CC BY-NC-ND 4.0 · J Lab Physicians 2019; 11(03): 234-239
DOI: 10.4103/JLP.JLP_154_18
Original Article

Estimating the burden of enteric fever in Chhattisgarh: A single-center study on culture-positive cases from a newly built tertiary care hospital

Debabrata Dash
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
,
Padma Das
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
,
Anudita Bhargava
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
,
Ujjwala Nitin Gaikwad
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
,
Sanjay Singh Negi
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
,
Archana Wankhede
Department of Microbiology, All India Institute of Medical Sciences, Raipur, Chhattisgarh, India
› Author Affiliations
Financial support and sponsorship Nil

Abstract

BACKGROUND: Enteric fever is the most common cause of community acquired blood stream infections in under developed and developing countries. The enteric fever is exclusive to humans and transmitted through the faeco-oral route. Though India is an endemic zone for enteric fever, the data is very scarce from Central India. The present study was undertaken to determine the prevalence of enteric fever in this region and to know the antimicrobial susceptibility pattern of the isolated typhoidal Salmonellae.

MATERIAL AND METHOD: We conducted a retrospective analysis of blood culture positive cases of enteric fever over a period of two years (December 2015 to December 2017). All blood cultures submitted for suspected enteric fever and associated symptoms were included in the study. Relevant demographic, clinical and laboratory data were analyzed.

RESULT: A total of 51 cases (3.56%) were of typhoidal Salmonella from a total of 1430 blood culture submission. Salmonella Typhi were 70.5% while Salmonella Paratyphi A were 29.5% of the total isolated Salmonellae. The most vulnerable age group was 10-19years (41.2%). The mean minimum inhibitory concentration of ciprofloxacin for Salmonella Typhi and Salmonella Paratyphi A are 1.20 and 1.97 μg/ml respectively. All the isolates were susceptible to ceftriaxone. Highest isolation was in the July – September quarter (35.3%).

CONCLUSION: There is a high prevalence of the disease which needs urgent focus on safe water, sanitation services and also to establish guidelines for empiric therapy for enteric fever.



Publication History

Received: 23 November 2018

Accepted: 31 May 2019

Article published online:
07 April 2020

© 2019.

Thieme Medical and Scientific Publishers Private Ltd.
A-12, Second Floor, Sector -2, NOIDA -201301, India

