Background: Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi.
Methodology: A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.
Results: One-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035) and C-reactive protein (CRP) values (47.0 mg/L vs. 36 mg/L; p = 0.034) were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR) (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole).;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS) was observed in 96.9% (62/64) of Salmonella Typhi isolates versus 11.5% (21/183) of Salmonella Paratyphi A isolates (all but one from 2015). All isolates were susceptible to azithromycin and ceftriaxone.
Conclusions: In Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and DCS compared to Salmonella Paratyphi A.
Download full-text PDF |
Source |
|---|---|
| http://www.ncbi.nlm.nih.gov/pmc/articles/PMC5624643 | PMC |
| http://dx.doi.org/10.1371/journal.pntd.0005964 | DOI Listing |
Publication Analysis
Top Keywords
Similar Publications
MtlD as a therapeutic target for intestinal and systemic bacterial infections.
J Bacteriol
December 2024
Department of Microbiology, The Ohio State University, Columbus, Ohio, USA.
Unlabelled: The ability to treat infections is threatened by the rapid emergence of antibiotic resistance among pathogenic microbes. Therefore, new antimicrobials are needed. Here we evaluate mannitol-1-phosphate 5-dehydrogenase (MtlD) as a potential new drug target.
View Article and Find Full Text PDFEvaluation of a point-of-care immunochromatographic assay for enteric fever in Dhaka, Bangladesh: a prospective diagnostic accuracy study.
Lancet Microbe
December 2024
Massachusetts General Hospital, Harvard Medical School, Harvard T.H. Chan School of Public Health, Boston, MA, USA. Electronic address:
Background: There is a shortage of rapid, accurate, and low-cost assays for diagnosing enteric fever. The dual-path platform for typhoid (DPPT) assay had high accuracy in retrospective studies with banked plasma samples. We aimed to evaluate the diagnostic accuracy of the DPPT assay in a prospective study using fingerstick capillary blood.
View Article and Find Full Text PDFA newly developed oral infection mouse model of shigellosis for immunogenicity and protective efficacy studies of a candidate vaccine.
Infect Immun
December 2024
Division of Clinical Medicine, ICMR-National Institute of Cholera and Enteric Diseases, Kolkata, West Bengal, India.
infection poses a significant public health challenge in the developing world. However, lack of a widely available mouse model that replicates human shigellosis creates a major bottleneck to better understanding of disease pathogenesis and development of newer drugs and vaccines. BALB/c mice pre-treated with streptomycin and iron (FeCl) plus desferrioxamine intraperitoneally followed by oral infection with virulent resulted in diarrhea, loss of body weight, bacterial colonization and progressive colitis characterized by disruption of epithelial lining, loss of crypt architecture with goblet cell depletion, increased polymorphonuclear infiltration into the mucosa, submucosal swelling (edema), and raised proinflammatory cytokines and chemokines in the large intestine.
View Article and Find Full Text PDFAntibiotics' resistance profile of pathogens isolated from fish products sold in the city of Bangangté, Cameroon: Aqueous extracts from spices' formulations used as accompanying soup of braised fish as antimicrobial alternative.
Heliyon
December 2024
Department of Processing and Quality Control of Aquatic Products, Institute of Fisheries and Aquatic Sciences at Yabassi, University of Douala, PoBox 7236, Douala, Cameroon.
The present study aimed to evaluate the antimicrobial activity of aqueous extracts of the mixture of spices used as accompanying soup of braised fish against multidrug resistant (MDR) bacteria isolated from raw and braised fish collected in the city of Bangangté, Cameroon. A survey was conducted in the city of Bangangté to diagnose the braising fish processes. Pathogens were isolated from raw and braised fish samples collected in fish farms and selling points, and their susceptibility to 16 commonly used antibiotics was tested using the Kirby-Bauer disk diffusion method.
View Article and Find Full Text PDFThe Vanishing Infarct: A Rare Presentation of MERS Due to Salmonella Infection in Middle-Aged Patient.
J Assoc Physicians India
December 2024
Consultant Radiologist, Department of Radiology, Bethany Hospital, Thane, Maharashtra, India.
Enteric fever is caused by Salmonella typhi and Salmonella paratyphi A and B, which can present clinically with variety of symptoms. We report a case of a middle-aged gentleman with salmonella infection who developed reversible corpus callosum splenium infarcts, which is an unusual presentation of enteric fever. The condition was reversed with antibiotics routinely used to treat enteric fever in the country.
View Article and Find Full Text PDFWant AI Summaries of new PubMed Abstracts delivered to your In-box?
Enter search terms and have AI summaries delivered each week - change queries or unsubscribe any time!