MULTIPLE DRUG RESISTANCE, EXTENSIVELY DRUG RESISTANCE TYPHOID FEVER AND DISEASE SPECTRUM IN PEDIATRIC POPULATION PRESENTING WITH FEVER WITHOUT LOCALIZING SIGNS (FWLS): A CROSS SECTIONAL STUDY

Abstract

Objective: To find out the frequency of typhoid in patients presetting with high grade fever and to find the multiple drug resistance (MDR) and extensively drug resistance (XDR) in a diagnosed case of typhoid.

Methods: This cross sectional study was conducted at Pediatrics department Naseer Teaching Hospital, Peshawar. All the participants were enrolled using non-probability sampling, their symptoms, clinical signs, blood culture and culture sensitivities were recorded. Data was analyzed using the statistical package for social science (SPSS) version 21.

Results: A total of 166 participants were included in the study.  Out of these 71 patients significantly had a positive blood culture. ( p value = <0.001) Sensitivity for generations of antibiotics was also studied which showed Trimethoprim, Ceftriaxone, Chloramphenicol and Ampicillin to be least sensitive. Azithromycin, Meropenem and Imipenem were more sensitive. Most of patients were XDR  35 (49.3%).

Conclusion: Since in pediatric population fever is a very common complaint, typhoid disease should be suspected and ruled out as a differential especially in patients presenting with fever without localizing signs (FWLS). Also, in order to counter extensive drug resistance the importance of planned appropriate dosing of antibiotics must be emphasized at all levels of healthcare.

Key Words: Typhoid, Fever without localizing signs (FWLS), Fever, Pediatric, MDR, XDR