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

BackgroundTyphoid fever resistance is on the increase and this frustrates efforts at treatment. Persistence of multiple drug-resistant (MDR) typhoid fever leads to higher mortality rate since treatment is evasive. ObjectivesThis study intended to identify if liver enzymes and lactate levels are related to aggravating MDR in patients diagnosed with typhoid fever. Methods50 subjects were recruited, 45 were positive for Widal test and further subjected to stool culture examination for the presence of S. Typhi. All subjects blood were analysed for lactate, alanine aminotransferase (ALT), aspartate aminotransferase (AST), and alkaline phosphatase (ALP) ResultsGrowth of S. Typhi was observed in only eight subjects out of the 45 Widal positive test subjects. The eight positive S. Typhi isolates showed resistance to the first line drugs, macrolides and 3rd generation cephalosporins but showed susceptibility to fluoroquinolones. ALP, AST, ALT and blood lactate were elevated in all multi-drug resistant patients. Highest levels of liver enzymes were observed in subjects resistant to the greatest number of antibiotics. However, there was no significant correlation of increase in blood lactate level and ALP when compared with increase in resistance based on number of antibiotics (R2=0.2858, R2=0.4675). ConclusionLactate and liver enzyme levels increase markedly during typhoid fever infection, however in MDR scenario, especially in resistance to different classes of antibiotics, the metabolic toll on the liver increases and is reflected in elevation of AST and ALT.