Clinical Profile, Laboratory Findings, Antimicrobial Resistance and Antibiotic Usage in Children with Culture Positive Enteric Fever

2020 ◽  
Author(s):  
Pradeep Kumar Sharma ◽  
Nikhil Vinayak ◽  
Girraj K. Aggarwal ◽  
R. D. Srivastava ◽  
Pradeep Kumar Aggarwal
Keyword(s):  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Antibiotic Usage ◽  
Clinical Profile ◽  
Laboratory Findings ◽  
Culture Positive

scholarly journals Clinical Profile and Sensitivity Pattern of Salmonella Serotypes in Children: A Hospital Based Study

2011 ◽  
Vol 31 (3) ◽  
pp. 180-183 ◽  
Author(s):  
BG Joshi ◽  
K Keyal ◽  
R Pandey ◽  
BM Shrestha
Keyword(s):  
Salmonella Enterica ◽  
Enteric Fever ◽  
Wide Spectrum ◽  
Clinical Profile ◽  
Age Group ◽  
Cross Sectional ◽  
Female Ratio ◽  
Sensitivity Pattern ◽  
Study Results ◽  
Culture Positive

Introduction: Enteric fever is a systemic infection caused by the bacteria, Salmonella enterica serovar Typhi (S.typhi) and Salmonella enterica serovara Paratyphi (S. paratyphi A, B and C). Most of the burden of the disease is limited to the developing world and the disease still has the issues like wide spectrum of clinical presentation and multidrug resistance. Objectives: This study was done to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive enteric fever. Methods: A prospective cross-sectional study was conducted in Civil Service Hospital from February 2010 to January 2011 in the paediatric population in the age group of 2 to 14 years. Children with Salmonella species isolated in blood culture were included in the study. Results: Out of the 40 children with culture positive enteric fever, male to female ratio was 1.3:1 with common age group between 11-14 years. S typhi was isolated in 25 cases while S. paratyphi in 15 cases. Clinical features of S. typhi and S. paratyphi were indistinguishable. Both S.typhi and S. paratyphi were found to be 100% sensitive to drugs like Ceftriaxone, Cefotaxime, Cefixime and Chloramphenicol. Sensitivity to Ofloxacin was 100% in S. paratyphi and 92% in S.typhi. Similarly sensitivity of Azithromycin was 92% and 93% for S.typhi and S. paratyphi respectively. Conclusion: Salmonella serotype is still 100 % sensitive to third generation cephalosporin. Some percentage of resistance is seen with Ofloxacin in S. typhi and with Azithromycin in both S.typhi and S. paratyphi. Key words: Enteric fever; S.typhi; S.paratyphi; Sensitivity DOI: http://dx.doi.org/10.3126/jnps.v31i3.4382 J Nep Paedtr Soc 2011;31(3): 180-183

scholarly journals Clinical profile of culture proven enteric fever in children at university teaching hospital, Nepal

2015 ◽  
Vol 1 (2) ◽  
pp. 42-45
Author(s):  
Ganesh Shah ◽  
Amrit Ghimire ◽  
Shrijana Shrestha
Keyword(s):  
Abdominal Pain ◽  
Enteric Fever ◽  
Clinical Signs ◽  
Antibiotic Sensitivity ◽  
Response To Therapy ◽  
Clinical Profile ◽  
University Teaching ◽  
Cross Sectional ◽  
Sensitivity Pattern ◽  
Culture Positive

