Extensive Drug Resistant Typhoid in Pediatric Age Group

Abstract

Abstract:
Objectives: To determine the frequency of extensive drug resistant (XDR) Typhoid in pediatric age group in Peads unit IV Bolan Medical Complex Hospital Quetta.
Materials and Methods: This study was conducted in the Department of Pediatrics Unit-II Bolan medical college hospital Quetta. Detailed history and physical examination of children with suspected enteric fever was carried out. Using aseptic measures 3-5 ml of venous blood was collected into BactecPeds Plus culture bottles before initiation of therapy. Antimicrobial susceptibility testing was performed. Isolates resistant to ciprofloxacin, co-trimoxazole, chloramphenicol, ampicillin and ceftriaxone were deemed as extensively drug resistant positive. Later, results were analyzed by senior resident which again were checked by consultant before putting the data onto Proforma. Afterwards, data analysis procedure was started as soon as required sample data was achieved. All the demographic details and study results were recorded on a predesigned data collection proforma.
Results: A total of 137 patients with mean length of hospital stay of 7.51+2.01 days were enrolled. Out of total 79 (58%) were males and 58 (42%) were female. The frequency of blood culture positive to Samonela Typhi in our study was found to be 66%. Moreover, the overall patients found with extensively dug resistance were 35 % out of 137. There was significant relationship found between blood culture positivity and extensive drug resistance. Out of 91 positive blood cultures, 48 were extensive drug resistance respectively.
Conclusion: The occurrence of XDR typhoid infection secondary to antimicrobial resistance has also put a huge impact on our population. Azithromycin is a convenient choice based on cost of therapy and availability in oral form. However, there is a remarkable response observed on treatment with Meropenem along with Azithromycin in XDR typhoid fever. Typhoid conjugate vaccine (TCV) vaccination can significantly decrease the burden of typhoid and may also impact antimicrobial resistance.