jsmc-10137

CHARACTERISTIC FEATURES OF CULTURE POSITIVE ENTERIC FEVER IN PEDIATRIC TEACHING HOSPITAL IN SULAIMANI GOVERNORATE

Tara H Tyib a and Haydar Fakhir a

a Department of Pediatics, College of Medicine, University of Sulaimani.

Submitted: 7/8/ 2016; accepted: 19/3/2017; Published 21/12/2017

DOI Link: https://doi.org/10.17656/jsmc.10137

ABSTRACT

Background

Typhoid fever is still common disease in our country, and at the present time we are facing resistant cases to usual antibiotics.

Objectives

This study has been carried out to identify the clinical and laboratory characteristics of these microorganisms.

Materials and Methods

This is a prospective study done from October 2008 to October 2009, in Sulaimani Pediatric Teaching hospital. Blood cultures were taken from patients suspected of having Typhoid fever ,only patients with positive cultures were included in this study. Data regarding age, sex, residency, clinical presentation, duration of fever at presentation, response to treatment and antibiotic susceptibility were all analyzed by SPSS version 16.0.

Results

Ninety six patients whom with culture proved cases of Enteric fever, 55 males and 41 females. The age of the patients were from 1 month -14 years with an average of 6.8 years. The duration of fever before attendance to medical care was (2-19) days with a mean of 7 days. Mean days needed for subsidence of fever was 5 days ranging from 2-10 days. Mean duration of admission was about 8.5 days, while mean duration of treatment was 14 days. Headache was the most common symptom (67.7%) followed by abdominal pain in 56.6%, diarrhea in 31.2%, While the symptoms least encountered were confusion 5.2% and constipation 1%. Splenomeagly was the commonest sign (56.2%) followed by hepatomegaly (35.4%) and neck stiffness was positive in (3.1%)of the patients whom had normal CSF examination. The mean WBC count was 5.378 109/l, with 61% of the patients having neutrophilia and 20.7% having lymphocytosis and 18.3% having equal distribution. Most of the isolates were sensitive to amikacin 87%, followed by doxycycline 85.7%, ciprofloxacin 81.5%, azithromycin 60%. Cefotaxime and ceftriaxone had sensitivities of about 52-54%, while there was 75% resistance to chloramphenicol and nearly 99% resistance to ampicillin. All cases were culture positive; 99% for Salmonella typhi and only 1% grew Salmonella para typhi A and B. The incidence of complications was about 10.4%,GIT bleeding being the most common 4.2% followed by renal failure and hepatitis 2% and ataxia 1.1%. Mortality rate was (1.1%).

Conclusion

Typhoid fever has different presentations according to the locality and also may change its presentation in form of outbreaks in a specific locality. The disease was multidrug resistant, this may be due to previous misuse of antibiotics.

KEYWORDS

Typhoid fever, Enteric fever, Culture positive, Salmonella.

References

1. Buhutta Z. Salmonella. In: Nelson Textbook of Pediatrics. Behrman RE ,Kleigman RM. 18th edition . WB Saunders , Philadelphia, 2011:1182-1192.

2. Ashcroft MT .Typhoid and paratyphoid fever in tropic .J Trop Med Hyg. 1999:67:185 -189.

3. Baver F.K., Bower AG. Typhoid fever of short duration. AmJ Med sd. 1996:22174-178.

4. Peter Ball . Typhoid fever .In : Color guide of infectious diseases. Peter ball,James A.Gray, 2nd edition. London, Churchill Livingstone, 1998:69-71.

5. Sheibani B, Kadhim M, Al Rekabi S. Azithromycin: Is it a favorable alternative therapeutic option against salmonella species ?QMJ 2007; 3: 21-27.

6. Al Bahhash F, AbdulZahraa S, Al Kufi M.Clinical and laboratory studies of hospitalized children with typhoid fever in Al Najaf. Al Qadisia Medical Journal 2006;1:63-72.

7. Malik A , Malik R, ,Zaidi J,et al.Typhoid Fever in Malaysian Children. Medical Journal of Malaysia 2001;56:478-490.

8. Mahmoud N. AL-Khushali, Azhar N. Al-Khafaji Z, et al. Al.Typhoid and paratyphoid fever in children in Kadhimiya Hospital.Iraqi J. Comm. Med 2007 ;20(2):337-341.

9. Jawad K, AL-Khafaji T, Hadi F, et al .Prevalence of Typhoid Fever among Pediatric Patients at AL-Musaib District.Medical Journal of Babylon 2006 Volume 3 No. 1-2:75-80.

10. Al-Khushali M. Typhoid & paratyphoid fevers in Salahaldin Governorate.Tikrit Medical Journal 2008; 14(2):107- 111.

11. Shanan H .Survey about Typhoid fever in Refaaye sector, Thiqar.Journal of Thi-QarUniversity ,March 2008 ;3(4):2-8.

12. Mohammad S M , Sherko A O, Bakir R R, et al. Enteric Fever in Sulaimani Pediatric Teaching Hospital: Risk factors, Presentation and Drug Susceptibility. Journal of Sulaimani Medical College 2014:4 (1); 55-61.

13. Alshok M, Alamidi B.Typhoid Fever Complications in Babylon.Medical Journal Of Babylon 2004:1(2);149-154.

14. Mweu E, Mike E. Typhoid fever in children in Africa.Tropical Medicine and International Health2008:13( 4):532-540.

15. Alshaibani R.Ceftriaxone Therapy Vs. Ciprofloxacin In Treatment Of Typhoid Fever In Adult Patients.Qadisia Medical Journal 2009:5(8);44-49.

16. Yaramis A, Yildirim I, Katar S . Clinical and Laboratory Presentation of Typhoid Fever.International Pediatrics 4/2001: 16(4);227-231.

17. Dina A. Al-Roubaeay A, Al-Ani A, et al.Value of Widal Test in Diagnosis of Typhoid Fever.Iraqi J. Comm. Med., JAN. 2008 21 (1);13-17.

18. Krishna S, Balakrishna S, Sumathi S, et al. A Comparative Study Of Typhoid Fever And Widal Test In The Diagnosis Of Typhoid Fever.Journal of Evolution of Medical and Dental Sciences 2013:Volume 2/ Issue 21/ May 27 2013;3720-3725.

19. Shanthi J , Usha R, Balagurunathan R .A brief study of diagnosis and frequency of typhoid fever incidence by Widal test.Annals of Biological Research, 2012, 3 (4):1847-1851.

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