Clinical profile and outcome in enteric fever
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1Department of Pediatrics, Medical College, Rohtak, Haryana.
Abstract:
Sixty five blood culture positive cases of S. typhi were studied for clinical profile. A total of 64.6% were multidrug resistant and 35.4% were chloramphenicol sensitive. In patients with multidrug resistant S. typhi the age was higher (p < 0.01), and incidence of complications such as shock (35.7%), encephalopathy (42.9%), myocarditis (14.3%) and gastric hemorrhage (4.7%) were more frequent, compared to chloramphenicol sensitive group. Cases with multidrug resistant S. typhi (MDRST) were treated with oral ciprofloxacin; the period of defervescence of fever was significantly less (p < 0.05) compared to the chloramphenicol group. Our study suggests the use of ciprofloxacin in the treatment of MDRST without any side effects.
Insights
Multidrug-resistant Salmonella Typhi (MDRST) infections present with higher complication rates and older age. Oral ciprofloxacin effectively reduced fever duration in MDRST patients compared to chloramphenicol.
Area of Science:
- Infectious Diseases
- Microbiology
- Clinical Medicine
Background:
- Typhoid fever, caused by Salmonella Typhi (S. typhi), remains a significant global health concern.
- Increasing antimicrobial resistance, particularly multidrug resistance (MDR), complicates treatment strategies for typhoid fever.
- Understanding the clinical profile and treatment outcomes of MDR S. typhi is crucial for effective patient management.
Purpose of the Study:
- To investigate the clinical characteristics and treatment outcomes of patients with S. typhi bloodstream infections.
- To compare the incidence of complications between multidrug-resistant S. typhi (MDRST) and chloramphenicol-sensitive S. typhi.
- To evaluate the efficacy of oral ciprofloxacin in treating MDRST infections.
Main Methods:
- Retrospective analysis of 65 blood culture-positive S. typhi cases.
- Clinical data collection including patient demographics, symptoms, complications, and treatment regimens.
- Statistical comparison of clinical profiles and treatment outcomes between MDRST and chloramphenicol-sensitive groups.
Main Results:
- 64.6% of S. typhi isolates were multidrug-resistant.
- MDRST patients were older and experienced higher rates of shock, encephalopathy, myocarditis, and gastric hemorrhage.
- Treatment with oral ciprofloxacin resulted in a significantly shorter fever defervescence period compared to chloramphenicol.
Conclusions:
- Multidrug-resistant S. typhi is associated with increased patient age and a higher burden of severe complications.
- Oral ciprofloxacin demonstrates superior efficacy in reducing fever duration for MDRST infections.
- Ciprofloxacin is a safe and effective treatment option for multidrug-resistant typhoid fever.