The emergence and outbreak of multidrug-resistant typhoid fever in China

Yan, Mei; Li, Xinlan; Liao, Qiaohong; Li, Fang; Zhang, Jing; Kan, Biao

doi:10.1038/emi.2016.62

Cited by 44 publications

(39 citation statements)

References 29 publications

Supporting

Mentioning

Contrasting

Unclassified

Order By: Relevance

“…20 Children are more prone to acquire resistance because they have less immune responses, receive more empirical treatment and encounter more health care providers. 21 Similar to studies from other part of subcontinents, India 22 , China 23 , Bangladesh 24 and parts of Pakistan 18 , male gender has predominance in XDR Typhoid fever. Among risk factors of typhoid fever, drinking unboiled water (either line water directly or after filtration) identified as a leading culprit which is similar to previous observations in Karachi 25 and other parts of the developing world 24,26 , where provision of safe water supply is a huge problem.…”

Section: Discussionsupporting

confidence: 69%

Extended drug resistance in children with typhoid fever.

Anwar

Rais

Jamil

et al. 2020

TPMJ

View full text Add to dashboard Cite

In developing countries, typhoid fever is mostly seen due to poor public health and low socioeconomic indices. Currently Pakistan is going through the largest outbreak of XDR typhoid fever which has resulted in increased morbidity and mortality especially in pediatric population. Objectives: To see the pattern of extended drug resistant typhoid fever in different areas of Karachi. Study Design: Cross sectional study. Setting: Department of pediatrics, Ziauddin Hospital (KDLB, NORTH, CLIFTON campus). Period: 6 months from October 2018 till March 2019. Material & Methods: All patients who presented with history of fever for 3 or more days with signs and symptoms of typhoid fever were recruited. For data collection a self-structured questionnaire was used. Age, gender, socioeconomic status, personal hygiene, water supply and sanitation were taken into account. Blood samples were sent for cultures. Salmonella isolates were tested for antibiotic susceptibility. Tested antimicrobials were ampicillin, TMP/SMX, cefixime, ceftriaxone, aztreonam, ciprofloxacin, azithromycin, meropenem. For data analysis SPSS version 22 was used. Results: Out of 415 patients, 235 had culture proven typhoid fever. Salmonella typhi was isolated in 94.4%of the patients and salmonella paratyphi was isolated in 5.57%. Of the 235, Males were 62% and females were 42.4%. Major determinants associated with acquiring salmonella infection were young age (74%), male sex (62%), middle and low socioeconomic status (83.8%), living in west district of Karachi (54.9%) and drinking line water (79.2%). Extended drug resistance was encountered in 69.5%. Most of the isolates were sensitive to meropenem and azithromycin (96.7 %, and 95.5% respectively). Ceftriaxone resistance was prevelant in all three districts of Karachi (p value <0.001), in different age groups 1-6yrs (98%), 7-12 yrs(91%), 13-18 yrs (100%) and in males(58%) predominantly. Conclusion: Karachi is facing an outbreak of XDR typhoid fever. Risk of acquiring extended drug resistant typhoid fever is increased in younger age group 1-6 yrs, males, west district of Karachi and poor socioeconomic status. Drinking unboiled water is identified as one of the major culprits. Actions should be taken at all health care levels to monitor the judicious use of antibiotics, and preventive strategies like safe water supply, improved sanitation along with typhoid vaccination are suggested to overcome this outbreak.

show abstract

Section: Discussionsupporting

confidence: 69%

Extended drug resistance in children with typhoid fever.

Anwar

Rais

Jamil

et al. 2020

TPMJ

View full text Add to dashboard Cite

show abstract

“… 2 Antimicrobial-resistant strains of Salmonella Typhi and Salmonella Paratyphi, the causative agents of typhoid and paratyphoid fever, respectively, have been an emerging issue worldwide since the early 1980s. 3 This led to the commencement of large-scale targeted vaccination programs aimed at immunizing schoolchildren in high-burden areas because they make up the most susceptible age group. A national school-based immunization program began in 1977 targeting children aged 7–12 years.…”

Section: Introductionmentioning

confidence: 99%

Typhoidal Salmonella Trends in Thailand

Techasaensiri

Radhakrishnan

Als

et al. 2018

The American Journal of Tropical Medicine and Hygiene

View full text Add to dashboard Cite

Abstract.Typhoid and paratyphoid fever remain endemic diseases in Thailand with wide variation in subnational incidence trends. We examined these trends alongside contextual factors to study potential interactions and guide control strategies for this disease. Culture-confirmed typhoid and paratyphoid fever data from 2003 to 2014 were collected from the Ministry of Public Health website. Contextual factor data were collected from various sources including World Health Organization/United Nations Children’s Fund Joint Monitoring Program, United Education Statistical World Bank database, World Bank, Development Research group, and global child mortality estimates published in the Lancet. Typhoid fever exhibited a declining trend with peak incidence reported in 2003 at 8.6 cases per 100,000 persons per year. Incidence dropped to three cases per 100,000 persons in 2014. The trend in paratyphoid fever remained stable with the peak incidence of 0.77 cases per 100,000 persons observed in 2009. Subnational variations of typhoid were seen throughout the study period with the highest incidence observed in the northwestern region of Thailand. Increases in female literacy, and access to improved water and sanitation were observed with decreases in poverty head count ratio and diarrheal mortality rate per 1,000 live births. Case fatality remained consistently low at 0.4% or less in all years with reported deaths. At the national level, typhoid fever incidence has shown a notable decline; however, incidence appears to have plateaued since 2007 with access to improved water supply and sanitation above 80%. Eliminating this disease will require strong disease prevention measures in conjunction with effective treatment interventions.

show abstract

“…Furthermore, international travel increases the spread of resistant S. Typhi isolates (6). In China, multidrug-resistant (MDR) S. Typhi isolates that are resistant to ampicillin (AMP), chloramphenicol (CL), and trimethoprim-sulfamethoxazole (SXT) have been found (7).…”

Section: Introductionmentioning

confidence: 99%