 
  • References

  • 1 Crump JA, Sjölund-Karlsson M, Gordon MA, Parry CM. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial management of invasive salmonella infections. Clin Microbiol Rev 2015;28:901-37.
  • 2 Veeraraghavan B, Pragasam AK, Bakthavatchalam YD, Ralph R. Typhoid fever: Issues in laboratory detection, treatment options concerns in management in developing countries. Future Sci OA 2018;4:FSO312.
  • 3 Antillón M, Warren JL, Crawford FW, Weinberger DM, Kürüm E, Pak GD, et al. The burden of typhoid fever in low- and middle-income countries: A meta-regression approach. PLoS Negl Trop Dis 2017;11:e0005376.
  • 4 John J, Van Aart CJ, Grassly NC. The burden of typhoid and paratyphoid in India: Systematic review and meta-analysis. PLoS Negl Trop Dis 2016;10:e0004616.
  • 5 Iyer RN, Jangam RR, Jacinth A, Venkatalakshmi A, Nahdi FB. Prevalence and trends in the antimicrobial susceptibility pattern of Salmonella enterica serovars typhi and paratyphi A among children in a pediatric tertiary care hospital in South India over a period of ten years: A retrospective study. Eur J Clin Microbiol Infect Dis 2017;36:2399-404.
  • 6 Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, et al. A study of typhoid fever in five Asian countries: Disease burden and implications for controls. Bull World Health Organ 2008;86:260-8.
  • 7 Sharma P, Dahiya S, Manral N, Kumari B, Kumar S, Pandey S, et al. Changing trends of culture-positive typhoid fever and antimicrobial susceptibility in a tertiary care North Indian hospital over the last decade. Indian J Med Microbiol 2018;36:70-6.
  • 8 Joshi S. Antibiogram of S. enterica serovar typhi and S. enterica serovar paratyphi A: A multi-centre study from India. WHO South East Asia J Public Health 2012;1:182-8.
  • 9 Akhtar S, Sarker MR, Jabeen K, Sattar A, Qamar A, Fasih N. Antimicrobial resistance in Salmonella enterica serovar typhi and paratyphi in South Asia-current status, issues and prospects. Crit Rev Microbiol 2015;41:536-45.
  • 10 Capoor MR, Nair D. Quinolone and cephalosporin resistance in enteric fever. J Glob Infect Dis 2010;2:258-62.
  • 11 Sharma P, Dahiya S, Kumari B, Balaji V, Sood S, Das BK, et al. Pefloxacin as a surrogate marker for quinolone susceptibility in Salmonella enterica serovars typhi and paratyphi A in India. Indian J Med Res 2017;145:687-92.
  • 12 Chaudhari DM, Renjen PN, Sardana R, Butta H. Nocardia farcinica brain abscess in an immunocompetent old patient: A case report and review of literature. Ann Indian Acad Neurol 2017;20:399-402.
  • 13 Menezes GA, Harish BN, Khan MA, Goessens W, Hays JP. Antimicrobial resistance trends in blood culture positive Salmonella paratyphi A isolates from Pondicherry, India. Indian J Med Microbiol 2016;34:222-7.
  • 14 Choudhary A, Gopalakrishnan R, Nambi PS, Ramasubramanian V, Ghafur KA, Thirunarayan MA. Antimicrobial susceptibility of Salmonella enterica serovars in a tertiary care hospital in Southern India. Indian J Med Res 2013;137:800-2.
  • 15 Palit A, Ghosh S, Dutta S, Sur D, Bhattacharya MK, Bhattacharya SK. Increasing prevalence of Salmonella enterica serotype paratyphi-A in patients with enteric fever in a Periurban slum setting of Kolkata, India. Int J Environ Health Res 2006;16:455-9.
  • 16 Basu S, Dewan ML, Suri JC. Prevalence of salmonella serotypes in India: A 61-year study. Bull World Health Organ 1975;52:331-6.
  • 17 Gautam V, Gupta NK, Chaudhary U, Arora DR. Sensitivity pattern of Salmonella serotypes in Northern India. Braz J Infect Dis 2002;6:281-7.
  • 18 Kanungo S, Dutta S, Sur D. Epidemiology of typhoid and paratyphoid fever in India. J Infect Dev Ctries 2008;2:454-60.
  • 19 Chande C, Shrikhande S, Kapale S, Agrawal S, Fule RP. Change in antimicrobial resistance pattern of Salmonella typhi in central India. Indian J Med Res 2002;115:248-50.
  • 20 Chitnis S, Chitnis V, Hemvani N, Chitnis DS. Ciprofloxacin therapy for typhoid fever needs reconsideration. J Infect Chemother 2006;12:402-4.
  • 21 Clinical and Laboratory Standards Institute. M 100- S26 Performance Standards for Antimicrobial Susceptibility Testing; Twenty-Sixth Informational Supplement. Wayne, Pa: Clinical and Laboratory Standards Institute; 2016.
  • 22 Clinical and Laboratory Standards Institute. M -100 S25 Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Fifth Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute; 2015.
  • 23 Clinical and Laboratory Standards Institute. M 100 S27 Performance Standards for Antimicrobial Susceptibility Testing: Twenty-Seventh Informational Supplement. Wayne, PA: Clinical and Laboratory Standards Institute; 2017.
  • 24 Dewan AM, Corner R, Hashizume M, Ongee ET. Typhoid fever and its association with environmental factors in the Dhaka metropolitan area of Bangladesh: A spatial and time-series approach. PLoS Negl Trop Dis 2013;7:e1998.
  • 25 Sinha A, Sazawal S, Kumar R, Sood S, Reddaiah VP, Singh B, et al. Typhoid fever in children aged less than 5 years. Lancet 1999;354:734-7.
  • 26 Modi R. Clinical profile and treatment outcome of typhoid fever in children at a teaching hospital, Ahmedabad, Gujarat, India. Int J Med Sci Public Health 2016;5:212.
  • 27 Devaranavadagi RA, Srinivasa S. A study on clinical profile of typhoid fever in children. Int J Contemp Pediatr 2017;4:1067-73.
  • 28 Bhattacharya SS, Dash U. A sudden rise in occurrence of Salmonella paratyphi a infection in Rourkela Orissa. Indian J Med Microbiol 2007;25:78-9.
  • 29 Sood S, Kapil A, Dash N, Das BK, Goel V, Seth P. Paratyphoid fever in India: An emerging problem. Emerg Infect Dis 1999;5:483-4.
  • 30 Teh CS, Chua KH, Thong KL. Paratyphoid fever: Splicing the global analyses. Int J Med Sci 2014;11:732-41.
  • 31 Bharmoria A, Vaish VB, Tahlan AK, Majumder S. Analysis of attributing characteristics of Salmonella enterica serovar Paratyphi A, B and C across India during 6 years (2010 to 2015). Med Microbiol Diagn 2016;5:220-4. Available from: https://www.omicsonline.org/open-access/analysis-of-attributing-characteristics-of-salmonella-enterica-serovarparatyphi-a-b-and-c-across-india-during-6-years-2010-to-2015-2161-0703-1000220.php?aid=69878. [Last accessed on 2018 Jun 10].
  • 32 Saad NJ, Lynch VD, Antillón M, Yang C, Crump JA, Pitzer VE. Seasonal dynamics of typhoid and paratyphoid fever. Sci Rep 2018;8:6870.
  • 33 Vollaard AM, Ali S, van Asten HA, Widjaja S, Visser LG, Surjadi C, et al. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA 2004;291:2607-15.
  • 34 Black RE, Cisneros L, Levine MM, Banfi A, Lobos H, Rodriguez H. Case-control study to identify risk factors for paediatric endemic typhoid fever in Santiago, Chile. Bull World Health Organ 1985;63:899-904.
  • 35 Rai S, Jain S, Prasad KN, Ghoshal U, Dhole TN. Rationale of azithromycin prescribing practices for enteric fever in India. Indian J Med Microbiol 2012;30:30-3.
  • 36 Manesh A, Balaji V, Kumar DR, Rupali P. A case of clinical and microbiological failure of azithromycin therapy in Salmonella enterica serotype typhi despite low azithromycin MIC. Int J Infect Dis 2017;54:62-3.