Multidrug-resistant typhoid fever: a review

Abstract

Introduction: Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs for treatment such as chloramphenicol, ampicillin and trimethoprimsulfamethoxazole. Since the mid-1980s, MDRTF has caused outbreaks in several countries in the developing world, resulting in increased morbidity and mortality, especially in affected children below five years of age and those who are malnourished. Methodology: Two methods were used to gather the information presented in this article. First PubMed was searched for English language references to published relevant articles. Secondly, chapters on typhoid fever in standard textbooks of paediatric infectious diseases and preventive and social medicine were reviewed. Results: Although there are no pathognomonic clinical features of MDRTF at the onset of the illness, high fever ( > 104°F), toxaemia, abdominal distension, abdominal tenderness, hepatomegaly and splenomegaly are often reported. The gold standard for the diagnosis of MDRTF is bacterial isolation of the organism in blood cultures. Ciprofloxacin and ceftriaxone are the drugs most commonly used for treatment of MDRTF and produce good clinical results. Conclusion: MDRTF remains a major public health problem, particularly in developing countries. Mass immunization in endemic areas with either the oral live attenuated Typhi 21a or the injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in the prevention of MDRTF.

Molecular and Bacteriological Study for Salmonella Typhi Isolated From Typhoid Patient in Samawa City.

“…The results that are obtained from this study found in figure ( 6 ) reveal that all S .typhi isolates are sensitive (100%) for ceftriaxone ,cefepime, cefazolin, chloramphenicol, imipenem, while other S.typhi isolates were showed resistance rates (28.57%) for ampicillin , pencillin G , ciprofloxacin also S.typhi isolates were resistance (42.85%) for amikacin , (71.42%)for gentamicin ,nitrofurane and trimethoprine-sulfa and (85.71%) for tobramycin respectively . All S. typhi isolates are resistance (100%)for tetracycline and erythromycin.…”

“…It also produces no gas when grown in Triple Sugar Iron agar, which is used to differentiate it from other Enterobacteriaceae. Despite the emergence of newer antibacterial drugs, enteric fever has continued to be a major health problem (6). S .typhi gained resistance to antibiotics like ampicillin,ceftriaxone, and co-trimoxazole, besides developing resistance to efficacious drugs like ciprofloxacin.…”

A study of the Biochemical and Haematological parameters in Patients of Typhoid Fever

“…The incidence of cardiac involvement in typhoid is variable [21][22], Myopathy can cause severe myoglobinuria and elevated CK was found in 60% of typhoid fever patients [21]. Table ( and bone marrow suppression [4]. As a result of these complication, Hematological subcutaneous abscess, subphrenic abscess and cutaneous ulcers and biochemical parameters could be afford correlation and thereby serves as indications for more reliable and diagnosis aid of the infection which could changes the necessary antibiotic therapy [9].…”

“…Typhoid fever is caused by Salmonella Enteric a Serovar Typhi, a gram-negative bacterium [4]. The organism is transmitted by the fecal-oral route; thus the disease is often associated with poor sanitation and hygiene [3,5].…”

Fiebre, ictericia y hepatitis: no siempre es infección viral

“…La ampicilina, cloranfenicol y trimetroprima-sulfametoxazol (TMP-SMX) fueron por muchos años los antibióticos de primera línea en el tratamiento de la fiebre entérica, pero su uso empírico e indiscriminado facilitó la generación de cepas resistentes (21,28). En 1972 se aislaron cepas resistentes al cloranfenicol en países como México, India, Vietnam y Corea (29); en 1980 se aislaron cepas resistentes a los 3 medicamentos de primera línea, dando origen a las cepas conocidas como resistentes a múltiples medicamentos (29).…”