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Current pattern of enteric fever: a prospective clinical and microbiological study

Madhoolika Verma1, Yogesh Parashar, Anuradha Singh

  • 1Department of Paediatrics, Holy Family Hospital, New Delhi.

Journal of the Indian Medical Association
|April 4, 2008
PubMed

Insights

Enteric fever is common in young children, with Salmonella typhi being the primary cause. Current antibiotic sensitivity shows high efficacy for ceftriaxone, cefixime, and cefotaxime, with some older antibiotics regaining effectiveness.

Area of Science:

  • Pediatrics
  • Infectious Diseases
  • Microbiology

Background:

  • Enteric fever poses a significant health challenge, particularly in preschool-aged children.
  • Understanding the clinical presentation and causative agents is crucial for effective management.

Purpose of the Study:

  • To investigate the clinical characteristics of enteric fever in children under 18.
  • To determine the current antibiotic susceptibility patterns of Salmonella typhi and Salmonella paratyphi.

Main Methods:

  • A prospective study involving 145 blood culture-confirmed enteric fever cases in children.
  • Utilized the Bauer-Kirby agar disc diffusion method for in-vitro antibiotic sensitivity testing.

Main Results:

  • Enteric fever predominantly affected children aged 2-9 years (65%).
  • Salmonella typhi caused 92% of infections; Salmonella paratyphi A was responsible for 8% of cases.
  • High in-vitro sensitivity was observed for ceftriaxone (99%), cefixime (99%), and cefotaxime (99%).
  • Sensitivity to ampicillin (87%), amoxicillin (89%), and chloramphenicol (86%) is reappearing.
  • Nalidixic acid resistance was notably high at 88%.

Conclusions:

  • Enteric fever is a considerable issue in the preschool population.
  • Third-generation cephalosporins and certain older antibiotics demonstrate good efficacy against Salmonella species causing enteric fever.
  • High resistance to nalidixic acid necessitates careful antibiotic selection.

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