (58%), abdominal pain (48%), cough (22%) and loose stools (14%) and the Widal test was positive in 75% patients. Eighty per cent of the salmonella isolates were resistant to amoxycillin, chloramphenicol and co-trimoxazole drugs, but all were sensitive to ciprofloxacin and ceftriaxone. Forty patients developed complications: encephalopathy (18), melaena (12), haematemesis (10), epistaxis (4), hepatitis (4), acalculous cholecystitis (4), bowel perforation (3) and nephritis (2). Complications were more frequent in children with multidrug-resistant typhoid. The final antibiotic required to render the children afebrile included ciprofloxacin (80), ceftriaxone, amoxycillin (4), chloramphenicol (4), amoxycillin and gentamicin (4), amoxycillin with chloramphenicol (2), and furazolidone (2). The defervesence time was least with ceftriaxone and greatest with amoxycillin. All the affected children made a complete recovery.