Introductions: Enteric fever is one of the major public health issues in Nepal. The present study was designed to analyze the clinical profile and antibiotic sensitivity pattern in the cases of culture positive typhoid fever.Methods: This was a cross sectional study done by reviewing the hospital record files of children admitted in paediatric ward of Patan Hospital with culture positive enteric fever over a period of seven years from January 2007 to December 2013. The mode of presentation, sensitivity pattern of isolates from blood culture, response to therapy and the complications were recorded and analyzed.Results: There were total of 119 culture positive enteric fever admitted to children ward during this period, 64 (53.7%) males and 55 (46.3%) females. Common symptoms were fever (100%), vomiting 37 (31.09%), diarrhea 27 (22.68%), abdominal pain 31 (26%) cough 24 (20%), and constipation six (5%). Common clinical signs were hepatomegaly 41 (34.4%), splenomegaly 25 (21%), and chest signs 10 (8.4%). Sensitivity to ceftriaxone was 96.6% in this study. Ninety four percent of salmonella typhi in 2013 were resistant to quinolones.Conclusions: Fever, vomiting, abdominal pain, diarrhea and cough were major manifestations and encephalopathy was common complication of enteric fever in this study. Resistance to many of the drugs are emerging. An appropriate antibiotic has to be initiated only after culture sensitivity in typhoid fever.Journal of Patan Academy of Health Sciences. 2014 Dec;1(2):42-45

scholarly journals Antimicrobial Resistance in Typhoidal Salmonella in Nepal: Surveillance for Enteric Fever, 2016-2019

2021 ◽  
Vol 19 (1) ◽  
pp. 162-169
Author(s):  
Rajeev Shrestha ◽  
Navin Adhikari ◽  
Sailesh Pradhan ◽  
Ritu Amatya ◽  
Basudha Shrestha ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Current Trend ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Asian Countries ◽  
First Line ◽  
The Status ◽  
Culture Positive

Background: Enteric fever (caused by Salmonella enterica) has been associated with poor hygiene and is endemic in the South-Asian countries. The increase in resistance to first line antimicrobials has been observed, while the emergence of multi/extremely drug resistance cases have been identified in several countries. The objective of this study is to analyze the current trend of antimicrobial resistance in Salmonella isolates in Nepal, and to identify the status of multi- and extremely- drug resistant isolates.Methods: We recruited individuals at study hospitals with suspected enteric fever between September 2016 and August 2019 and performed blood cultures. The Salmonella isolates were tested for antimicrobial susceptibility and the antimicrobial resistance trend was evaluated.Results: 1438 positive blood culture isolates were studied for antimicrobial resistance. 88% were culture positive for Salmonella Typhi and 12% for Salmonella Paratyphi. Multidrug resistant S. Typhi cases appeared mostly in December 2018 and January 2019, while there were no multidrug resistant S. Paratyphi cases. Also, extremely drug resistant S. Typhi cases were not observed during the study period. Conclusions: The Salmonella isolates were mostly susceptible to first-line antimicrobials, cephalosporins and others. Many fluoroquinolones non-susceptible Salmonella were obtained, nevertheless their overall trend seems to be declining. In addition, the S. Paratyphi total cases are reducing since September 2017. Among S. Typhi isolates, only few were multidrug resistant and there were no extremely drug resistant isolates. Keywords: Antimicrobial resistance; enteric fever; multi-drug resistant; Nepal; Salmonella; typhoid

ANTIMICROBIAL SUSCEPTIBILITY IN CULTURE POSITIVE ENTERIC FEVER

2019 ◽  
Vol 3 (7) ◽  
Author(s):  
Dr. Manish Kulshrestha ◽  
Dr. Anjali Kulshrestha
Keyword(s):  
Bone Marrow ◽  
Blood Culture ◽  
Nalidixic Acid ◽  
Antimicrobial Susceptibility ◽  
Salmonella Enterica ◽  
Enteric Fever ◽  
Multidrug Resistant ◽  
Bone Marrow Culture ◽  
Diffusion Method ◽  
Culture Positive

