Clinicoepidemiological and Genotyping Correlation of Pediatric Scrub Typhus from Chandigarh, India.

ABSTRACT

OBJECTIVE: We studied the clinical phenotypes and prevalent genotypes of Orientia tsutsugamushi in our area using indirect immunofluorescence assay (IFA). METHODS: We prospectively screened all febrile children presenting to our hospital over three years. From among children who were scrub typhus positive by ELISA we selected a sample of convenience for IFA testing to determine the genotypes of O. tsutsugamushi using four strains namely Boryong, Gilliam, Karp and Kato. RESULTS: Of all scrub positive patients (n=77), we tested 14 samples using IFA and all 14 samples were IFA positive. Karp genotype (n=7) was most prevalent followed by Kato (3), Boryong (1) and Gilliam (1) genotypes; 2 patients were positive for mixed genotype. There was high prevalence of organ dysfunction among IFA positive children. Three most common organ dysfunctions included hematological derangement in all, liver involvement in 10 (71%), and encephalopathy and shock in 4 each. CONCLUSIONS: Karp was the most prevalent genotype of O. tsutsugamushi in our area.