Age-related clinical and microbiological characteristics of enteric fever in India.
A retrospective, hospital-based study at Safdarjang Hospital, India, was undertaken between January 1999 and December 2003 to estimate age-related epidemiological, clinical and microbiological characteristics in enteric fever cases. A total of 750 blood-culture-proven cases of enteric fever were studied. The majority of cases occurred in children aged 5-12 years and 24.8% of cases were in children up to 5 years of age. Salmonella serotypes showed an age-related predilection, with paratyphoid fever more common in adults. Classically-described clinical features of the disease were comparable among patients under and above 5 years of age. Hepatomegaly, anaemia and complications in general were more frequent in children up to 5 years of age. The antimicrobial resistance pattern, irrespective of Salmonella serotype, did not reveal a statistically significant difference across age groups for the different antibiotics tested. Multidrug resistance was seen only in Salmonella enterica serotype Typhi but not in S. Paratyphi A isolates. However, resistance to nalidixic acid was comparable in both serotypes. Age-related differences of serotype isolation rates, clinical presentation and associated complications are noteworthy for better case management and policy planning. More epidemiological studies regarding reasons for age-related differential serotype patterns would enable and guide public health strategies to contain enteric fever in endemic locations.
Walia
Mandeep
M
Department of Pediatrics, V.M. Medical College and Safdarjang Hospital, New Delhi 110052, India.
Gaind
Rajni
R
Paul
Premila
P
Mehta
Rajesh
R
Aggarwal
Pushpa
P
Kalaivani
Mani
M
D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D000368:Aged; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D019353:Endemic Diseases; D005260:Female; D006801:Humans; D007194:India / Q000453:epidemiology; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012189:Retrospective Studies; D012485:Salmonella typhi / Q000302:isolation & purification*; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology
D000900:Anti-Bacterial Agents