Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care Hospital of a Low- and Middle-Income Country

Nadia Nusrat; Md Rafiqul Islam; Nibedita Paul; Neshwa Rahman; Ambigga Krishnapillai; Md Ahsanul Haq; Mainul Haque

doi:10.7759/cureus.30784

Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care Hospital of a Low- and Middle-Income Country

Cureus. 2022 Oct 27;14(10):e30784. doi: 10.7759/cureus.30784. eCollection 2022 Oct.

Authors

Nadia Nusrat¹, Md Rafiqul Islam¹, Nibedita Paul¹, Neshwa Rahman¹, Ambigga Krishnapillai², Md Ahsanul Haq³, Mainul Haque⁴

Affiliations

¹ Pediatrics, Delta Medical College & Hospital, Dhaka, BGD.
² Primary Care Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, MYS.
³ Biostatistics, International Centre for Diarrhoeal Disease Research, Bangladesh (ICDDR, B), Dhaka, BGD.
⁴ Pharmacology and Therapeutics, National Defence University of Malaysia, Kuala Lumpur, MYS.

Abstract

Background: Globally, enteric fever (EF) significantly gives rise to an appalling death toll. It is an endemic illness in Bangladesh and South Asia. The condition manifests in a wide range of clinical features in children. Nowadays, antibiotic resistance is an international stumbling block that hampers the appropriate treatment and outcome of EF.

Objective: The study evaluated the clinical and laboratory characteristics and antibiotic sensitivity pattern of Salmonella enterica in children.

Methods: This prospective research was conducted at Delta Medical College and Hospital, Dhaka, Bangladesh, from January 2017 to December 2019. A total of 200 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for Salmonella with suggestive clinical features.

Results: All the patients had a fever, and most had coated tongue, vomiting, abdominal pain, organomegaly, and diarrhea. Among the selected 200 cases of EF, 43.5% were Salmonella typhi culture-positive. A high erythrocyte sedimentation rate (ESR) was observed in a substantial number (53%) of patients. Ceftriaxone was the most sensitive (100%) antibiotic through laboratory analysis, followed by cefotaxime (95.1%). Among the oral antibiotics used, cefixime (92.8%) was the most sensitive.

Conclusion: EF in children can present with varied clinical manifestations. Selective antibiotic treatment according to sensitivity patterns is crucial for effective illness management and will reduce morbidity and mortality in the pediatric population.

Keywords: antimicrobial sensitivity; bangladesh; blood culture; developing countries; form; laboratory aspects; paediatric; symptoms and signs; teaching hospital; typhoid fever.