Open AccessREVIEW OF FIFTY CULTURE PROVEN SALMONELLA CASES
Author(s) -
Shalini Duggal,
Priyanka Banerjee,
T.D. Chugh
Publication year - 2016
Publication title -
indian journal of medical sciences/indian journal of medical sciences (print)
Language(s) - English
Resource type - Journals
eISSN - 1998-3654
pISSN - 0019-5359
DOI - 10.18203/issn.0019-5359.indianjmedsci20163534
Subject(s) - medicine , gastroenterology , blood culture , widal test , salmonella , erythrocyte sedimentation rate , ciprofloxacin , salmonella typhi , immunology , microbiology and biotechnology , antibiotics , biology , biochemistry , genetics , escherichia coli , gene , bacteria
BACKGROUND: Enteric fever has huge global burden. Surrogate markers may have a role in early diagnosis. AIM: Unselected retrospective analysis of 50 culture positive Salmonella enterica cases for epidemiology, laboratory markers, antibacterial susceptibility, therapy, and outcome was done. This was a retrospective chart review of electronic medical records for 50 patients with Salmonella in blood cultures for in our hospital during May 2009-April 2010. MATERIALS AND METHODS: Blood culture was by automated Bactec™ system and antimicrobial susceptibility test was performed by disk diffusion method or automated system Phoenix 100™. Sensitivity of Widal, S. typhi IgM, C-reactive protein (CRP), total leukocyte count, erythrocyte sedimentation rate (ESR), differential eosinophil and lymphocyte counts, and liver enzymes, was determined for these cases. RESULTS: Salmonella cases were seen in all ages from 8 months to 59 years; serotype Typhi was the most common (72%). Sensitivity of S. typhi IgM immunochromatographic test was 78.9%, of Widal was 88.8%, and that of CRP, serum aspartate transaminase (AST), and serum alanine transaminase (ALT) ranged from 81.8 to 89.4%. Eosinophil count of zero and ESR were found to be 78.2% and 85.7% sensitive. Nalidixic acid resistance was seen in 96% cases and ciprofloxacin resistance/intermediate sensitivity in 26% cases. Resistance was not seen with ceftriaxone, while ampicillin, chloramphenicol, and co-trimoxazole (ACCo) resistance was 4%. Seven cases relapsed mostly due to improper treatment associated with choice/dose/duration of antibiotics. CONCLUSIONS: Surrogate laboratory markers can be utilized pending culture results. Though antibiotics and vaccines against Salmonella, and good sanitation facilities are available, it causes morbidity in all sections, gender, and ages of society. Strategies of prevention have not been very successful; therefore, early detection and effective treatment can prevent its complications and relapses.