scholarly journals Cephalosporin-resistant typhoid

2020 ◽  
Vol 8 ◽  
pp. 2050313X2091783
Author(s):  
Noella Maria Delia Pereira ◽  
Ira Shah
Keyword(s):  
Developing Countries ◽  
Cerebrospinal Fluid ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Antimicrobial Stewardship ◽  
Salmonella Typhi ◽  
Third Generation ◽  
Sanitation And Hygiene ◽  
Cerebrospinal Fluid Examination ◽  
Third Generation Cephalosporins

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.

scholarly journals Typhoid fever: a review

2017 ◽  
Vol 4 (2) ◽  
pp. 300 ◽  
Author(s):  
Uttam Kumar Paul ◽  
Arup Bandyopadhyay
Keyword(s):  
Typhoid Fever ◽  
Paediatric Population ◽  
Salmonella Typhi ◽  
Third Generation ◽  
Once Daily ◽  
Contaminated Food ◽  
Adults And Children ◽  
Third Line ◽  
Flagellar Antigen ◽  
Third Generation Cephalosporins

Typhoid fever is still a deadly disease in developing countries, particularly in India. Although, the paediatric population is mostly affected by this disease, yet the disease is an important cause of morbidity and mortality in adult populations also. In India, most of the cases of typhoid fever are diagnosed clinically, or at the most by the Widal test which is not fool proof. The disease typhoid fever is an orally transmitted communicable infectious disease caused by the bacteria Salmonella typhi. It is usually caused by consuming impure water and contaminated food. Salmonella typhi is serologically positive for lipopolysaccharide antigens O9 and O12, protein flagellar antigen Hd, and polysaccharide capsular antigen Vi. S. typhi Vi-positive strains are more infectious and virulent than Vi-negative strains. Following the incubation period of 7 to 14 days, there is onset of fever and malaise. The fever is then accompanied by chills, headache, malaise, anorexia, nausea, vague abdominal discomfort, dry cough and myalgia. These are followed by coated tongue, tender abdomen, hepatomegaly, and splenomegaly. Azithromycin (10mg/kg) given once daily for seven days has proven effective in the treatment of typhoid fever in some adults and children. A dose of 1g per day for five days was also found to be more effective in most adults. Of the third generation cephalosporins, oral Cefixime (15-20mg per kg per day, for adults, 100-200mg twice daily) has been widely used. Intravenous third generation cephalosporins (ceftriaxone, cefotaxime) are effective. Aztreonam and imipenem are potential third line drugs.

scholarly journals Drug-Resistant Salmonella typhi in Pakistan

2019 ◽  
Vol 59 (1) ◽  
pp. 31-33 ◽  
Author(s):  
Christine E. Petrin ◽  
Russell W. Steele ◽  
Elizabeth A. Margolis ◽  
Justin M. Rabon ◽  
Holly Martin ◽  
...  
Keyword(s):  
United States ◽  
Typhoid Fever ◽  
Enteric Fever ◽  
The United States ◽  
Salmonella Typhi ◽  
Antimicrobial Treatment ◽  
Third Generation ◽  
Drug Resistant ◽  
Oral Transmission ◽  
Third Generation Cephalosporins

Enteric fever (formerly typhoid fever) is a bacterial illness caused by fecal-oral transmission of Salmonella typhi or paratyphi. In early 2018, an outbreak of Salmonella typhi resistant to third-generation cephalosporins, ampicillin, ciprofloxacin, trimethroprim-sulfamethoxazole, and chloramphenicol was reported in Pakistan. This strain, termed “extensively resistant typhi,” has infected more than 5000 patients in endemic areas of South Asia, as well as travelers to and from these areas, including 5 cases in the United States. We present the case of one such child who developed extensively resistant enteric fever during a recent visit to Pakistan and required broader antimicrobial treatment than typically required. Clinicians should be aware that incoming cases of enteric fever may be nonsusceptible to commonly recommended antibiotics and that extensively resistant typhi requires treatment with carbapenems such as meropenem or azithromycin.

scholarly journals A Rare Case of Salmonella Typhi Presenting with Tonsillitis

2021 ◽  
pp. 294-296
Author(s):  
S. Aarifaa ◽  
Kaliannan Mayilananthi ◽  
Durga Krishnan ◽  
V. R. Mohan Rao ◽  
Praveen Srinivas
Keyword(s):  
Developing Countries ◽  
Case Report ◽  
Blood Culture ◽  
Typhoid Fever ◽  
Rare Case ◽  
Enteric Fever ◽  
Clinical Presentation ◽  
Salmonella Typhi ◽  
Oral Manifestations ◽  
Oral Ulcers

