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PRINT ISSN : 2319-7692
Online ISSN : 2319-7706 Issues : 12 per year Publisher : Excellent Publishers Email : editorijcmas@gmail.com / submit@ijcmas.com Editor-in-chief: Dr.M.Prakash Index Copernicus ICV 2018: 95.39 NAAS RATING 2020: 5.38 |
Enteric fever is a global health problem and is also endemic in India. The etiologic agents of enteric fever i.e. S. typhi and S. paratyphi occurs mostly through food-borne or waterborne transmission. Worldwide, however, there are an estimated 22 million cases of enteric fever annually, with 600,000 deaths and an estimate of the annual typhoid incidence rate of 493.5 per 100,000 person years was reported from India in 2008. The laboratory diagnosis of enteric fever is very important mainly in this post-antibiotic era. Isolation of Salmonella by blood culture is proof that the patient has a salmonella septicemia and still is the definitive diagnosis for a patient. Antibiotic therapy is the only effective treatment for enteric fever. Currently, fluoroquinolones and third generation cephalosporins are drugs of choice for treatment of typhoid fever though recent reports of decreased susceptibility to these agents and emergence of resistance to chloramphenicol, ampicillin and cotrimoxazole have led to the prospect of re-emergence of untreatable typhoid fever and an increasing global burden. A total of 110 nos. of blood samples were collected from patients (cases) clinically suspected of Enteric fever for a duration of one year from August’2016-July’ 2017. Salmonella isolation was done by conventional methods of culture. Species identification was done by KBO11. Confirmed Salmonella isolates were tested by serotyping and antimicrobial susceptibility of isolated Salmonella spp were tested by modified Kirby-Bauer disc diffusion method as per the recommendation of Clinical and Laboratory Standard Institute (CLSI). Out of 110 blood culture samples, Salmonella spp were isolated and prevalence was 18.18% (20 cases) , out of which S.typhi (18 cases-90 %) was most commonly isolated organism followed by S. paratyphi (2cases -10 %). 70% of the culture positive cases were males (14 ) and 30% were females (6) , with a male and female ratio 2.33 : 1. The majority of the blood culture confirmed cases (55%) belong to the age group of 21-40 years. Though enteric fever cases occurred in all months throughout the year , maximum cases occurred during the rainy season from April-July followed by August-September. All 18 S.Typhi isolates showed sensitivity to Ceftriaxone (100%), Azithromycin (100 %) whereas sensitivity to Cotrimoxazole (94.44 %) and Chloramphenicol (88.88 %) was also high. 100% sensitivity was observed to third-generation cephalosporins. Least sensitivity was observed to Nalidixic acid. Though nowadays, rapid diagnostic procedures is being used to “suspect” enteric fever it is prudent to follow them up with blood culture confirmation. In-vitro antibiotic sensitivity should be routinely carried out in all patients of enteric fever for prompt and effective management which will minimise the indiscriminate use of antibiotics.