Antimicrobial resistance problems in typhoid fever

Saragih, Restuti Hidayani; Purba, Giovani Christin Faitino

doi:10.1088/1755-1315/125/1/012091

Cited by 4 publications

(7 citation statements)

References 10 publications

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“…The burden of faeco-orally transmitted infectious diseases, such as typhoid, are reflective of substandard public health measures, and are highly prevalent in LMICs including Nepal [15]. The emergence, selection, and spread of antimicrobial resistant variants of Salmonella enterica serovars Typhi and Paratyphi A have been observed, leading to the subsequent treatment failure [1,2,[16][17][18].…”

Section: Discussionmentioning

confidence: 99%

“…The global burden of antimicrobial resistance (AMR) is steadily increasing, while the discovery of new antimicrobials has effectively stopped, creating new challenges in therapeutic management of infectious diseases [1]. The therapeutic management of previously readily treatable diseases, such as typhoid fever, is becoming difficult because of rapid emergence of multi-drug resistant (MDR) variants [2]. It is known that use/misuse of antimicrobials is one of the key factors aiding the accelerated evolution, selection, and spread of antimicrobial resistant bacterial pathogens [1].…”

Section: Introductionmentioning

confidence: 99%

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Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

Shrestha

Manandhar

Maharjan

et al. 2022

Preprint

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Background: Unregulated antimicrobial use is common in both hospital and community settings of low- and middle-income countries (LMICs). However, discrete data regarding the use/misuse of antimicrobials at pharmacies in LMICs are limited. This study was conducted to understand the knowledge, attitude, and practice of pharmacy employees on antimicrobial dispensing in Nepal. Methods: We conducted a cross-sectional survey using a structured questionnaire on 801 pharmacy employees working in community and hospital pharmacies located in Lalitpur metropolitan city (LMC) of Kathmandu, Nepal between April 2017 and March 2019. Results: Not all respondents replied to all questions asked. A majority (92%, 738/801) of respondents agreed that the demand for non-prescription antimicrobials was common. Sixty nine percent (437/635) of participants responded that they would ask of prescription before dispensing. Suspected respiratory tract infection was the most common reason demanding for non-prescription antimicrobials, identified by 68% (535/792) of respondents. Azithromycin was the most commonly prescribed and sold antimicrobials, as reported by 46%, (361/787) and 48% (377/779) of participants respectively. A majority (87%; 696/800) of respondents agreed on antimicrobial resistance (AMR) to be a global public health threat; 54% (429/796) perceived antimicrobial misuse to be an important driver of AMR, while only 39% (315/801) replied that judicious dispensing of antimicrobials can help curb AMR. Conclusion: Our study revealed that the unfounded dispensing and use of antimicrobials is prevalent among pharmacies in Kathmandu, Nepal. This overreliance on antimicrobials, notably azithromycin, may escalated the burden of AMR. We identified several drivers of inappropriate antimicrobial dispensing practice in pharmacies, which will aid public health authorities in addressing these issues. Further studies considering the role of other stakeholders, such as physicians, veterinarians, general public, and policy makers are required to obtain a more holistic perspectives on the practices of antimicrobial use so to curb the extant AMR crisis.

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Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

Shrestha

Manandhar

Maharjan

et al. 2022

Preprint

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“…10,11 In view of the decreasing trend of MDR strains of S. typhi and increasing fluoroquinolone resistance, it may be prudent for clinicians to consider the use of first-line antimicrobials for typhoid fever. 5,12 Antimicrobial resistance displayed by Salmonella is a growing public threat. Improvement in environment sanitation and hygiene combined with early vaccination and antimicrobial stewardship is necessary to reduce the emerging resistance to cephalosporins and fluoroquinolones.…”

Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Cephalosporin-resistant typhoid

