Paratyphoid fever- Emerging problem in South India

Ragini Bekur, K. E. Vandana, K. N. Shivashankara, Rohit Valsalan, Vishwanath Sathyanarayanan

Research output: Contribution to journalArticle

Abstract

Objective: To review the clinical profile and drug susceptibilities of Salmonella paratyphi A in a tertiary care hospital. Methods: Retrospective analyses of 113 patients with paratyphoid fever and 101 culture proven Salmonella paratyphi A infection were included in the study. The study extended over a period of 3 years (2006-2008). Diagnosis of patients were based on clinical features, serology and blood culture. The drug susceptibility testing of the isolates were performed by the disc diffusion method. Clinical presentation, laboratory parameters, susceptibility patterns of isolates, treatment and clinical response were studied. Results: Of the 113 cases, 77 (68.4%) were males and 36 were females (32.8%), which included 2 pediatric patients. Fever was the most common symptom (100.0%) followed by loose stools (37.2%), headache (35.4%), myalgia (31.9%), pain abdomen (29.2%), dry cough (19.5%) and vomiting (13.3%). All patients were clinically cured. Majority of the isolates (46%) were resistant to cotrimoxazole in 2006, however they became 100% sensitive in 2007 and 2008. whereas the strains became 100% sensitive to ampicillin and chloramphenicol only in 2008. In 2006 the sensitivity of organisms to ciprofloxacin was 89% but in 2007 and 2008 there has been an increasing resistance to ciprofloxacin (46% and 86%) respectively. Surprisingly 3 isolates (8.1%) were resistant to ceftriaxone in 2006, showed 100% sensitivity in 2008. Common drugs used were ceftriaxone in 100 cases (88.4%) and ciprofloxacin in 13 cases (11.6%). One patient had relapse of paratyphoid fever after treatment with ciprofloxacin which responded to ceftriaxone. Conclusions: Paratyphoid fever A is one of the emerging infections and a significant problem in India. An increasing resistance to fluoroquinolones is noted. Continuous monitoring of drug susceptibilities is mandatory in instituting appropriate therapy.

Original languageEnglish
Pages (from-to)815-817
Number of pages3
JournalAsian Pacific Journal of Tropical Medicine
Volume3
Issue number10
DOIs
Publication statusPublished - 01-10-2010

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Paratyphoid Fever
India
Ciprofloxacin
Ceftriaxone
Salmonella paratyphi A
Pharmaceutical Preparations
Drug Monitoring
Myalgia
Fluoroquinolones
Sulfamethoxazole Drug Combination Trimethoprim
Chloramphenicol
Serology
Tertiary Healthcare
Ampicillin
Infection
Cough
Tertiary Care Centers
Abdomen
Vomiting
Headache

All Science Journal Classification (ASJC) codes

  • Medicine(all)

Cite this

Bekur, Ragini ; Vandana, K. E. ; Shivashankara, K. N. ; Valsalan, Rohit ; Sathyanarayanan, Vishwanath. / Paratyphoid fever- Emerging problem in South India. In: Asian Pacific Journal of Tropical Medicine. 2010 ; Vol. 3, No. 10. pp. 815-817.
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abstract = "Objective: To review the clinical profile and drug susceptibilities of Salmonella paratyphi A in a tertiary care hospital. Methods: Retrospective analyses of 113 patients with paratyphoid fever and 101 culture proven Salmonella paratyphi A infection were included in the study. The study extended over a period of 3 years (2006-2008). Diagnosis of patients were based on clinical features, serology and blood culture. The drug susceptibility testing of the isolates were performed by the disc diffusion method. Clinical presentation, laboratory parameters, susceptibility patterns of isolates, treatment and clinical response were studied. Results: Of the 113 cases, 77 (68.4{\%}) were males and 36 were females (32.8{\%}), which included 2 pediatric patients. Fever was the most common symptom (100.0{\%}) followed by loose stools (37.2{\%}), headache (35.4{\%}), myalgia (31.9{\%}), pain abdomen (29.2{\%}), dry cough (19.5{\%}) and vomiting (13.3{\%}). All patients were clinically cured. Majority of the isolates (46{\%}) were resistant to cotrimoxazole in 2006, however they became 100{\%} sensitive in 2007 and 2008. whereas the strains became 100{\%} sensitive to ampicillin and chloramphenicol only in 2008. In 2006 the sensitivity of organisms to ciprofloxacin was 89{\%} but in 2007 and 2008 there has been an increasing resistance to ciprofloxacin (46{\%} and 86{\%}) respectively. Surprisingly 3 isolates (8.1{\%}) were resistant to ceftriaxone in 2006, showed 100{\%} sensitivity in 2008. Common drugs used were ceftriaxone in 100 cases (88.4{\%}) and ciprofloxacin in 13 cases (11.6{\%}). One patient had relapse of paratyphoid fever after treatment with ciprofloxacin which responded to ceftriaxone. Conclusions: Paratyphoid fever A is one of the emerging infections and a significant problem in India. An increasing resistance to fluoroquinolones is noted. Continuous monitoring of drug susceptibilities is mandatory in instituting appropriate therapy.",
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Bekur, R, Vandana, KE, Shivashankara, KN, Valsalan, R & Sathyanarayanan, V 2010, 'Paratyphoid fever- Emerging problem in South India', Asian Pacific Journal of Tropical Medicine, vol. 3, no. 10, pp. 815-817. https://doi.org/10.1016/S1995-7645(10)60196-4

Paratyphoid fever- Emerging problem in South India. / Bekur, Ragini; Vandana, K. E.; Shivashankara, K. N.; Valsalan, Rohit; Sathyanarayanan, Vishwanath.

In: Asian Pacific Journal of Tropical Medicine, Vol. 3, No. 10, 01.10.2010, p. 815-817.

Research output: Contribution to journalArticle

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AU - Bekur, Ragini

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