Assessment of raised alanine aminotransferase (ALT) and its relation with antibiotic resistance in enteric fever among children

Objective: To study the abnormality of alanine aminotransferase (ALT) in enteric fever among children and test the association between raised alanine aminotransferase and antibiotic resistance. Study Design: Prospective longitudinal study. Place and Duration of Study: Paediatric Department, KRL Hospital, Islamabad, from Oct 2018 to Mar 2020. Methodology: A total of 100 patients were enrolled as per inclusion criteria. Detailed clinical history was taken, and a physical examination was done. In addition, laboratory tests, i.e., complete blood count, liver function tests and blood culture, were performed to validate the inclusion and exclusion criteria and to collect the data of required variables mentioned in a structured proforma. Results: Out of 100 culture-proven typhoid fever patients, 57% were male and 43% female. The average age was 7.79 ± 3.3 years. Raised alanine aminotransferase (>45 U/l) was observed in 60%. The alanine aminotransferase was raised in at least 51% of the population having typhoid fever with a p-value of 0.035. The results also showed that the proportion of extensive drug-resistant (XDR) typhoid was more significant in patients with raised alanine aminotransferase than in patients with normal alanine aminotransferase with a p-value of 0.003. Conclusion: Based on our study, we concluded that high alanine aminotransferase is related to enteric fever. We also observed that those having raised alanine aminotransferase have more chances of extensively drug-resistant typhoid. (author)