Pereira

Shah

2020

SAGE Open Medical Case Reports

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Typhoid fever is endemic in developing countries like India. An increasing prevalence of resistance to cephalosporins and fluoroquinolones by Salmonella isolates is seen. We present an 8-month-old boy with invasive Salmonella typhi disease. Blood culture showed S. typhi sensitive to ampicillin–sulbactam and cotrimoxazole but resistant to fluoroquinolones and third-generation cephalosporins. Cerebrospinal fluid examination revealed an aseptic meningitic picture. He was treated with intravenous meropenem and azithromycin following which his condition improved. This case highlights the need for improvement in environment sanitation and hygiene combined with early vaccination against typhoid fever and antimicrobial stewardship to help reduce the emerging resistance to cephalosporins and fluoroquinolones.

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“…Kegagalan terapi antibiotik pada kasus demam tifoid akan menyebabkan komplikasi berupa perforasi pada saluran pencernaan yang dapat menyebabkan mortalitas (Saragih & Purba, 2018).…”

unclassified

Kajian Literatur: Profil Resistensi Salmonella typhi dan Pemilihan Antibiotik Pada Demam Tifoid

Sanjaya

Meriyani

Juanita

et al. 2022

J. Pharm. Sci. Clin. Res.

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Demam tifoid merupakan penyakit infeksi yang disebabkan oleh bakteri Gram-negatif yaitu Salmonella typhi. Munculnya multidrug-resistant Salmonella typhi (MDRST) dan extensively drug-resistant (XDR) Salmonella typhi menjadi ancaman baru dalam keberhasilan terapi demam tifoid. Efektivitas terapi pada demam tifoid memerlukan kajian tentang profil resistensi Salmonella typhi terhadap antibiotik yang diamati dari minimum inhibitory concentration (MIC) dan mutasi genetika, sehingga dapat dilakukan pemilihan antibiotik yang tepat pada demam tifoid dengan MDR dan XDR Salmonella typhi. Kajian literatur ini mengumpulkan dan menelaah informasi yang diperoleh dari hasil-hasil penelitian dari berbagai artikel internasional tentang resistensi Salmonella typhi terhadap antibiotik pada deman tifoid. Pencarian artikel menggunakan database PubMed, PlosOne, dan ScienceDirect sejak tahun 2011 hingga September 2021. Artikel yang diperoleh dari 192 artikel, terdapat delapan (8) artikel yang relevan, yang mana diketahui bahwa isolat Salmonella thypi resisten terhadap Ampisilin, Amoksisilin, kombinasi Amoksisilin-Asam Klavulanat, Kloramfenikol, Siprofloksasin, Ofloksasin, Levofloksasin, Asam Nalidiksat, Trimetoprim, dan kombinasi Trimetoprim-Sulfametoksazol yang diamati pada MIC90. Nilai MIC akan berdampak pada penentuan dosis yang efektif untuk mencapai konsentrasi terapetik sehingga dapat mempengaruhi indeks farmakokinetik dan farmakodinamik. Gen yang bertanggung jawab terhadap MDRST dan XDR Salmonella typhi yaitu: blaTEM-1, catA, dhfr1b, sul1, sul2, class 1 integron, gyrA dan gyrB, serta parC. Azitromisin dan Seftriakson menjadi pilihan terapi utama untuk terapi empiris pada demam tifoid. Adanya nilai MIC dan parameter farmakokinetik/farmakodinamik dapat digunakan untuk menginterpretasikan sensitivitas bakteri terhadap antibiotik, yang dapat digunakan sebagai salah satu rujukan dalam menyusun kebijakan penggunaan antibiotik.

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Antimicrobial resistance problems in typhoid fever

Cited by 4 publications

References 10 publications

Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

Perspectives of pharmacy employees on an inappropriate use of antimicrobials in Kathmandu, Nepal

Cephalosporin-resistant typhoid

Kajian Literatur: Profil Resistensi Salmonella typhi dan Pemilihan Antibiotik Pada Demam Tifoid

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