Clinical profile and outcome in enteric fever

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.