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CC BY-NC-ND 4.0 · Journal of Gastrointestinal Infections 2023; 13(02): 074-078
DOI: 10.1055/s-0043-1774409
Original Article

Profile of Enteric Fever in Children Admitted to a Tertiary Care Center in North India

Disha Joshi
1   Department of Paediatrics, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
,
Veenu Gupta
2   Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
,
Deepak Bhat
1   Department of Paediatrics, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
,
Menal Gupta 
2   Department of Microbiology, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
,
Gurdeep Singh Dhooria
1   Department of Paediatrics, Dayanand Medical College & Hospital, Ludhiana, Punjab, India
› Author Affiliations Funding None.
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Abstract

Background Enteric fever is a community-acquired systemic infection which is more common in resource-limited overcrowded communities with poor access to sanitation and its management is compounded by the increasing antimicrobial resistance to the first-line antibiotics used.

Materials and Methods This descriptive study reports the clinical profile of children with enteric fever managed at the departments of pediatrics and microbiology of a tertiary care hospital from February 2020 to August 2021. All inpatients who were confirmed (blood culture positive) or probable cases (clinical and serological evidence by Widal test) of enteric fever were included. Profile of all cases and antibiotic sensitivity pattern in culture positive cases were studied.

Results Of the 70 cases enrolled, 40% were females and 60% males, and majority (52.9%) was in the age group of > 5 years. At admission, fever was the most common presentation along with abdominal symptoms. Widal test was positive in 84.6% cases and was found to be 80% sensitive when compared to the gold-standard blood culture. Both Salmonella Typhi (74.3%) and S. Paratyphi (12.9%) isolates were 100% sensitive to azithromycin, cotrimoxazole, and ceftriaxone. Quinolones and second-generation cephalosporin cefuroxime showed high resistance in comparison. None of the isolates was multidrug resistant. All cases were discharged after successful treatment.

Conclusion The burden of disease and antibiotic susceptibility of enteric fever needs to be monitored to guide clinicians in selection of antibiotics.

Keywords

enteric fever - children - Salmonella - blood culture

Ethical Clearance

This article has been approved by institutional ethical committee(IEC).


Author's Contribution

All authors contributed equally to the article.


Data Availability Statement

There is no data associated with this work.




Publication History

Received: 15 May 2023

Accepted: 21 July 2023

Article published online:
12 October 2023

© 2023. Gastroinstestinal Infection Society of India. This is an open access article published by Thieme under the terms of the Creative Commons Attribution-NonDerivative-NonCommercial License, permitting copying and reproduction so long as the original work is given appropriate credit. Contents may not be used for commercial purposes, or adapted, remixed, transformed or built upon. (https://creativecommons.org/licenses/by-nc-nd/4.0/)