Typhoid fever is an endemic infection in developing countries like India. Oral manifestations of enteric fever and typhoid tonsillitis have rarely been reported in the literature.   We report a 20 year old male, showing tonsillitis to be an integral part of clinical presentation of typhoid fever.The patient presented with fever, throat pain and oral ulcers. Blood culture and swab from tonsils showed significant growth of Salmonella typhi.This case report adds light to tonsillitis as a rare clinical manifestation of typhoid fever.

scholarly journals Stool shedding of Salmonella Typhi in children with blood culture-confirmed typhoid fever

2020 ◽  
Vol 101 ◽  
pp. 123
Author(s):  
M. Srinivasan ◽  
S. Giri ◽  
S. Kulandaipalayam Natarajan ◽  
N. Kumar ◽  
V.R. Mohan ◽  
...  
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Salmonella Typhi

scholarly journals Culture proven Salmonella typhi co-infection in a child with Dengue fever: a case report

2015 ◽  
Vol 9 (09) ◽  
pp. 1033-1035 ◽  
Author(s):  
Rangan Srinivasaraghavan ◽  
Parameswaran Narayanan ◽  
Thandapani Kanimozhi
Keyword(s):  
Risk Factors ◽  
Developing Countries ◽  
Case Report ◽  
Infectious Diseases ◽  
Typhoid Fever ◽  
Dengue Fever ◽  
Salmonella Typhi ◽  
Infectious Agents ◽  
Dengue Outbreak ◽  
Concurrent Infections

Infectious diseases are one of the major causes of morbidity and mortality in developing countries. Sometimes concurrent infections with multiple infectious agents may occur in one patient, which make the diagnosis and management a challenging task. The authors here present a case of co-infection of typhoid fever with dengue fever in a ten-year-old child and discuss the pertinent issues. The authors emphasize that the risk factors predicting the presence of such co-infections, if developed, will be immensely useful in areas where dengue outbreak occurs in the background of high transmission of endemic infections.

scholarly journals A Patient with Typhoid Hepatitis

2021 ◽  
Vol 22 (2) ◽  
pp. 154-158
Author(s):  
M Vitanata Arfijanto ◽  
Isty Rindryastuti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Gastrointestinal Symptoms ◽  
Signs And Symptoms ◽  
Hemorrhagic Fever ◽  
Liver Function Tests ◽  
Salmonella Typhi ◽  
Abnormal Liver Function ◽  
Grade Ii ◽  
Ig G

Typhoid hepatitis is typhoid fever accompanied by symptoms of jaundice, hepatomegaly and abnormal liver function tests. The incidence varies between 0.4% -26% of typhoid fever patients. We report a case of a 34-year-old male, presented with fever, epistaxis, gastrointestinal symptoms, thrombocytopenia and elevated AST/ ALT, thus the patient was first diagnosed as dengue hemorrhagic fever grade II. On day 9th the signs and symptoms were persisted, Ig M and Ig G Dengue was negative. Then we evaluated the virus marker for hepatitis and blood culture. The results were negative for HBsAg, anti HCV and Ig M anti HAV, but Salmonella typhi detected on blood culture. The patient was treated with ceftriaxone 1000mg bid iv and get better then discharged from hospital.

scholarly journals Utility of A Single Widal Test in The Diagnosis of Typhoid Fever

2012 ◽  
Vol 35 (2) ◽  
pp. 53-58 ◽  
Author(s):  
ABM Shahidul Alam ◽  
Fahim Ahmed Rupam ◽  
Farhana Chaiti
Keyword(s):  
Blood Culture ◽  
Typhoid Fever ◽  
Predictive Value ◽  
Salmonella Typhi ◽  
Definitive Diagnosis ◽  
Blood Cultures ◽  
Widal Test ◽  
Female Ratio ◽  
The Mean ◽  
Agglutinin Titer

