MULTIDRUG-RESISTANT SALMONELLA-TYPHI IN PAKISTANI CHILDREN - CLINICAL-FEATURES AND TREATMENT

Multidrug-resistant Salmonella typhi has become a major public health problem. In this study, typhoid fever was diagnosed by isolation of Sa lmonella typhi from blood or by a positive Widal's reaction in 170 Pak istani children. There were 111 boys (65%) and 59 girls (35%). The ave rage age was 6.2 years; 4 (2%) were less than 1 year old, 78 (46%) wer e 1 to 5 years old, and 88 (52%) were more than 5 years old. All patie nts were pretreated with antibiotics. Salmonella typhi was detected by culture in 109 cases (64%), by Widal's test in 84 (49%), and by both in 23 (14%). All 79 isolates that were multidrug resistant were sensit ive to ofloxacin, cefotaxime, and ceftriaxone. Clinical features of in fections due to resistant S typhi did not differentiate these from oth er cases of typhoid. Fifty-five infections (70%) due to resistant S ty phi were treated with ofloxacin and 24 (30%) with ceftriaxone. Sixteen patients had complications, and all recovered.