RESUMO
Background: Enteric fever is a major public health problem in developing countries like India. It affects all age groups but young children are at highest risk. Timely management with appropriate antimicrobial therapy can reduce both morbidity and mortality. In recent years, the emergence of antimicrobial resistance is a significant challenge. Therefore, this study was undertaken to study antibiotic sensitivity pattern of the Salmonella isolates. Aims and Objectives: The aim of this study was to estimate the prevalence of resistance to commonly used antibiotics in the Salmonella isolates. Materials and Methods: Children between 6 months and 14 years of age admitted for fever and whose blood culture was positive for Salmonella Typhi or Salmonella Paratyphi A, B, or C were included in the study over a period of 2 years (August 2018–July 2020). Results: There were 155 patients of enteric fever whose blood culture results were positive for S. Typhi/S. Paratyphi who were included in the study. Out of the 155 culture positive cases, S. Typhi was isolated in 135 (87.1%), S. Paratyphi A in 16 (10.3%) and S. Paratyphi B in 4 (2.6%) cases. All the 135 isolates of S. Typhi were sensitive to cephalosporins. High rate of sensitivity was noted for the first-line drugs – amoxicillin, ampicillin, and trimethoprim-sulfamethoxazole. All 16 isolates of S. Paratyphi A were sensitive to cephalosporins. All the isolates of S. Paratyphi B tested were sensitive to cephalosporins, azithromycin, nalidixic acid, and trimethoprim-sulfamethoxazole. Conclusion: At present, there is low prevalence of resistance to first-line drugs and third-generation cephalosporins and high resistance to fluoroquinolones, nalidixic acid, and azithromycin as noted in this region. Rational antibiotic selection should be based on sensitivity pattern to prevent emergence of resistant strains.
RESUMO
Objective: To compare the effectiveness of intermittent with daily chemotherapy (both containing rifampicin) in childhood tuberculosis (age ≤16yrs) in achieving cure/ significant improvement. Design: Systematic Review and Meta-analysis. Methods: MEDLINE and the Cochrane Library were searched for randomized trials of antitubercular regimens containing rifampicin, in children 16 yrs or less with tuberculosis. Two reviewers independently assessed trial eligibility and quality. Data from full articles of selected studies were independently extracted by two authors and analyzed. The odds ratio was obtained for the pooled data in two groups (intermittent and daily therapy). Outcome variables: Cure/significant improvement, relapse rate and adverse events. Results: Four randomized controlled trials comparing twice weekly and daily therapy including 466 children (pulmonary 439; extrapulmonary 27) met the inclusion criteria. Baseline data were comparable. On quality assessment, 3 studies scored 2 and one study scored 3 out of 5 points. Per protocol analysis showed that children receiving intermittent regimen were less likely to be cured than those receiving daily therapy (OR 0.27; 95% CI: 0.14, 0.51). The results of intention to treat analysis suggest similar trend towards lower cure rates with twice weekly regimen (OR 0.66; 95% CI: 0.23-1.84). Conclusion: Twice weekly intermittent short course therapy is less likely to cure tuberculosis in children as compared to daily therapy. There is a need for better quality randomized controlled trials for assessing efficacy of alternate schedule for intermittent therapy for childhood tuberculosis.
RESUMO
House shrews (Suncus murinus) and rats (Rattus rattus diardii), trapped during a survey period from July 1978 to December 1979 and thereafter on a random basis, from residences within and outside the Veterinary Research Institute, Ipoh, Malaysia campus, were bacteriologically examined for the presence of salmonellae. Of the 55 shrews and 8 rats examined, 39 (71%) shrews and 2 (25%) rats were found positive. There were 46 Salmonella isolates which included 5 dual infections. These were serotyped as S. weltevreden, S. bareilly, S. stanley, S. augustenborg, S. hvittingfoss, S. emek, S. paratyphi B, S. ohio and S. matopeni in order of frequency of isolation. The significance of these findings especially with regard to salmonellosis in man and animals is discussed.