Sensitivity Patterns of Isolated Salmonella Typhi in Children with Typhoid Fever

Abstract

<i>Background and objective</i>: Enteric fever is a common febrile illness and one of te major health problem in Bangladesh. So the present study was conducted to determine the demographic characteristics, clinical profile, hematological feature and current sensitivity patterns of isolated S typhi in patients suffering from enteric fever in some of the tertiary care hospitals in Dhaka. <i>Materials & Methods</i>: This was a cross sectional study conducted in the Department of Pediatrics, Bangabandhu Sheikh Mujib Medical University (BSMMU), Dhaka Medical College Hospital (DMCH) and SSMCH – Sir Salimullah Medical College & Hospital (SSMCH), Dhaka, Bangladesh for a period of one year from July 2015 to June 2016. A total number of 100 children with enteric fever were studied and diagnose were based on clinical features, Wedel test and blood culture. <i>Results</i>: Out of 100 diagnosed enteric fever children, 60 (60%) were male and 40 (40%) were female. Fever was present in all patients. Other most common manifestation are loss of appetite, vomiting, diarrhea, headache and constipation. Coated tongue was the predominant examination finding followed by hepatomegaly, splenomegaly and abdominal tenderness. Sensitivity to ceftriaxone was 100% in our study while resistance to nalidixic acid was 90%. MDR S.typhi is still a threat but there was re-emergence of sensitivity to Cotrimoxazole and Chloramphenicol. <i>Conclusion</i>: The study concluded that clinical pattern of typhoid fever conforms well to that of known pattern of the disease in children. Blood culture profile shows widespread emergence of nalidixic acid related resistant strains and the sporadic occurrence of cephalosporin resistant strains of S. Typhi. However, the first line antibiotics such as chloramphenicol and cotrimoxazole still have a role to play in the treatment of typhoid due to re-emergence of sensitivity.