Liver Enzymes and Blood Lactate Profile of Patients Diagnosed with Typhoid Fever in Abuja, Nigeria

Abstract

Salmonella enterica serotype Typhi antibiotics resistance is on the increase and this frustrates efforts at treatment. Persistence of drug-resistant typhoid fever leads to higher mortality rate because treatment is evasive. Lactate is a marker of the severity of stress response in illnesses and liver function enzymes are indicative of the health of the liver. This study intended to identify the effect of drug resistant typhoid fever infection on liver enzymes and blood lactate levels of patients diagnosed with typhoid fever. Fifty subjects were recruited, forty-five were positive for Widal test and further subjected to stool culture examination for the identification of Salmonella Typhi. All patient’s blood were analysed for lactate, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP). Salmonella Typhi were identified in eight out of forty-five Widal positive test patients. The eight positive Salmonella Typhi isolates showed resistance to the Amoxicillin (30 mcg), Tetracycline(30 mcg), Cotrimoxazole (25 mcg), Ceftriazone (30 mcg), Levofloxacin (5 mcg), Gentamicin (30 mcg) and Netillin (30 mcg) but showed susceptibility to ofloxacin (5 mcg). ALP (158.1±8.32 IU/L), AST(55.1±6.78 U/L), ALT (65.2 ±4.96U/L) and blood lactate (10.5±2.4 mmol/L), were elevated in all drug resistant patients when compared to reference standard ALT (7-56 U/L), AST (10-40 U/L), ALP (20-120IU/L), lactate (0.8-2.2 mmol/L). ALT, AST and ALP enzyme levels increased with increasing number of resistances to antibiotics. Untreated typhoid fever infection exerts metabolic toll on liver functions.