Amar Jeet Chitkara1, Shweta Chitkara2, Parvinder Singh Narang3, Meera Sundharam3, Madhu Goyal3. 1. Department of Pediatrics, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India. Correspondence to: Dr AJ Chitkara, Director, Pediatrics, Max Superspeciality Hospital, Shalimar Bagh, Delhi 110 088, India. drajchitkara@gmail.com. 2. Department of Microbiology, Lady Hardinge Medical College, New Delhi, India. 3. Department of Pediatrics, Max Superspeciality Hospital, Shalimar Bagh, New Delhi, India.
Abstract
OBJECTIVE: To describe the demographic, clinical, laboratory and bacteriological profile of children with diagnosis of typhoid fever over a six-year period. METHODS: Case record analysis of hospitalized children (≤5 y) with culture positive typhoid fever. RESULTS: Blood culture was positive in 100 (61%) of 166 suspected cases, with 78 isolates of Salmonella Typhi and 22 Salmonella Paratyphi A. Only 12 children were aged below two years. Hepatomegaly (32), splenomegaly (44), eosinopenia (42), positive widal (15, 21.1%) and positive Typhidot IgM (18, 28.1%) were not consistently observed. High susceptibility to Ampicillin, Chloramphenicol, Cotrimoxazole (87, 89, and 94, isolates, respectively), 100% susceptibility to third generation cephalosporins and Azithromycin, and high resistance to Nalidixic Acid [(S. Typhi 48 (61.5%)], S. Paratyphi A 16 (72.7%)) were observed. CONCLUSIONS: We observed a high isolation rate of salmonella in blood culture, despite prior use of antibiotics. Most salmonella isolates were susceptible in vitro to standard drugs, except nalidixic acid.
OBJECTIVE: To describe the demographic, clinical, laboratory and bacteriological profile of children with diagnosis of typhoid fever over a six-year period. METHODS: Case record analysis of hospitalized children (≤5 y) with culture positive typhoid fever. RESULTS: Blood culture was positive in 100 (61%) of 166 suspected cases, with 78 isolates of Salmonella Typhi and 22 Salmonella Paratyphi A. Only 12 children were aged below two years. Hepatomegaly (32), splenomegaly (44), eosinopenia (42), positive widal (15, 21.1%) and positive Typhidot IgM (18, 28.1%) were not consistently observed. High susceptibility to Ampicillin, Chloramphenicol, Cotrimoxazole (87, 89, and 94, isolates, respectively), 100% susceptibility to third generation cephalosporins and Azithromycin, and high resistance to Nalidixic Acid [(S. Typhi 48 (61.5%)], S. Paratyphi A 16 (72.7%)) were observed. CONCLUSIONS: We observed a high isolation rate of salmonella in blood culture, despite prior use of antibiotics. Most salmonella isolates were susceptible in vitro to standard drugs, except nalidixic acid.