Background & objectives: The clinical diagnosis of typhoid fever is difficult, as the presenting symptoms are often diverse and similar to those observed with other febrile illnesses. The definitive diagnosis of typhoid fever requires the isolation of Salmonella typhi or paratyphi from the patient concerned. Since patients often receive antibiotics prior to a confirmatory diagnosis, there is uncertainty that bacteria can be isolated from the blood cultures. Besides this, the facilities for blood culture are not always available or feasible. All these limitations have made Widal test the most utilized diagnostic test for typhoid fever. Many studies have produced data which had cast serious doubts on the value of the Widal Test and thus reappraisal of the role of a single Widal test is needed.Methods & materials: This study was carried out to determine the changes in clinical pattern of enteric fever. A total of 153 children, aged 0 to 14 years, diagnosed as typhoid fever (either positive blood culture for Salmonella typhi or paratyphi) were induced in the study. Of them, 86 children were with a definitive diagnosis of typhoid or paratyphoid fever as indicated by the isolation of S. typhi or S. paratyphi from the blood and 17 had negative blood culture but were clinically suspected of having typhoid fever. The control group was comprised of 50 children with non-typhoidal fevers The Widal test was carried out using rapid slide agglutination method and its accuracy was assessed by comparing the findings with that obtained through blood culture.Result: The mean age of the patients was 5.2 ± 2.8 years and the youngest and oldest patients were 0.7 and 14 years respectively and male to female ratio was roughly 1:1. Nearly one-quarter (24.6%) of the patients had been suffering from the disease for >10 days and the mean duration of illness was 8.2 ± 3.3 days. Widal Test result showed that an ‘O’ agglutinin titer of cut-off value e”1:40 gave a sensitivity of 87.2%, a specificity of 47.1%, a positive predictive value (PPV) of 89.2% and a negative predictive value (NPV) of 42.1%. The sensitivity and NPV decreased with the increase in titer levels and were 56.9% and 31.5% at cut-off value of e” 1:320, while the specificity and PPV increased with the increase in titer levels from 47.1% and 89.2% respectively at a titer of e”1:40 to 100% at a titer of e” 1:320. The ‘titer behaved in the same way as did the ‘O’ agglutinin titer. Similarly when H’ agglutinin was used the sensitivity and NPV decreased from 65% and 31.7% at a titer of e”1:40 to only 25% and 20% respectively at a titer of > 1:320, while specificity and PPV increased from 76.4% and 81.1% at >1:40 to 94.1% and 95.6% respectively at e” 1:320. When either ‘O’ or ‘H’ antibody titer of e”1:160 was used, a good sensitivity (71%), specificity (70.6%) and PPV (92.4%) resulted, though NPV decreased to 32.4%.Conclusion: The Widal test can be of diagnostic value when blood cultures are not available nor practically feasible.DOI: http://dx.doi.org/10.3329/bjch.v35i2.10377  Bangladesh J Child Health 2011; Vol 35 (2): 53-58

scholarly journals Comparison of results obtained by widal agglutination test & polymerase chain reaction among clinically suspected typhoid fever cases

2015 ◽  
Vol 30 (2) ◽  
pp. 46-50
Author(s):  
Shafinaz Khan ◽  
Md Ruhul Amin Miah ◽  
Shammin Haque ◽  
Chowdhury Rafia Naheen
Keyword(s):  
Polymerase Chain Reaction ◽  
Blood Culture ◽  
Typhoid Fever ◽  
False Negative ◽  
Salmonella Typhi ◽  
Widal Test ◽  
Chain Reaction ◽  
Polymerase Chain ◽  
Positive Results ◽  
Prior Antibiotic Treatment

The diagnosis of typhoid fever currently depends on isolation of Salmonella Typhi from blood. The sensitivity of blood culture is very low due to prior antibiotic treatment which is a common practice in Bangladesh. The sensitivity of blood culture also decreases at later stage of the disease. Widal test is the most utilized test in Bangladesh next to blood culture because it is inexpensive, less invasive. But the result of the test is controversial due to false negative & false positive results in some cases.  In this study, a recently introduced polymerase chain reaction-based technique (which has 100% specificity for S. Typhi) was compared with widal test among 80 clinically suspected typhoid fever cases.  Among 80 cases, the respective figures of positivity for PCR & widal test were 70% & 43.75% respectively.  It can be concluded that PCR based technique is more sensitive & much superior to widal for diagnosis of typhoid fever. DOI: http://dx.doi.org/10.3329/bjpp.v30i2.22683 Bangladesh J Physiol Pharmacol 2014; 30(2): 46-50

scholarly journals When first line treatment of neonatal infection is not enough: blood culture and resistance patterns in neonates requiring second line antibiotic therapy in Bangui, Central African Republic

