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Age-related clinical and microbiological characteristics of enteric fever in India

Mandeep Walia1, Rajni Gaind, Premila Paul

  • 1Department of Pediatrics, V.M. Medical College and Safdarjang Hospital, New Delhi 110052, India.

Transactions of the Royal Society of Tropical Medicine and Hygiene
|June 13, 2006
PubMed

Insights

This study on enteric fever found that Salmonella serotypes and complications vary by age, with younger children experiencing more issues. Understanding these age-related differences is key for effective public health strategies.

Area of Science:

  • Infectious Diseases
  • Epidemiology
  • Microbiology

Background:

  • Enteric fever, caused by Salmonella serotypes Typhi and Paratyphi, remains a significant public health concern, particularly in endemic regions.
  • Age is a critical factor influencing disease epidemiology and clinical presentation, necessitating age-specific analysis.

Purpose of the Study:

  • To investigate age-related epidemiological, clinical, and microbiological characteristics of enteric fever.
  • To identify differences in Salmonella serotype prevalence, clinical manifestations, and antimicrobial resistance across various age groups.

Main Methods:

  • A retrospective hospital-based study of 750 blood-culture-proven enteric fever cases.
  • Data collection spanned from January 1999 to December 2003 at Safdarjang Hospital, India.
  • Analysis included age distribution, Salmonella serotype isolation, clinical features, complications, and antimicrobial resistance patterns.

Main Results:

  • Enteric fever predominantly affected children aged 5-12 years, with 24.8% of cases in those under 5 years.
  • Salmonella serotypes exhibited age-related predilection; paratyphoid fever was more common in adults.
  • Hepatomegaly, anemia, and complications were more frequent in children under 5.
  • Multidrug resistance was observed in Salmonella enterica serotype Typhi but not in S. Paratyphi A; nalidixic acid resistance was comparable.

Conclusions:

  • Age-related variations in serotype isolation, clinical presentation, and complications are significant for enteric fever management.
  • Public health strategies for enteric fever control in endemic areas should consider these age-specific patterns.
  • Further epidemiological research is needed to understand the reasons behind differential serotype patterns by age.

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