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低收入和中等收入国家一家三级护理医院儿童肠热病的临床和实验室特征及抗生素敏感性模式

Clinical and Laboratory Features of Enteric Fever in Children and Antibiotic Sensitivity Pattern in a Tertiary Care Hospital of a Low- and Middle-Income Country.

作者信息

Nusrat Nadia, Islam Md Rafiqul, Paul Nibedita, Rahman Neshwa, Krishnapillai Ambigga, Haq Md Ahsanul, Haque Mainul

机构信息

Pediatrics, Delta Medical College & Hospital, Dhaka, BGD.

Primary Care Medicine, Faculty of Medicine and Defence Health, National Defence University of Malaysia, Kuala Lumpur, MYS.

出版信息

Cureus. 2022 Oct 27;14(10):e30784. doi: 10.7759/cureus.30784. eCollection 2022 Oct.

DOI:10.7759/cureus.30784
PMID:36320797
原文链接:https://pmc.ncbi.nlm.nih.gov/articles/PMC9614183/
Abstract

BACKGROUND

Globally, enteric fever (EF) significantly gives rise to an appalling death toll. It is an endemic illness in Bangladesh and South Asia. The condition manifests in a wide range of clinical features in children. Nowadays, antibiotic resistance is an international stumbling block that hampers the appropriate treatment and outcome of EF.

OBJECTIVE

The study evaluated the clinical and laboratory characteristics and antibiotic sensitivity pattern of in children.

METHODS

This prospective research was conducted at Delta Medical College and Hospital, Dhaka, Bangladesh, from January 2017 to December 2019. A total of 200 pediatric cases of EF were included in this study who were either culture positive or had significantly raised Widal test titer for with suggestive clinical features.

RESULTS

All the patients had a fever, and most had coated tongue, vomiting, abdominal pain, organomegaly, and diarrhea. Among the selected 200 cases of EF, 43.5% were culture-positive. A high erythrocyte sedimentation rate (ESR) was observed in a substantial number (53%) of patients. Ceftriaxone was the most sensitive (100%) antibiotic through laboratory analysis, followed by cefotaxime (95.1%). Among the oral antibiotics used, cefixime (92.8%) was the most sensitive.

CONCLUSION

EF in children can present with varied clinical manifestations. Selective antibiotic treatment according to sensitivity patterns is crucial for effective illness management and will reduce morbidity and mortality in the pediatric population.

摘要

背景

在全球范围内,伤寒显著导致了惊人的死亡人数。它是孟加拉国和南亚的一种地方病。这种疾病在儿童中表现出广泛的临床特征。如今,抗生素耐药性是阻碍伤寒适当治疗和预后的一个国际障碍。

目的

本研究评估了儿童伤寒的临床和实验室特征以及抗生素敏感性模式。

方法

这项前瞻性研究于2017年1月至2019年12月在孟加拉国达卡的三角洲医学院和医院进行。本研究共纳入200例儿童伤寒病例,这些病例要么培养阳性,要么肥达试验效价显著升高且具有提示性临床特征。

结果

所有患者均有发热,大多数患者有舌苔、呕吐、腹痛、脏器肿大和腹泻。在选定的200例伤寒病例中,43.5%培养阳性。相当数量(53%)的患者观察到红细胞沉降率(ESR)升高。通过实验室分析,头孢曲松是最敏感的抗生素(100%),其次是头孢噻肟(95.1%)。在所使用的口服抗生素中,头孢克肟最敏感(92.8%)。

结论

儿童伤寒可表现出多种临床表现。根据敏感性模式进行选择性抗生素治疗对于有效管理疾病至关重要,并且将降低儿童人群的发病率和死亡率。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/0416a789f33f/cureus-0014-00000030784-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/01789662d472/cureus-0014-00000030784-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/518d2bb3aec0/cureus-0014-00000030784-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/0416a789f33f/cureus-0014-00000030784-i03.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/01789662d472/cureus-0014-00000030784-i01.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/518d2bb3aec0/cureus-0014-00000030784-i02.jpg
https://cdn.ncbi.nlm.nih.gov/pmc/blobs/8849/9614183/0416a789f33f/cureus-0014-00000030784-i03.jpg

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