Haematological Manifestations in Children with Extended Drug-Resistant Salmonella Typhi Infections in a Tertiary Care Hospital

Authors

  • Nazish Tahir
  • Saeed Akhtar Khan Khattak
  • Nighat Jamal
  • Ghulam Murtaza Shaikh
  • Rabia Ahmad
  • Waleed Ahmed

Keywords:

XDR Salmonella typhi, drug-resistant S. Typhi, High-grade fever, thrombocytopenia, leukopenia, blood culture test.

Abstract

OBJECTIVE: To analyze the haematological parameters in children affected by extended drug-resistant salmonella typhi (XDR S. typhi) infections in a Tertiary care hospital.

METHODOLOGY: This Descriptive Cross-Sectional study was carried out at the Department of Haematology at PNS SHIFA Hospital, Karachi, from November 2021 to October 2022. Seventy children with XDR S. Typhi on blood culture were selected using a consecutive sampling technique. The study focused on haematological parameters, i.e., haemoglobin (Hb), WBC count, and platelet count. Descriptive statistics were expressed as mean ±SD, and the Chi-square test was applied. A p-value ?0.05 was considered statistically significant.

RESULTS: Out of the total of 70 children (under 12 years of age) included in the study, 41 (58.6%) were male and 29 (41.4%) were female. The mean age was 8.17±2.92 years. Anaemia was observed in 51% percent of cases. Leucopenia and thrombocytopenia were noted in 44% and 54% of cases. Seventeen children had bicytopenia, while pancytopenia was seen in only two children.

CONCLUSION: XDR S. Typhi infection causes significant cytopenias. Therefore, patients with a history of sustained fever with cytopenias should be worked up for possible XDR S. Typhi infection.

References

Klemm EJ, Shakoor S, Page AJ, Qamar FN, Judge K, Saeed DK et al. Emergence of an extensively drug-resistant Salmonella enterica serovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third generation cephalosporins. mBio. 2018; 9(1): e00105-18. doi: 10.1128/mBio. 00105-18.

Ahmedullah H, Khan FY, Al Maslamani M, Al Soub H, Chacko K, Khattab MA, et al. Epidemiological and clinical features of Salmonella Typhi infection among adult patients in Qatar: a hospital-based study. Oman Med J. 2018; 33(6): 468-72. doi: 10.5001/omj.2018.87.

Hussain A, Satti L, Hanif F, Zehra NM, Nadeem S, Bangash TM et al. Typhoidal Salmonella strains in Pakistan: an impending threat of extensively drug-resistant Salmonella Typhi. Eur J Clin Microbiol Infect Dis. 2019; 38: 2145-49. doi: doi: 10.1007/s10096-019-03658-0.

Shahid S, Mahesar M, Ghouri N, Noreen S. A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug-resistant (XDR) Salmonella Typhi isolates in children in Karachi. BMC Infect Dis. 2021; 21(1): 900. doi: 10.1186/s12879-021-06599-2.

Milligan R, Paul M, Richardson M, Neuberger A. Vaccines for preventing typhoid fever. Cochrane Database Syst. Rev. 2018(5). CD001261. doi. 10.1002/1465 1858.CD001261.pub4.

Fatima M, Kumar S, Hussain M, Memon NM, Vighio A, Syed MA et al. Morbidity and mortality associated with typhoid fever among hospitalized patients in Hyderabad district, Pakistan, 2017-2018: retrospective record review. JMIR Public Health Surveill. 2021; 7(5): e27268. doi: 10.2196/27268.

Anjum M, Soomro S, Kulsoom S, Bibil S, Asim S, Riaz M. Clinical Spectrum, Laboratory Profile and Antibiotic Susceptibility Pattern of Children with Enteric Fever at a Tertiary Care Hospital of Karachi. J Islamic Int Med Coll. 2021; 16(1): 4-9.

Marchello CS, Carr SD, Crump JA. A systematic review on antimicrobial resistance among Salmonella Typhi worldwide. Am J Trop Med Hyg. 2020; 103(6): 2518-27. doi: 10.4269/ajtmh.20-0258.

