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Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care
Nadia Nusrat1, Md Rafiqul Islam1, Nibedita Paul1
1Pediatrics, Delta Medical College & Hospital, Dhaka, BGD.
Insights
Enteric fever (EF) in children presents with diverse symptoms. Ceftriaxone and cefixime show high sensitivity, guiding effective antibiotic treatment to reduce pediatric morbidity and mortality.
Area of Science:
- Pediatric Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Enteric fever (EF) causes significant mortality globally, particularly in South Asia.
- Pediatric EF presents with a wide spectrum of clinical features.
- Antibiotic resistance poses a major challenge in managing EF.
Purpose of the Study:
- To evaluate the clinical and laboratory characteristics of pediatric EF.
- To determine the antibiotic sensitivity patterns of *Salmonella enterica* in children.
Main Methods:
- Prospective study of 200 pediatric EF cases in Dhaka, Bangladesh (Jan 2017-Dec 2019).
- Inclusion criteria: culture-positive or elevated Widal titer with suggestive clinical signs.
- Clinical and laboratory data, including antibiotic sensitivity, were analyzed.
Main Results:
- Fever was universal; common symptoms included coated tongue, vomiting, abdominal pain, organomegaly, and diarrhea.
- *Salmonella typhi* was culture-positive in 43.5% of cases.
- High erythrocyte sedimentation rate (ESR) observed in 53% of patients. Ceftriaxone (100%) and cefotaxime (95.1%) showed highest sensitivity; oral cefixime (92.8%) was most sensitive.
Conclusions:
- Pediatric EF exhibits varied clinical presentations.
- Tailoring antibiotic treatment based on sensitivity patterns is vital.
- Effective management can reduce pediatric morbidity and mortality from EF.
Background:
Globally, enteric fever (EF) significantly gives rise to an appalling death toll. It is an endemic illness in Bangladesh and South Asia. The condition manifests in a wide range of clinical features in children. Nowadays, antibiotic resistance is an international stumbling block that hampers the appropriate treatment and outcome of EF.
Objective:
The study evaluated the clinical and laboratory characteristics and antibiotic sensitivity pattern of Salmonella enterica in children.
Methods:
This prospective research was conducted at Delta Medical College and Hospital, Dhaka, Bangladesh, from January 2017 to December 2019. A total of 200 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for Salmonella with suggestive clinical features.
Results:
All the patients had a fever, and most had coated tongue, vomiting, abdominal pain, organomegaly, and diarrhea. Among the selected 200 cases of EF, 43.5% were Salmonella typhi culture-positive. A high erythrocyte sedimentation rate (ESR) was observed in a substantial number (53%) of patients. Ceftriaxone was the most sensitive (100%) antibiotic through laboratory analysis, followed by cefotaxime (95.1%). Among the oral antibiotics used, cefixime (92.8%) was the most sensitive.
Conclusion:
EF in children can present with varied clinical manifestations. Selective antibiotic treatment according to sensitivity patterns is crucial for effective illness management and will reduce morbidity and mortality in the pediatric population.
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