INTRODUCTION: Enteric fever includes typhoid and paratyphoid fever. Peak incidence is seen in children 5–15 years of age; but in regions where the disease is highly endemic, as in India, children younger than 5 years of age may have the highest infection rates. There are about 22 million new typhoid cases occur each year. Young children in poor, resource limited areas, who make up the majority of the new cases and there is a mortality figures of 215,000 deaths annually. A sharp decline in the rates of complications and mortality due to typhoid fever is observed as a result of introduction of effective antibiotic therapy since 1950s. MDR-ST became endemic in many areas of Asia, including India soon after multidrug-resistant strains of Salmonella enterica serotype typhi (MDR-ST) that were resistant to all the three first-line drugs then in use, namely chloramphenicol, amoxycillin and co-trimoxazole emerged in early 1990s. MATERIAL AND METHODS: Only blood culture or bone marrow culture positive cases were included. The patients with culture isolated enteric fever were included in the study. Antimicrobial susceptibility testing was carried out by disk diffusion method using antibiotic discs. The analysis of the antimicrobial susceptibility was carried out as per CLSI interpretative guidelines. RESULTS: A total of 82 culture positive cases were included in the present study. 80 culture isolates were from blood culture and 2 from the bone marrow culture. Salmonella entericasubspecies enterica serovartyphi (S typhi) was isolated from 67 (81.70%) patients while Salmonella enterica subspecies entericaserovarparatyphi (S paratyphi A) was isolated from 13 (15.85%) cases and 2 (2.44%) were Salmonella enterica subspecies entericaserovarschottmuelleri (S paratyphi B). Of the 82 cases 65(79.3%) isolates were resistant to ciprofloxacin, 17 (20.7%) were resistant to nalidixic acid, one (1.2%) case each was resistant to Cefotaxime and ceftriaxone, 2 (2.4%) were resistant to chloramphenicol, 10 (12.2%) were resistant and to cotrimoxazole 3 (3.7%) were resistant. CONCLUSION: In a culture positive cases 65(79.3%) isolates were resistant to ciprofloxacin and 17 (20.7%) were resistant to nalidixic acid. Multidrug resistant isolates were 65(79.3%).

Pharyngeal gonorrhoea in men who have sex with men

2021 ◽  
pp. 095646242097562
Author(s):  
Daniel Richardson ◽  
Alice Pickering ◽  
Daniel Trotman ◽  
Kayleigh Nichols ◽  
Zoe Buss ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Sore Throat ◽  
Routine Screening ◽  
Transmission Dynamics ◽  
Hiv Status ◽  
Sex With Men ◽  
Culture Positive

Pharyngeal gonorrhoea is important in the transmission dynamics of gonorrhoea, and generation of antimicrobial resistance and the performing of culture remains vital. We reviewed the notes of men who have sex with men (MSM) presenting to our clinic with a positive pharyngeal NAAT for gonorrhoea between January and December 2019. There were 383 cases of NAAT-positive pharyngeal gonorrhoea, and 28 (7%, 95% CI = 5.11–10.36) reported sore throat at presentation. Pharyngeal cultures were taken from 270/383 (70%), and 73/270 (27%) were culture positive with available antimicrobial sensitivities. Overall, the presence of pharyngeal symptoms was not associated with pharyngeal chlamydia (OR = 1.6, CI = 0.19–13.32, p = 0.7), HIV status (OR = 1.1, CI = 0.47–2.57, p = 0.8), positive cultures (OR = 1.9, CI = 0.78–4.62, p = 0.2) or age ( p = 0.3). Routine screening of MSM for pharyngeal gonorrhoea is important to maintain surveillance and measures need to be taken to improve pharyngeal culture sampling from MSM.

scholarly journals Is Antimicrobial Resistance Pattern of Enteric Fever Changing in Kathmandu Valley?