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Andrea Nebbioso ◽  
Oluwakemi F. Ogundipe ◽  
Ernestina Carla Repetto ◽  
Calorine Mekiedje ◽  
Hugues Sanke-Waigana ◽  
...  
Keyword(s):  
Blood Culture ◽  
Klebsiella Oxytoca ◽  
Neonatal Infection ◽  
Sub Saharan Africa ◽  
Gram Negative Bacteria ◽  
Third Generation ◽  
Antibiotic Resistant ◽  
Gram Negative ◽  
Sub Saharan ◽  
Third Generation Cephalosporins

Abstract Background Infectious diseases account for the third most common cause of neonatal deaths. Globally, antibiotic resistance (ABR) has been increasingly challenging neonatal sepsis treatment, with 26 to 84% of gram-negative bacteria resistant to third-generation cephalosporins. In sub-Saharan Africa, limited evidence is available regarding the neonatal microbiology and ABR. To our knowledge, no studies have assessed neonatal bacterial infections and ABR in Central-African Republic (CAR). Therefore, this study aimed to describe the pathogens isolated and their specific ABR among patients with suspected antibiotic-resistant neonatal infection admitted in a CAR neonatal unit. Methods This retrospective cohort study included neonates admitted in the neonatal unit in Bangui, CAR, from December 2018 to March 2020, with suspected antibiotic-resistant neonatal infection and subsequent blood culture. We described the frequency of pathogens isolated from blood cultures, their ABR prevalence, and factors associated with fatal outcome. Results Blood cultures were positive in 33 (26.6%) of 124 patients tested (17.9% for early-onset and 46.3% for late-onset infection; p = 0.002). Gram-negative bacteria were isolated in 87.9% of positive samples; with most frequently isolated bacteria being Klebsiella pneumoniae (39.4%), Escherichia coli (21.2%) and Klebsiella oxytoca (18.2%). All tested bacteria were resistant to ampicillin. Resistance to third-generation cephalosporins was observed in 100% of tested Klebsiella pneumoniae, 83.3% of isolated Klebsiella oxytoca and 50.0% of tested Escherichia coli. None of the tested bacteria were resistant to carbapenems. Approximately 85.7 and 77.8% of gram-negative tested bacteria were resistant to first-line (ampicillin-gentamicin) and second-line (third-generation cephalosporins) treatments, respectively. In hospital mortality, adjusted for blood culture result, presence of asphyxia, birth weight and sex was higher among neonates with positive blood culture (adjusted relative risk [aRR] = 2.32; 95% confidence interval [CI] = 1.17–4.60), male sex (aRR = 2.07; 95% CI = 1.01–4.26), asphyxia (aRR = 2.42; 95% CI = 1.07–5.47) and very low birth weight (1000–1499 g) (aRR = 2.74; 95% CI = 1.3–5.79). Conclusion Overall, 77.8% of confirmed gram-negative neonatal infections could no longer effectively be treated without broad-spectrum antibiotics that are not routinely used in sub-Saharan Africa referral hospitals. Carbapenems should be considered an option in hospitals with surveillance and antibiotic stewardship.

scholarly journals Emergence of Ceftriaxone Resistance during a Case of Pneumococcal Meningitis with Fatal Evolution

2019 ◽  
Vol 64 (3) ◽  
Author(s):  
A. Mizrahi ◽  
J. C. Marvaud ◽  
B. Pilmis ◽  
J. C. Nguyen Van ◽  
C. Couzigou ◽  
...  
Keyword(s):  
Cerebrospinal Fluid ◽  
Streptococcus Pneumoniae ◽  
Pneumococcal Meningitis ◽  
Binding Protein ◽  
Third Generation ◽  
Penicillin Binding Protein ◽  
Content Type ◽  
Neurological Improvement ◽  
Third Generation Cephalosporins ◽  
Fatal Evolution

ABSTRACT We report a case of a 62-year-old man treated for Streptococcus pneumoniae meningitis by ceftriaxone and dexamethasone. After neurological improvement, neurological degradation by vasculitis occurred, despite effective concentrations of ceftriaxone in the serum and cerebrospinal fluid (CSF). S. pneumoniae with increased MICs to third-generation-cephalosporins (3GC) was isolated from the ventricular fluid 10 days after the isolation of the first strain. Isolate analysis showed that a mutation in the penicillin-binding protein 2X (PBP2X) has occurred under treatment.

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