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  • References

  • 1 John J, Van Aart CJ, Grassly NC. The burden of typhoid and paratyphoid in India: systematic review and meta-analysis. PLoS Negl Trop Dis 2016; 10 (04) e0004616
    CrossrefPubMedGoogle Scholar
  • 2 Crump JA, Luby SP, Mintz ED. The global burden of typhoid fever. Bull World Health Organ 2004; 82 (05) 346-353
    PubMedGoogle Scholar
  • 3 Buckle GC, Walker CL, Black RE. Typhoid fever and paratyphoid fever: systematic review to estimate global morbidity and mortality for 2010. J Glob Health 2012; 2: 010401
    CrossrefPubMedGoogle Scholar
  • 4 Rabasa A, Mava Y, Pius S, Timothy SY, Baba UA. Typhoid fever in children: clinical presentation and risk factors. Niger J Paediatr 2013; 40: 60-63
    Google Scholar
  • 5 Azmatullah A, Qamar FN, Thaver D, Zaidi AK, Bhutta ZA. Systematic review of the global epidemiology, clinical and laboratory profile of enteric fever. J Glob Health 2015; 5 (02) 020407
    CrossrefPubMedGoogle Scholar
  • 6 Kumar S, Rizvi M, Berry N. Rising prevalence of enteric fever due to multidrug-resistant Salmonella: an epidemiological study. J Med Microbiol 2008; 57 (Pt 10): 1247-1250
    CrossrefPubMedGoogle Scholar
  • 7 John J, Bavdekar A, Rongsen-Chandola T, Dutta S, Kang G. NSSEFI Collaborators. Estimating the incidence of enteric fever in children in India: a multi-site, active fever surveillance of pediatric cohorts. BMC Public Health 2018; 18 (01) 594
    CrossrefPubMedGoogle Scholar
  • 8 Winn WC. Guidelines for the Collection, Transport, processing, Analysis, and Reporting of Cultures from Specific Specimens Sources. Koneman's Color Atlas and Textbook of Diagnostic Microbiology. 6th ed.. Philadelphia: Lippincot Williams & Wilkins; 2006: 67-110
    Google Scholar
  • 9 Sinha B, Rongsen-Chandola T, Goyal N. et al; SEFI tier 1 collaborators. Incidence of enteric fever in a pediatric cohort in North India: comparison with estimates from 20 years earlier. J Infect Dis 2021; 224 (Suppl. 05) S558-S567
    CrossrefPubMedGoogle Scholar
  • 10 Saigal K, Ghosh A, Deepika D. et al. Varied presentations of enteric fever in pediatric population: North India. Bacterial infections. Int J Infect Dis 2021; 101 (S1): 120-158
    Google Scholar
  • 11 Wani JN, Bhat AS, Yusuf S, Qureshi UA. Clinical spectrum of enteric fever in children admitted to a tertiary care hospital. Int J Contemp Pediatrics 2020; 7 (07) 1530-1533
    CrossrefGoogle Scholar
  • 12 Nusrat N, Islam MR, Paul N. et al. Clinical and laboratory features of enteric fever in children and antibiotic sensitivity pattern in a tertiary care hospital of a low- and middle-income country. Cureus 2022; 14 (10) e30784
    PubMedGoogle Scholar
  • 13 Bharati S, Pal M, Bharati P. Prevalence of anemia among 6- to 59-month-old children in India: the latest picture through the NFHS-4. J Biosoc Sci 2020; 52 (01) 97-107
    CrossrefPubMedGoogle Scholar
  • 14 Maheshwari V, Kaore NM, Ramnani VK, Sarda S. A comparative evaluation of different diagnostic modalities in the diagnosis of typhoid fever using a composite reference standard: a tertiary hospital based study in central India. J Clin Diagn Res 2016; 10 (10) DC01-DC04
    PubMedGoogle Scholar
  • 15 Malini A, Barathy C, Madhusudan NS, Johnson C. Clinical and microbiological profile of enteric fever among pediatric patients in a tertiary care center in South India: a cross-sectional study. J Clin Sci 2020; 17: 74-79
    CrossrefGoogle Scholar
  • 16 Sharma P, Dahiya S, Manral N. et al. Changing trends of culture-positive typhoid fever and antimicrobial susceptibility in a tertiary care North Indian Hospital over the last decade. Indian J Med Microbiol 2018; 36 (01) 70-76
    CrossrefPubMedGoogle Scholar
  • 17 Behera JR, Rup AR, Dash AK, Sahu SK, Gaurav A, Gupta A. Clinical and laboratory profile of enteric fever in children from a tertiary care centre in Odisha, Eastern India. Cureus 2021; 13 (01) e12826
    PubMedGoogle Scholar
  • 18 McAteer J, Derado G, Hughes M. et al. Typhoid fever in the US pediatric population, 1999–2015: opportunities for improvement. Clin Infect Dis 2021; 73 (11) e4581-e4589
    CrossrefPubMedGoogle Scholar
  • 19 Siddiqui FJ, Rabbani F, Hasan R, Nizami SQ, Bhutta ZA. Typhoid fever in children: some epidemiological considerations from Karachi, Pakistan. Int J Infect Dis 2006; 10 (03) 215-222
    CrossrefPubMedGoogle Scholar
  • 20 Dahiya S, Malik R, Sharma P. et al. Current antibiotic use in the treatment of enteric fever in children. Indian J Med Res 2019; 149 (02) 263-269
    CrossrefPubMedGoogle Scholar