2013 ◽  
Vol 32 (3) ◽  
pp. 221-228
Author(s):  
Ganesh Kumar Rai ◽  
Subhana Karki ◽  
Bina Prajapati
Keyword(s):  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Resistance Pattern ◽  
Kathmandu Valley ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern

Introduction: Enteric fever is a public health problem in developing countries including Nepal. Antimicrobial sensitivity pattern of Salmonella sp causing enteric fever is changing over time and also differs according to geographical location. Periodic surveillance of antimicrobial resistance of Salmonella sp is mandatory for management of enteric fever rationally. The objective of this study was to analyze the resistance pattern of Salmonella sp to commonly used antimicrobials. Materials and Methods: This was a retrospective study undertaken reviewing the records of blood isolates of Salmonella sp over one year period at Kanti Children’s Hospital, Nepal. Antimicrobial sensitivity testing was done following Kirby Bauer’s disk diffusion technique using Muller Hinton agar. Results: Salmonella typhi was found to be 100% resistance to ampicillin and resistance to nalidixic acid and ciprofloxacin was also high. The resistance to chloramphenicol and ofloxacin was low. No resistance was found to amoxicillin, ceftriaxone, cefotaxime and amikacin. However, among the sensitive isolates of Salmonella typhi intermediate sensitivity to ceftriaxone and ceftazidime was reported to be high. Among the isolates of S paratyphi A, the resistance to nalidixic acid was 100% followed by 75% to ciprofloxacin. No resistance was found to chloramphenicol, ceftriaxone, cefixime, amikacin and low resistance to amoxicillin and ofloxacin. Among the sensitive isolates of S paratyphi A, majority of them were only moderately sensitive to cefotaxime and ceftazidime and about 1/3 of the organisms had only intermediate sensitivity to ceftriaxone. Conclusiion: Commonly used parenteral third generation cephalosporins, first line drugs like chloramphenicol and amoxicillin and ofloxacin among fluoroquinolones were found to be effective in vitro in treating enteric fever. However, Salmonella typhi was found to be highly resistant to the most frequently used drugs like ciprofloxacin and cefixime and Salmonella paratyphi A to ciprofloxacin. A comparative chart of antimicrobial sensitivity of enteric fever in children over 10 year period from different hospitals of Kathmandu valley is also presented in the study. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6625 J. Nepal Paediatr. SocVol.32(3) 2012 221-228

scholarly journals Clinical Profile and Outcome of COVID-19 in Children at a Tertiary Hospital, Dhaka

2021 ◽  
Vol 39 (3) ◽  
pp. 154-159
Author(s):  
Mahbuba Sultana ◽  
Sayla Chowdhury ◽  
Abdullah Al Amin
Keyword(s):  
Prospective Observational Study ◽  
Laboratory Finding ◽  
Armed Forces ◽  
Paediatric Population ◽  
Tertiary Hospital ◽  
High Serum ◽  
Clinical Profile ◽  
Military Hospital ◽  
Laboratory Findings ◽  
Structured Questionnaire

Background: Since the first detection on 8th March 2020 in Bangladesh, the number of cases is rising alarmingly. The paediatric population is also getting infected in Bangladesh. So far there is no study of COVID in children in this country. Aim: This study reports on clinical profile, laboratory findings and outcomes of COVID-19 children admitted to Combined Military Hospital (CMH), Dhaka. Materials and Methods: In this prospective observational study, RT-PCR confirmed fifty COVID-19 patients aged below twelve years were included. Relevant investigations were done in the Armed Forces Institute of Pathology (AFIP). Data were collected from patients and/or their attendants by a structured questionnaire. Results: Mean age was 59.96±43.24 months, 48% were male and 52% were female. Predominant symptoms were fever (44%), cough (26%), anosmia (26%) and diarrhea (12%). There was neutropenia in 66% and lymphocytosis in 84% of cases. Mean neutrophil and lymphocyte counts were 38±13% and 52.5±13%, respectively. Significantly raised CRP observed in 14% and high serum procalcitonin was in10% of cases. Serum LDH, D-Dimer and ferritin were raised in 80%,34% and 6% of affected children, respectively. The majority (98%) of the children were improved and discharged from the hospital. One child died in this cohort. Conclusion: Fever and cough were the predominant symptoms of COVID-19 affected children in this study. Lymphocytosis and neutropenia were two important laboratory finding. Death in COVID-19 is also not uncommon. J Bangladesh Coll Phys Surg 2021; 39(3): 154-159

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