Maheshwari V, Kaore NM, Ramnani VK, Sarda S. A comparative evaluation of different diagnostic modalities in the diagnosis of typhoid fever using a composite reference standard: a tertiary hospital-based study in Central India. J Clin Diagn Res. 2016; 10(10): DC01-DC04. doi: 10.7860/JCDR/2016/20426.8684.

Siba V, Horwood PF, Vanuga K, Wapling J, Sehuko R, Siba PM et al. Evaluation of serological diagnostic tests for typhoid fever in Papua New Guinea using a composite reference standard. Clin Vaccine Immunol. 2012; 19(11): 1833-7.

doi: 10.1128/CVI.00380-12.

Ndako JA, Dojumo VT, Akinwumi JA, Fajobi VO, Owolabi AO, Olatinsu O. Changes in some haematological parameters in typhoid fever patients attending Landmark University Medical Center, Omuaran-Nigeria. Heliyon. 2020; 6(5): e04002. doi: 10.1016/j.heliyon.2020.e04002.

Abro AH, Abdou AM, Gangwani JL, Ustadi AM, Younis NJ, Hussaini HS. Hematological and biochemical changes in typhoid fever. Pak J Med Sci. 2009; 25(2): 166-71.

Abiduzzaman MF, Afroze S, Ghosh UK, Rahat F, Sultana A, Choudhury AM. Hematological and Biochemical Parameters of Children with Typhoid Fever in Complicated versus Uncomplicated Cases Admitted in Dr. MR Khan Shishu Hospital. JMRKSH. 2021; 2(1): 10-14.

Ahdi SG, Batool A, Siddique AW, Waqas A, Gul R, Saleem F. The Menace Of Drug Resistant Salmonella Typhi In Children: Experience From A Tertiary Care Hospital in Pakistan. Pak Pediatr J. 2022; 46(3): 260-7.

Tashfeen S, Asif N, Farooq M. Haematological profile derangements in patients due to non-resistant and resistant typhoid fever. Pak Armed Forces Med J. 2021; 71(5): 1615-18. doi: 10.51253/pafmj.v71i5.4359.

Dhillon SP, Neeraj L, Sehajpreet S, Vijay G, Tanushree J, Narinder S. To study haematological profile of Enteric fever patients. Int J Curr Res Med Sci. 2017; 3(7): 24-9. doi: 10.22192/ijcrms.2017.03.07.004.

Prayudha R, Palancoi NA, Jalaluddin S. Profile of Leukocyte Count in Children with Typhoid Fever at the Dr. Tadjuddin Chalid Hospital, Makassar. J Health Sci. 2021; 14(02): 160-5. doi: 10.33086/jhs.v14i02.1864.

Gaffar A, Seedat YK, Coovadia YM, Khan Q. The white cell count in typhoid fever. Trop Geogr Med. 1992; 44(1-2): 23-7.

Raza SK, Javaid H, Bajwa H, Saleem K, Hashim M. Evaluation of haematological variables in patients with typhoid in Pakistan. Pak J Health Sci. 2022: 3(6): 73-7. doi:10.54393/pjhs.v3i06.104

Tengli MB, Kauser SH, Uplaonkar SV. Haematological profile in typhoid fever. Indian J Pathol Oncol. 2017; 4(2): 263-5. doi: 10.18231/2394-6792.2017.0054

Subhan M, Sadiq W. Case of enteric fever with bicytopenia. Cureus. 2017; 9(12): e1910. doi: 10.7759/cureus.1910.

Downloads

Published

05-04-2024

How to Cite

1.
Nazish Tahir, Khattak SAK, Jamal N, Shaikh GM, Rabia Ahmad, Waleed Ahmed. Haematological Manifestations in Children with Extended Drug-Resistant Salmonella Typhi Infections in a Tertiary Care Hospital. J Liaq Uni Med Health Sci [Internet]. 2024 Apr. 5 [cited 2024 Dec. 22];23(01):53-7. Available from: http://ojs.lumhs.edu.pk/index.php/jlumhs/article/view/1272