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Clinico-Bacteriological Profile of Typhoid Fever in a Private Sector Hospital in New Delhi

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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.

Conclusion

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.

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References

  1. Mogasale V, Maskery B, Ochiai RL, Lee JS, Mogasale VV, Ramani E, et al. Burden of typhoid fever in low-income and middle-income countries: A systematic literature-based update with risk-factor adjustment. Lancet Glob Health. 2014;2:e570–80.

    Article  Google Scholar 

  2. World Health Organization. Typhoid Vaccines: WHO Position Paper — March 2018. Weekly Epidemiological Record. 2018;13:153–72.

    Google Scholar 

  3. Meiring JE, Gibani M, Basnyat B, Bentsi-Enchill AD, Clemens J, Darton TC, et al. The Typhoid Vaccine Acceleration Consortium (TyVAC): Vaccine Effectiveness Study Designs: Accelerating the introduction of typhoid conjugate vaccines and reducing the global burden of enteric fever. Report from a Meeting held on 26–27 October 2016, Oxford, UK. Vaccine. 2017;35:5081–8.

    Article  Google Scholar 

  4. Ochiai RL, Acosta CJ, Danovaro-Holliday M, Baiqing D, Bhattacharya SK, Agtini MD, et al. A study of typhoid fever in five Asian countries: Disease burden and implications for controls. Bull World Health Organ. 2008;86:260–8.

    Article  Google Scholar 

  5. Feasey NA, Gaskell K, Wong V, Msefula C, Selemani G, Kumwenda S, et al. Rapid emergence of multidrug resistant, H58-lineage Salmonella typhi in Blantyre, Malawi. PLoS Negl Trop Dis. 2015;9:e0003748.

    Article  Google Scholar 

  6. Parry CM, Wijedoru L, Arjyal A, Baker S. The utility of diagnostic tests for enteric fever in endemic locations. Expert Rev Anti Infect Ther. 2011;9:711–25.

    Article  Google Scholar 

  7. Sanjeev H, Nayak S, Pai AKB, Rai R, Karnaker V, Ganesh HR. A systematic evaluation of Rapid Dot-EIA, blood culture and Widal test in the diagnosis of typhoid fever. Nitte University J Health Science. 2013;3:21–4.

    Google Scholar 

  8. Upadhyay R, Nadkar MY, Muruganathan A, Tiwaskar M, Amarapurkar D, Banka NH, et al. API Recommendations for the Management of Typhoid Fever. J Assoc Physicians India. 2015;63:77–96.

    PubMed  Google Scholar 

  9. Ray P, Sharma J, Marak RSK, Garg RK. Predictive efficacy of nalidixic acid resistance as a marker of fluoroquinolone resistance in Salmonella enterica var Typhi. Indian J Med Res. 2006;124:105–8.

    CAS  PubMed  Google Scholar 

  10. Nair S, Ashton P, Doumith M, Connell S, Painset A, Mwaigwisya S, et al. WGS for surveillance of antimicrobial resistance: A pilot study to detect the prevalence and mechanism of resistance to azithromycin in a UK population of non-typhoidal Salmonella. J Antimicrob Chemotherap. 2016;71:3400–8.

    Article  CAS  Google Scholar 

  11. Ganesh R, Janakiraman L, Vasanthi T, Sathiyasekeran, M. Profile of typhoid fever in children from a tertiary care hospital in Chennai-South India. Indian J Pediatr. 2010;77:1089–92.

    Article  Google Scholar 

  12. Wong VK, Baker S, Pickard DJ, Parkhill J, Page AJ, Feasey NA, et al. Phylogeographical analysis of the dominant multidrug-resistant H58 clade of Salmonella Typhi identifies inter-and intracontinental transmission events. Nature Genet. 2015;47:632.

    Article  CAS  Google Scholar 

  13. Kuijpers LM, Phe T, Veng CH, Lim K, Ieng S, Kham C, et al. The clinical and microbiological characteristics of enteric fever in Cambodia, 2008–2015. PLoS Negl Trop Dis. 2017;11:e0005964.

    Article  Google Scholar 

  14. Hendriksen RS, Leekitcharoenphon P, Lukjancenko O, Lukwesa-Musyani C, Tambatamba B, Mwaba J, et al. Genomic signature of multidrug-resistant Salmonella enterica serovar Typhi isolates related to a massive outbreak in Zambia between 2010 and 2012. J Clin Microbiol. 2015;53:262–72.

    Article  CAS  Google Scholar 

  15. Klemm EJ, Shakoor S, Page AJ, Qamar FN, Judge K, Saeed DK, et al. Emergence of an extensively drug-resistant Salmonella enterica serovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third generation cephalosporins. MBio. 2018; doi: https://doi.org/10.1128/mBio.00105-18 2018;9:e00105-18.

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Funding

Funding: None

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Authors and Affiliations

  1. Department of Pediatrics, Max Superspeciality Hospita, Shalimar Bagh, New Delhi, 110 088, India

    Amar Jeet Chitkara, Parvinder Singh Narang, Meera Sundharam & Madhu Goyal

  2. Department of Microbiology, Lady Hardinge Medical College, New Delhi, India

    Shweta Chitkara

Authors
  1. Amar Jeet Chitkara
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  2. Shweta Chitkara
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  3. Parvinder Singh Narang
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  4. Meera Sundharam
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  5. Madhu Goyal
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Contributions

Contributors: AJC: conceived this study; AJC, PSN, MS: contributed to the design of study; SC,MG: helped with data collection and management; AJC,SC: contributed to analysis and manuscript writing. All authors approved the manuscript before submission

Corresponding author

Correspondence to Amar Jeet Chitkara.

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Competing interest: None stated.

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Chitkara, A.J., Chitkara, S., Narang, P.S. et al. Clinico-Bacteriological Profile of Typhoid Fever in a Private Sector Hospital in New Delhi. Indian Pediatr 56, 1033–1036 (2019). https://doi.org/10.1007/s13312-019-1686-0

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  • DOI: https://doi.org/10.1007/s13312-019-1686-0

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