Research Article Open Access
Akhtar et al., J Med Microb Diagn 2018, 7:4
DOI: 10.4172/2161-0703.1000288
Research Article Open Access
Journal of
Medical Microbiology & Diagnosis
ISSN: 2161-0703
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Volume 7 • Issue 4 • 1000288
J Med Microb Diagn, an open access journal
ISSN: 2161-0703
*Corresponding author: Anees Akhtar, Department of Microbiology, JNMC, AMU, Aligarh,
Uttar Pradesh, India, Tel: +91-955729217; E-mail: draneesakhtaralig@gmail.com
Received October 06, 2018; Accepted November 01, 2018; Published November
05, 2018
Citation: Akhtar A, Raza A, Kaushal N, Shukla I (2018) Trends of Socio-
Demographic Determinants, Clinical Features and Drug Resistance Pattern among
Cases of Enteric Fever in Western Uttar Pradesh, India. J Med Microb Diagn 7:
288. doi:10.4172/2161-0703.1000288
Copyright: © 2018 Akhtar A, et al. This is an open-access article distributed under
the terms of the Creative Commons Attribution License, which permits unrestricted
use, distribution, and reproduction in any medium, provided the original author and
source are credited.
Abstract
Introduction: Typhoid fever is a prolonged illness caused by Salmonella enterica subspecies enterica serotype
Typhi, causing an estimated 16.6 million new infections and 600,000 deaths each year. Clinical manifestation
of typhoid fever varies from uncomplicated high-grade fever to serious complications involving encephalopathy,
peritonitis, perforation and hemorrhage. With development of resistance against commonly used antibiotics,
quinolones and third generation cephalosporins are being used against multi drug resistant infections.
Aims and objective: We studied the changing trends of socio-demographic determinants, clinical features and
drug resistance pattern among cases of Enteric fever in western Uttar Pradesh in India. so that it may prove helpful
to the clinicians for the early diagnosis, management and fnally reducing mortality in our region.
Materials and methods: The study was performed on all patients attending Pediatric and Medicine OPD
or admitted in wards of Jawaharlal Nehru Medical College and Hospital (J.N.M.C.H), AMU, Aligarh, with clinical
presentation suggestive of typhoid fever.
Results: Out of 104 clinically suspected patients 44 (42.30%) belonged to age-group 21-40 years and 55
(52.88%) were males. maximum number of patients belonged to socio-economic class V with 42 (40.38%) patients,
majority of the cases were seen during April-June 46 (44.23%), most of the patients were educated up to pre-
school level consisting of 42 (40.38%). Fever was the most constant symptom in our series representing 104
(100%) patients, Headache was present in 92 (88.46%), abdominal pain in 83 (79.80%) patients, vomiting in 17
(16.34%), coated tongue 24 (23.07%), diarrhoea in 6 (5.77%), and constipation was seen in 8 (7.69%) patients in
our study. All the cases 12 (100%) sensitive for the azithromycin, ceftriaxone and Cefoperazone-Salbactum, while
8 (66.67%) cases showed resistance to ampicillin, chloramphenicol, and co-trimoxazole. While cefexime, cefepime
and ciprofoxacin were 10 (83.33%), 11 (91.66%), and 10 (83.33%) sensitive. While 2 (16.67%) cases were resistant
to nalidixic acid i.e., NARST.
Conclusion: enteric fever is endemic in our country and a signifcant number of patients are dying each year
and frequency of complications is also on rise so knowing the socio-demographic determinants , clinical features and
drug resistance pattern among cases may prove useful for the early diagnosis, management and fnally reducing
mortality.
Trends of Socio-Demographic Determinants, Clinical Features and Drug
Resistance Pattern among Cases of Enteric Fever in Western Uttar Pradesh,
India
Anees Akhtar*, Adil Raza, Neha Kaushal and Indu Shukla
Department of Microbiology, JNMC, AMU, Aligarh, Uttar Pradesh, India
Keywords: Drug resistance; Enteric fever
Introduction
Typhoid fever is a prolonged illness characterized by bacteremia
with Salmonella enterica subspecies enterica serotype Typhi, a highly
evolved gram-negative bacteria that infects humans. Typhoid is one
of the major cause of morbidity and mortality worldwide, causing an
estimated 16.6 million new infections and 600,000 deaths each year
[1]. Clinical manifestation of typhoid fever varies from uncomplicated
high-grade fever to serious complications involving encephalopathy,
peritonitis, perforation and haemorrhage. Te diagnosis of typhoid
fever on clinical grounds is difcult, as the presenting symptoms are
diverse and overlapping [2].
Te incidence of salmonellosis is on the rise in the most of the
developing countries, emergence of antibiotic resistance is also
alarming. Terefore, the efectiveness of antimicrobial chemotherapy
is limited, and also multidrug resistance strains were disseminated
worldwide; in 2004, Salmonellae resistant to extended spectrum
cephalosporins (ESCs) were reported in 43 countries [3]. β- Lactams
constitute the most important antibiotic family in therapeutic use,
because of their efciency and relative low toxicity. ESCs are currently the
agents of choice for such chemotherapy especially for infants and neonates,
for whom the use of fuoroquinolones is not yet approved [4,5].
Materials and Methods
Te present study was carried out in the Department of
Microbiology, J.N Medical College A.M.U, Aligarh during the period
from September 2011 to February 2014. Tis study was approved by the
institutional ethical committee JNMC, AMU, Aligarh.
Study group and design
Te study was conducted on all patients attending Pediatric and
Medicine OPD or admitted in wards of Jawaharlal Nehru Medical
College and Hospital (J.N.M.C.H), AMU, Aligarh, with clinical