The Clinical Course of Typhoid Fever And Resistance Pattern of Salmonella Typhi In Patients Admitted To A Tertiary Care Hospital In Pakistan

Objective: To investigate and document the clinical course of typhoid fever and the sensitivity pattern of Salmonella typhi to antibiotics among patients admitted to Pakistan Naval Ship Shifa Hospital. Study Design: Cross-sectional study. Place and Duration of Study: Pakistan Naval Ship Shifa Hospital, from Jul to Dec 2021. Methodology: The patients admitted with typhoid fever to the hospital during the study period were included using consecutive sampling. After getting informed consent, the patients’ demographic characteristics, course of the disease, blood culture sensitivity, the treatment administered, the complications that emerged, and the length of their hospital stay were noted. Results: There were 77 patients with culture-proven typhoid fever admitted during the study period. The mean age was 18.6±11.84 years (range 1-55 years). The most frequent presenting complaints were fever, abdominal pain, and vomiting. Additional symptoms included a rash, bodily aches, and weariness. Out of the 77 patients, 76(99%) were extensively drugresistant (sensitive to Meropenem and Azithromycin only). The complications noted were hepatitis, myocarditis, ascites, pleural effusion, and shock. The mean length of stay in the hospital was 16.56+3.87 days. The typical time gap between commencing culture-specific antibiotics and fever defervescence was 4.03±2.84 days. Conclusion: Almost all (99%) patients admitted with typhoid fever in PNS Shifa are extensively drug-resistant and require a relatively longer hospital stay for management.