DOI: 10.36347/sjams.2019.v07i12.016

Pages: 3903-3909

Background: Enteric fever is a common public health problem in Bangladesh. Antibiotic therapy is the choice of treatment but development of resistant to common antimicrobial drugs complicates the problem now a days. Methodology: This prospective observational study conducted in a tertiary care hospital at Dhaka from March to December 2016 among suspected case of Enteric fever as per case definition. Results: Among 212 suspected enteric fever 117 children were diagnosed as enteric fever by blood culture and/or widal test. Male: female were 1.3: 1. Maximum (70%) children were in age group 5 years or more. Most of the children were from urban slum area (53.6%) of Dhaka city. Cases were admitted throughout the year. Common presentation were fever (100%), anorexia (100%), pain abdomen (74.4%) and loose motions (46.1%). The common signs were hepatomegaly (41.9%), hepatosplenomegaly (5.1%) coated tongue (64.9%), pallor (74.4%). The complications rate was 35.9% and commonest being UTI and pneumonia. The overall positivity of widal test was 89.7% and the culture positivity was 32.5%. Among isolates, 94.7%were Salmonella typhiand 5.3% Salmonella paratyphi A. Among them18.1% isolates were multi drug resistant. Amoxyclav, Amoxycilline and Nalidaxic acid were 100% resistant whereas Cefixime, ceftriaxone. Meropenam and Ofloxacine were 100% sensitive. Ciprofloxacin was 72.2% sensitive among isolates. The most important macrolides, Azithromycin was only 22.2% sensitive among S.Typhi in this study. Conclusion: Enteric fever is most prevalent during summer & rainy session. WASA supplied water may play a role. Hepatomegaly is common. UTI and pneumonia are the commonest complication. Multidrug resistant cases are not so as high as other countries. Cefixime, Ceftriaxone. Meropenam and Ofloxacine are the drugs of choice. Ciprofloxacin is still could be chosen for the treatment of enteric fever. Higher rate of resistant to Azithromycin is alarming.