Health Condition 1: B968- Other specified bacterial agents as the cause of diseases classified elsewhere
Conditions
Interventions
Intervention1: Nil: Nil
Sponsors
Dr Faldu Om Pravin
Eligibility
Inclusion criteria
Inclusion criteria: All patients with blood culture-confirmed enteric fever Salmonella enterica serovar Typhi or Paratyphi A or B isolated from blood culture presenting to the tertiary care hospital during the study period Age Patients of among age groups Paediatric more than 1 year and Adult less than 75 year will be included Patients of all genders will be included without restriction Inpatients admitted cases from whom blood cultures are obtained and yield Salmonella isolates will be included Antimicrobial Susceptibility Testing Only isolates for which complete AST results against all first line antimicrobials ciprofloxacin ceftriaxone cefixime and azithromycin are available
Exclusion criteria
Exclusion criteria: Clinically Suspected but Blood Culture Negative Cases Patients with clinical suspicion of enteric fever but negative blood cultures will be excluded as the study focuses on microbiologically confirmed cases with available isolates for susceptibility testing Polymicrobial Bacteremia Blood cultures yielding more than one organism polymicrobial infections will be excluded to avoid confounding of susceptibility data Duplicate Isolates In cases where multiple blood cultures from the same patient yield the same Salmonella serovar during the same illness episode only the first isolate will be included to avoid duplication bias Contaminated Cultures Blood culture isolates identified as skin flora contaminants or laboratory contaminants will be excluded Non Salmonella Organisms Patients with bacteremia due to non typhoidal Salmonella or other organisms presenting with a fever of unknown origin will be excluded from the primary analysis
Design outcomes
Primary
| Measure | Time frame |
|---|---|
| Antimicrobial susceptibility profile Proportion of isolates susceptible non susceptible resistant to each first-line antibiotic reported as percentages eg Percentage ciprofloxacin non susceptible Percentage ceftriaxone resistantTimepoint: Day 0 Enrolment Baseline Blood culture collected isolate identified and AST performed for Azithromycin 3rd gen Cephalosporins Ciprofloxacin and Ofloxacin MIC value also recorded here | — |
Secondary
| Measure | Time frame |
|---|---|
| To develop a comprehensive institutional antibiogram of Salmonella Typhi and Paratyphi isolates against first line antimicrobial agents To correlate antibiotic resistance patterns with clinical outcomes To identify the sociodemographic and clinical profile of patients with drug resistant enteric fever To compare resistance patterns across age groups pediatric vs adult and gender Male vs Female To determine the minimum inhibitory concentration MIC of first line antimicrobialsTimepoint: Day 0 Demographics sociodemographic profile age group and gender recorded for resistance pattern correlation Day 0 Day 3 Day 7 WBC Neutrophil Lymphocyte Widal Titer and Blood Culture followed to track clinical response and defervescence Discharge Final outcomes recorded duration of fever length of hospital stay complications and mortality | — |
Countries
India
Contacts
Public ContactDr Faldu Om Pravin
Zydus Medical College and Hospital
Outcome results
None listed