Misbah Anjum, Shazia Soomro, Shazia Kulsoom, Safia Bibi, Sadaf Asim, Maira Riaz.
Clinical Spectrum, Laboratory Profile and Antibiotic Susceptibility Pattern of Children with Enteric Fever at a Tertiary Care Hospital of Karachi.
J Islamic Int Med Coll Jan ;16(1):4-9.

Objective: To describe the clinical, laboratory and antimicrobial susceptibility profile of enteric fever patients hospitalized at a tertiary care children hospital of Karachi. Study Design: Cross Sectional Study. Place and Duration of Study: The study was conducted in three medical units of National institute of child health (NICH) Karachi from September 01, 2018 till February 28, 2019. Materials and Methods: Patients of enteric fever diagnosed by positive blood culture for Salmonella enterica Serovar Typhi, hospitalized at National Institute of Child Health (NICH) Karachi were included. Clinical history and physical examination findings were recorded in Performa and routine laboratory tests and treatment was done according to hospital protocol. Outcome of patients was recorded in terms of alive or died. Data entry and analysis was done in SPSS 24.0. Descriptive statistics were applied for statistical analysis. Results: Total 76 patients with culture proven typhoid were enrolled in the study including 39(51.3%) males and 37(48.7%) females. Mean age of children was 5.7+ 2.81 years. Mean duration of fever in these patients was 19.04+8.39 days. Common symptoms were abdominal pain (64.5%), diarrhea (43.4%), vomiting (48.7%) and decreased appetite (67.1%). Antibiotic resistance profile showed 98.7% to chloramphenicol and trimethoprim-sulfamethoxazole, 96% resistance to ampicilline, 94.7% to cefixime and ceftriaxone, 82.2% to ciprofloxacin, 2.63% to azithromycine and no resistance to meropenam. All children were discharged with mean duration of hospital stay 8.296+3.33 days. Conclusion: There are high rates of resistance against commonly used antibiotics for the treatment of enteric fever, including fluoroquinolones and cephalosporins leaving only extremely limited and costly options for treatment and prolonged length of hospital stay due to need of intravenous therapy.

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