Multidrug-resistant typhoid in children: Presentation and clinical features

Z. A. Bhutta, S. H. Naqvi, R. A. Razzaq, B. J. Farooqui

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110 Citations (Scopus)


Typhoid accounts for 8% of pediatric admissions to the Aga Khan University Hospital in Karachi, Pakistan. Over a 4-year period (1986-1989), 355 children had typhoid documented by culture of blood or bone marrow. Strains of Salmonella, resistant to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole accounted for 20% of these cases. Compared with children infected by drug-susceptible strains of Salmonella, children with multiresistant infection were generally sicker at presentation and were more likely to be assessed as appearing ''toxic'' (P < .001), as having disseminated intravascular coagulation (P < .01), and as exhibiting hepatomegaly (P < .01). The mortality was 4.2% among children with multiresistant infection and 1.4% among those infected with strains susceptible to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole; the higher mortality in the former group was probably due to a longer duration of illness (P < .05) and to ineffectual oral antimicrobial therapy before hospitalization.

Original languageEnglish
Pages (from-to)832-836
Number of pages5
JournalReviews of Infectious Diseases
Issue number5
Publication statusPublished - 1991


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