Incidence of Enteric Fever and their Resistant Pattern among School going Children in Ghaziabad, Uttar PradeshA Matter of Concern

Introduction: Children still experience enteric fever as a severe health problem in developing countries like India. It is an infectious disease that exclusively affects humans. In the developing world, it is one of the most prevalent bacterial causes of acute febrile sickness and is spread by the consumption of unhygienic food or water.

Aim: To identify the incidence and resistance pattern of Salmonella Typhi and Salmonella Paratyphi isolated from school age children.

Materials and Methods: This cross-sectional study was conducted among children with Salmonella enterica infections in the Department of Microbiology, Santosh Medical College and Hospital in Ghaziabad, Uttar Pradesh, India. During the study period, (July 2021 to June 2022) a total of 776 blood samples were obtained from school going children (03-17 years old) and immediately inoculated into Bact/Alert aerobic blood culture bottle and incubated at 37°C for upto five days. After receiving a positive result from Bact/Alert, gram staining was done. Standard microbiological procedures were followed such as different biochemical reactions, agglutination with different antisera for the identification of Salmonella serotypes. Antibiotic susceptibility testing was done using the Kirby-Bauer disk diffusion method. Data was analysed by software version 16.0 of the Statistical Package for the Social Sciences (SPSS).

Results: Total 88 Salmonella isolates were found, of which 21 (23.86%) were Salmonella Paratyphi A and 67 (76.14%) were Salmonella Typhi. Infection rate was more common in summer season. S. Typhi as well as S. Paratyphi A was found to be most resistance to nalidixic acid {58 (86.6%), 19 (90.5%)} followed by ciprofloxacin {42 (62.7%), 18 (85.7%)}. Ceftriaxone and azithromycin resistance pattern among S. Typhi isolates was 07 (10.4%) and 15 (22.4%), respectively and among S. Paratyphi A it was found to be 07 (33.33%) and 06 (28.6%), respectively.

Conclusion: This study found an increase in resistance to ceftriaxone and azithromycin, which are frequently thought of as the best medications for empiric therapy in children. Regular monitoring of the resistance pattern is necessary for doctors to select the appropriate empiric therapy due to the increasing resistance to the available class of antibiotics.