మెడికల్ మైక్రోబయాలజీ & డయాగ్నోసిస్

Trends of Socio-Demographic Determinants, Clinical Features and Drug Resistance Pattern among Cases of Enteric Fever in Western Uttar Pradesh, India

Abstract

Anees Akhtar, Adil Raza, Neha Kaushal and Indu Shukla

Introduction: Typhoid fever is a prolonged illness caused by Salmonella enterica subspecies enterica serotype Typhi, causing an estimated 16.6 million new infections and 600,000 deaths each year. Clinical manifestation of typhoid fever varies from uncomplicated high-grade fever to serious complications involving encephalopathy, peritonitis, perforation and hemorrhage. With development of resistance against commonly used antibiotics, quinolones and third generation cephalosporins are being used against multi drug resistant infections.
Aims and objective: We studied the changing trends of socio-demographic determinants, clinical features and drug resistance pattern among cases of Enteric fever in western Uttar Pradesh in India. so that it may prove helpful to the clinicians for the early diagnosis, management and finally reducing mortality in our region.
Materials and methods: The study was performed on all patients attending Pediatric and Medicine OPD or admitted in wards of Jawaharlal Nehru Medical College and Hospital (J.N.M.C.H), AMU, Aligarh, with clinical presentation suggestive of typhoid fever.
Results: Out of 104 clinically suspected patients 44 (42.30%) belonged to age-group 21-40 years and 55 (52.88%) were males. maximum number of patients belonged to socio-economic class V with 42 (40.38%) patients, majority of the cases were seen during April-June 46 (44.23%), most of the patients were educated up to preschool level consisting of 42 (40.38%). Fever was the most constant symptom in our series representing 104 (100%) patients, Headache was present in 92 (88.46%), abdominal pain in 83 (79.80%) patients, vomiting in 17 (16.34%), coated tongue 24 (23.07%), diarrhoea in 6 (5.77%), and constipation was seen in 8 (7.69%) patients in our study. All the cases 12 (100%) sensitive for the azithromycin, ceftriaxone and Cefoperazone-Salbactum, while 8 (66.67%) cases showed resistance to ampicillin, chloramphenicol, and co-trimoxazole. While cefexime, cefepime and ciprofloxacin were 10 (83.33%), 11 (91.66%), and 10 (83.33%) sensitive. While 2 (16.67%) cases were resistant to nalidixic acid i.e., NARST.
Conclusion: enteric fever is endemic in our country and a significant number of patients are dying each year and frequency of complications is also on rise so knowing the socio-demographic determinants , clinical features and drug resistance pattern among cases may prove useful for the early diagnosis, management and finally reducing mortality.