Rasaily R, Dutta P, Saha M R, Mitra U, Lahiri M, Pal S C
National Institute of Cholera and Enteric Diseases, Beliaghata, Calcutta, India.
Eur J Epidemiol. 1994 Feb;10(1):41-6. doi: 10.1007/BF01717450.
A total of 592 children with clinical diagnosis of typhoid fever admitted to the Dr B. C. Roy Memorial Hospital for Children, Calcutta, India during the period between February 1990 and January 1992, were screened for Salmonella typhi by blood culture. S. typhi was isolated from 221 (37.3%) cases. The majority of the strains (92.3%) showed multi-drug resistant (MDR). They were resistant to chloramphenicol, ampicillin, tetracycline and trimethoprim-sulphamethoxazole. However, all the strains were uniformly (100%) susceptible to gentamicin, amikacin, furazolidone, norfloxacin and ciprofloxacin. Minimum inhibitory concentration of the antimicrobial agents against the resistant strains of S. typhi ranged between 200 and > 1600 micrograms/ml. Phage type 0 was most frequently encountered. The rate of isolation of S. typhi was more or less the same in all the pediatric age groups. The majority of the cases came from lower socio-economic classes with poor personal hygiene. Fever was the main presenting feature in all the cases. Other associated features of the MDR typhoid fever cases, who were uncomplicated during admission, were headache (36.0%), chill and rigor (23.2%), diarrhea (37.2%), anorexia (26.2%), vomiting (23.8%), cough (18.0%) and abdominal pain (19.8%). Hepatosplenomegaly was present in 42.4% cases. However, complications were less frequently encountered among the MDR typhoid fever cases who were uncomplicated during admission and treated as in-patients. Fourteen bacteriologically-confirmed MDR typhoid fever cases had jaundice and another 18 cases had an abnormal state of consciousness during admission. Four (2.0%) bacteriologically-confirmed MDR typhoid fever patients died during the period of observation.
1990年2月至1992年1月期间，印度加尔各答的B.C.罗伊儿童医院收治了592名临床诊断为伤寒热的儿童，通过血培养对他们进行伤寒沙门氏菌筛查。从221例（37.3%）中分离出伤寒沙门氏菌。大多数菌株（92.3%）表现出多重耐药（MDR）。它们对氯霉素、氨苄青霉素、四环素和甲氧苄啶 - 磺胺甲恶唑耐药。然而，所有菌株对庆大霉素、阿米卡星、呋喃唑酮、诺氟沙星和环丙沙星均呈100%敏感。抗菌药物对耐药伤寒沙门氏菌菌株的最低抑菌浓度在200至>1600微克/毫升之间。0型噬菌体最为常见。在所有儿童年龄组中，伤寒沙门氏菌的分离率大致相同。大多数病例来自社会经济阶层较低且个人卫生状况较差的人群。发热是所有病例的主要表现特征。入院时无并发症的多重耐药伤寒热病例的其他相关特征包括头痛（36.0%）、寒战（23.2%）、腹泻（37.2%）、厌食（26.2%）、呕吐（23.8%）、咳嗽（18.0%）和腹痛（19.8%）。42.4%的病例出现肝脾肿大。然而，入院时无并发症并作为住院患者治疗的多重耐药伤寒热病例中，并发症较少见。14例细菌学确诊的多重耐药伤寒热病例在入院时有黄疸，另有18例在入院时意识状态异常。在观察期间，4例（2.0%）细菌学确诊的多重耐药伤寒热患者死亡。
