Typhoid Fever: Issues in Laboratory Detection, Treatment Options &amp; Concerns in Management in Developing Countries

Veeraraghavan, Balaji; Pragasam, Agila Kumari; Bakthavatchalam, Yamuna Devi; Ralph, Ravikar

doi:10.4155/fsoa-2018-0003

Cited by 49 publications

(41 citation statements)

References 80 publications

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“…Moreover, S. Paratyphi strains showed even higher rate (99.42%) of NAR than S. Typhi (98.32%). Similar rates of resistance to nalidixic acid (NA) resistant isolates were reported in the studies through the Indian subcontinent by Singhal et al, Menezes et al and Veeraraghavan et al [10,39,40] A rise in DCS accompanied with a sustained decrease in the MDR typhoidal Salmonella has been noticed recently. [14] We have also had similar observations in our study.…”

Section: Discussionsupporting

confidence: 59%

Antimicrobial Susceptibility Trends in Salmonella enterica Isolates - A 6 Year Study from a Tertiary Care Hospital in North India

Dewan¹,

Verma²

2019

jemds

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Section: Discussionsupporting

confidence: 59%

Antimicrobial Susceptibility Trends in Salmonella enterica Isolates - A 6 Year Study from a Tertiary Care Hospital in North India

Dewan¹,

Verma²

2019

jemds

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“…With many reports of ceftriaxone resistance and absence of any new drug, the studies are ongoing to understand the combination of antibiotic in the treatment of typhoid fever. In an API conclave on enteric fever, it was recommended that combination therapy should be used in case of fever lasting for seven days and no clinical improvement with monotherapy3233.…”

Section: Discussionmentioning

confidence: 99%

Current antibiotic use in the treatment of enteric fever in children

Dahiya¹,

Malik²,

Sharma³

et al. 2019

Indian J Med Res

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Background & objectives: Antimicrobial resistance is a major challenge in the treatment of typhoid fever with limited choices left to empirically treat these patients. The present study was undertaken to determine the current practices of antibiotic use in children attending a tertiary care hospital in north India. Methods: This was a descriptive observational study in children suffering from enteric fever as per the case definition including clinical and laboratory parameters. The antibiotic audit in hospitalized children was measured as days of therapy per 1000 patient days and in outpatient department (OPD) as antibiotic prescription on the treatment card. Results: A total of 128 children with enteric fever were included in the study, of whom, 30 were hospitalized and 98 were treated from OPD. The mean duration of fever was 9.5 days at the time of presentation. Of these, 45 per cent were culture positive with Salmonella Typhi being aetiological agent in 68 per cent followed by S. Paratyphi A in 32 per cent. During hospitalization, the average length of stay was 10 days with mean duration of defervescence 6.4 days. Based on antimicrobial susceptibility ceftriaxone was given to 28 patients with mean duration of treatment being six days. An additional antibiotic was needed in six patients due to clinical non-response. In OPD, 79 patients were prescribed cefixime and additional antibiotic was needed in five during follow up visit. Interpretation & conclusions: Based on our findings, ceftriaxone and cefixime seemed to be the first line of antibiotic treatment for typhoid fever. Despite susceptibility, clinical non-response was seen in around 10 per cent of the patients who needed combinations of antibiotics.

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“…Increased inappropriate use of first line drugs has resulted in the emergence of multidrug-resistant (MDR) S. Typhi. Fluoroquinolones and the third-generation drugs have become alternative treatments of typhoid fever, but these drugs can cause undesirable side effects (Veeraraghavan et al, 2018). The Center for Disease Control and Prevention (CDC) ranks the incidence of typhoid fever that emerges by MDR-S. Typhi spread as a serious threat.…”

Section: Smentioning

confidence: 99%

Peer Review #2 of "Organic acids and 2,4-Di-tert-butylphenol: major compounds of Weissella confusa WM36 cell-free supernatant against growth, survival and virulence of Salmonella Typhi (v0.2)"

2020

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Background. Salmonella Typhi (S. Typhi), the causative agent of typhoid fever, causes serious systemic disease in humans. Antibiotic treatment is required for the S. Typhi infection, while the inappropriate use of antibiotics causes increased drug-resistant S. Typhi. Hence, alternative therapies through nonantibiotic approaches are urgently needed. The use of beneficial lactic acid bacterium and/or its metabolites to control typhoid fever represent a promising approach, as it may exert protective actions through various mechanisms. Method. In this study, the cell-free culture supernatant (CFCS) of Weissella confusa WM36 was evaluated via the antibacterial activity, and its metabolites were identified. In addition, the effects of CFCS on Salmonella virulence behaviors were also investigated. Result. Based on strong inhibition the growth of S. Typhi DMST 22842, organic acids (lactic acid and acetic acid) and 2,4-Di-tert-butylphenol (2,4 DTBP), were the main antibacterial metabolites presented in CFCS of strain WM36. Minimum inhibitory concentration (MIC) at 40% WM36-CFCS dramatically reduced the S. Typhi population to more than 99.99% at 4 h and completely inhibited biofilm formation, while sub-MIC at 20% (v/v) and MIC could reduce 100% of motility. Additionally, sub-MIC at only 10% (v/v) WM36-CFCS did down-regulate the expression of virulence genes which are responsible for the type-III secretion system, effector proteins, and quorum sensing (QS) system in this pathogen. Conclusion. W. confusa WM36 and its metabolites are shown to be a promising candidates, and an effective approach against typhoid Salmonella burden.

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Typhoid Fever: Issues in Laboratory Detection, Treatment Options & Concerns in Management in Developing Countries

Cited by 49 publications

References 80 publications

Antimicrobial Susceptibility Trends in Salmonella enterica Isolates - A 6 Year Study from a Tertiary Care Hospital in North India

Antimicrobial Susceptibility Trends in Salmonella enterica Isolates - A 6 Year Study from a Tertiary Care Hospital in North India

Current antibiotic use in the treatment of enteric fever in children

Peer Review #2 of "Organic acids and 2,4-Di-tert-butylphenol: major compounds of Weissella confusa WM36 cell-free supernatant against growth, survival and virulence of Salmonella Typhi (v0.2)"

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