title: Multidrug-resistant Salmonella typhi in Pakistani children: clinical features and treatment.
abstract: Multidrug-resistant Salmonella typhi has become a major public health problem. In this study, typhoid fever was diagnosed by isolation of Salmonella typhi from blood or by a positive Widal's reaction in 170 Pakistani children. There were 111 boys (65%) and 59 girls (35%). The average age was 6.2 years; 4 (2%) were less than 1 year old, 78 (46%) were 1 to 5 years old, and 88 (52%) were more than 5 years old. All patients were pretreated with antibiotics. Salmonella typhi was detected by culture in 109 cases (64%), by Widal's test in 84 (49%), and by both in 23 (14%). All 79 isolates that were multidrug resistant were sensitive to ofloxacin, cefotaxime, and ceftriaxone. Clinical features of infections due to resistant S typhi did not differentiate these from other cases of typhoid. Fifty-five infections (70%) due to resistant S typhi were treated with ofloxacin and 24 (30%) with ceftriaxone. Sixteen patients had complications, and all recovered.
authors.affiliation: Department of Pediatrics, University of Florida Health Science Center, Jacksonville, USA.
authors.forename: M H
authors.initials: MH
authors.lastname: Rathore
authors.forename: D
authors.initials: D
authors.lastname: Bux
authors.forename: M
authors.initials: M
authors.lastname: Hasan
mesh_terms: D000668:Ampicillin Resistance; D000890:Anti-Infective Agents / Q000627:therapeutic use; D002439:Cefotaxime / Q000627:therapeutic use; D002443:Ceftriaxone / Q000627:therapeutic use; D002511:Cephalosporins / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D002702:Chloramphenicol Resistance; D018432:Drug Resistance, Multiple; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D015242:Ofloxacin / Q000627:therapeutic use; D010154:Pakistan; D012485:Salmonella typhi / Q000187:drug effects* / Q000302:isolation & purification; D014296:Trimethoprim Resistance; D014435:Typhoid Fever / Q000150:complications / Q000175:diagnosis / Q000188:drug therapy*
chemical_list: D000890:Anti-Infective Agents; D002511:Cephalosporins; D002443:Ceftriaxone; D015242:Ofloxacin; D002439:Cefotaxime