Retrospective Cohort Study of Typhoid Fever in Paediatric Patients at a Tertiary Care Hospital in Karachi

Autor: Durfishan Dilshad, Muniba Firoz, Hanif Kamal, Mehak Gul Khan, Sana Anwa, Shabeen Naz, Raheela Gulzar, Syeda Yusra Sohail
Jazyk: angličtina
Rok vydání: 2024
Předmět:
Zdroj: Liaquat National Journal of Primary Care, Vol 6, Iss 3, Pp 253-258 (2024)
Druh dokumentu: article
ISSN: 2707-3521
2708-9134
DOI: 10.37184/lnjpc.2707-3521.6.54
Popis: Background: Salmonella enterica serotype Typhi (S. typhi) is responsible for causing Typhoid fever which is estimated to cause tens of millions of cases worldwide. Pakistan is currently experiencing an outbreak of extensively drug-resistant (XDR) typhoid. Objective: To document the frequency and clinical features of XDR typhoid and determine the utility of our treatment approach with ceftriaxone in the face of expanding resistance to this drug and document sensitivity patterns of S. typhi against other antibiotics. Methods: This retrospective cross-sectional study was conducted at the Paediatric ward and Intensive Care Unit of Liaquat National Hospital for 1 year (September 2021 to August 2022). Children aged 1 to 12 years who were diagnosed with typhoid fever were included in the study. Infants (below 1 year), suspected cases of typhoid fever without positive cultures, and cases of typhoid fever presenting in the outpatient department were excluded. SPSS v26 was used for data analysis. An independent t-test was applied for mean comparison while a chi-square/fisher-exact test was applied to check the association. P≤0.05 was considered as significant in all cases. Results: 86 cases of typhoid fever were included in the study. Mean age of the cohort was 6.012 (±3.068) years, having 15 (17.4%) MDR typhoid and 71 (82.6%) XDR cases. Fever was a common feature in all patients. Leukopenia was observed in 25.6% of cases. None of the cases showed sensitivity to ciprofloxacin. All 71 XDR cases were sensitive to meropenem and azithromycin. A significant difference was observed in terms of loose motions (p=0.005), cough (p=0.01) and seizures (p=0.03) between both groups. Conclusion: As resistance against commonly used antibiotics is emerging; organisms may show susceptibility to less commonly used first-line drugs. Ceftriaxone no longer appears to be an effective drug in the majority of cases of typhoid fever, by increase in extensively drug-resistant typhoid. Carbapenems and azithromycin are better choices for these patients; however, these should be used judiciously in an evidence-based manner.
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