Changing trends in antibiograms and clinical profile of salmonella enterica in pediatric population

摘要

Background and aims: Enteric fever is a major public health problem in tropical countries including India. There have been reports of changing antibiogram and age wise incidence. Hence this retrospective study was undertaken to find out its prevalence, antibiogram and clinical profile in our hospital setting.Methods: Case records of children in the age group of 0-18 years with positive blood culture for S. enterica serovar Typhi and serovar Paratyphi A strains, between November 2008 to December 2012 were analyzed.Results: A total of 532 cases of culture positive enteric fever were studied. There were 406 S. enterica serovar Typhi (76.3%) and 126 serovar Paratyphi A strains (23.7%). All strains were susceptible to third generation cephalosporins. One case of azithromycin resistance was documented. Widal titers were done for 158 patients of which 59.5% were negative.7% of the cases were below 2 years of age.Conclusions: Resistance to nalidixic acid has been increasing. Susceptibility to ampicillin, chloramphenicol and cotrimoxazole is high. Third generation cephalosporins continue to remain susceptible. Thus local antibiograms will improve patient care. Widal titers are not a sensitive parameter and emphasize the need for blood culture. In view of a high prevalence of typhoid and paratyphoid fever in children, it may be advisable to implement vaccination at an early age and also develop a bivalent vaccine.