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Multi drug resistant Salmonella typhi infection: clinical profile and therapy
P B Koul1, M V Murali, P P Sharma
1Department of Pediatrics, University College of Medical Sciences, Delhi.
Abstract:
Multiple drug resistant Salmonella typhi infection was observed in thirty five recent cases among forty eight children with bacteriologically proven enteric fever. Incidence of complications such as shock, myocarditis, encephalopathy and paralytic ileus was higher among these. A combination of cephalexin and gentamicin was successfully used in the management of these children.
Insights
A study found that most children with enteric fever had multi-drug resistant Salmonella Typhi. These infections led to more complications, but a combination of cephalexin and gentamicin proved effective for treatment.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Enteric fever, caused by Salmonella Typhi, is a significant public health concern, particularly in pediatric populations.
- Emergence of multi-drug resistant strains of Salmonella Typhi poses a therapeutic challenge.
- Complications of enteric fever can be severe and life-threatening.
Purpose of the Study:
- To investigate the prevalence of multi-drug resistant Salmonella Typhi in children with enteric fever.
- To assess the incidence of complications associated with resistant strains.
- To evaluate the efficacy of a combination antibiotic regimen in managing these infections.
Main Methods:
- Retrospective analysis of 48 pediatric cases with bacteriologically confirmed enteric fever.
- Identification of Salmonella Typhi isolates and assessment of their antibiotic resistance patterns.
- Clinical data review for complications and treatment outcomes.
Main Results:
- Multi-drug resistant Salmonella Typhi was identified in 35 out of 48 (72.9%) pediatric cases.
- Higher incidence of severe complications including shock, myocarditis, encephalopathy, and paralytic ileus observed in children with resistant infections.
- Successful management achieved using a combination of cephalexin and gentamicin.
Conclusions:
- Multi-drug resistance in Salmonella Typhi is highly prevalent in pediatric enteric fever cases.
- Resistant strains are associated with increased risk of severe complications.
- Combination therapy with cephalexin and gentamicin offers a viable treatment option for drug-resistant Salmonella Typhi infections.