scholarly journals A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug-resistant (XDR) Salmonella Typhi isolates in children in Karachi.

2020 ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Nida Ghouri ◽  
Saba Noreen
Keyword(s):  
Enteric Fever ◽  
Clinical Course ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Salmonella Typhi ◽  
Drug Resistant ◽  
Extensively Drug Resistant

Abstract Background: Enteric fever is a systemic infection, which can be caused by Salmonella enterica; Typhi and Paratyphi A. Over time, Salmonella Typhi has developed resistance to antibiotics resulting in the emergence of extensively drug-resistant (XDR) enteric fever. WHO estimated 5274 cases of XDR Enteric fever in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and outcomes of XDR enteric fever among the pediatric population coming to Indus HospitalMethods: A retrospective chart review of pediatric patients (aged one month to 15 years) seen in Indus Hospital between July 2017 to December 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about seasonality and distribution of cases, demographic details, signs and symptoms, clinical course, treatment, complications and outcomes of the cases treated for XDR Enteric feverResults: Six hundred and eighty children were included in the study. The median (IQR) age of the patients was 5 (2-8) years. More than half (n=391, 57.5%) of the patients were males. Most common clinical manifestations included fever, vomiting and diarrhea, noted in 680 (100%), 242 (35%) and 174 (25%) patients. Outcomes of 270 (39.7%) patients were recorded. Others were lost to follow up [351 (51.6%)], referred out [52 (7.6%)] or left against medical advice [7 (1%)]. 266 (39.1%) patients were cured, and four children (0.6%) expired. Seventy-eight patients (82%) and 15 patients (16.3%) got cured on Azithromycin and Meropenem alone while 157 on a combination of drugs.Conclusion: Our review indicated that children under five years of age were affected more with XDR Enteric fever. Meropenem and Azithromycin, either alone or in combination were the most effective antibiotics for treating XDR Enteric fever in children coming to Indus hospital

scholarly journals A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug resistant (XDR) Salmonella Typhi isolates in children in Karachi.

2020 ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Nida Ghouri ◽  
Saba Noreen
Keyword(s):  
Enteric Fever ◽  
Clinical Course ◽  
Pediatric Population ◽  
Clinical Manifestations ◽  
Systemic Infection ◽  
Retrospective Chart Review ◽  
Signs And Symptoms ◽  
Salmonella Typhi ◽  
Drug Resistant ◽  
Extensively Drug Resistant

Abstract Background: Enteric fever is a systemic infection, which can be caused by Salmonella enterica; Typhi and Paratyphi A. Over a period of time Salmonella Typhi has developed resistance to many antibiotics which has resulted in emergence of extensively drug resistant (XDR) enteric fever. WHO estimated 5274 cases of XDR Enteric fever in Karachi from November 2016 to December 2019.This study aims to determine clinical course, complications and outcomes of XDR enteric fever among the pediatric population coming to Indus HospitalMethods: A retrospective chart review of pediatric patients (aged 1 month–15 years) seen in Indus Hospital between July 2017 to December 2018 was conducted. A pre-designed data abstraction form was used to record detailed information about seasonality and distribution of cases, demographic details, signs and symptoms, clinical course, treatment, complications and final outcomes of the cases treated for XDR Enteric feverResults: Six hundred and eighty children were included in the study. The median (IQR) age of the patients was 5 (2-8) years. More than half (n=391, 57.5%) of the patients were males. Most common clinical manifestations included fever vomiting and diarrhea which were noted in 680 (100%), 242 (35%) and 174 patients (25%) Final outcomes of 270 (39.7%) patients have been recorded; 351 (51.6%) were lost to follow up, 52 (7.6%) were referred out and 7 (1%) left without medical advice. 266 (39.1%) patients were cured and 4 children (0.6%) expired. Seventy eight patients (82%) and 15 patients (16.3%) got cured on Azithromycin and Meropenum alone while 157 patients got cured on combination of drugs.Conclusion: Our review indicated that children under 5 years of age were affected more with XDR Enteric fever. Meropenum and Azithromycin, either alone or in combination were the most effective antibiotics for treating XDR Enteric fever in children coming to Indus hospital

scholarly journals A review of clinical profile, complications and antibiotic susceptibility pattern of extensively drug-resistant (XDR) Salmonella Typhi isolates in children in Karachi

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Saba Shahid ◽  
Marvi Mahesar ◽  
Nida Ghouri ◽  
Saba Noreen
Keyword(s):  
Pediatric Population ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
Response To Treatment ◽  
Delayed Response ◽  
Drug Resistant ◽  
First Line ◽  
Antibiotic Susceptibility Pattern ◽  
Extensively Drug Resistant ◽  
Children Under 5

Abstract Background Enteric fever is a systemic infection caused by Salmonella enterica serovar Typhi and Salmonella enterica serovar Paratyphi A, B, and C. There is an emergence of Typhoid fever caused by extensively drug-resistant Salmonella Typhi strain called XDR S.Typhi. This strain is resistant to recommended first-line antibiotics and cephalosporins. WHO estimated 5274 cases of XDR S.Typhi in Karachi from November 2016 to December 2019. This study aims to determine clinical course, complications and response to treatment of XDR S.Typhi among the pediatric population coming to Indus Hospital. Method We reviewed the records of children who had culture-proven XDR S.Typhi infection at Indus Hospital from July 2017 to December 2018. A pre-designed data abstraction form was used to record information about seasonality, demographic details, clinical features and course, treatment, complications and outcomes of the cases of XDR S.Typhi. Results The records of 680 children were reviewed. The median (IQR) age of the patients was 5 (2–8) years. More than half (n = 391, 57.5%) of the patients were males. The outcomes were recorded in 270 (40%) patients. Out of these, 234 (86.7%) children got cured within 14 days, while a delayed response to antibiotics was noted in 32 (11.9%) children. Seventy-six (29%) children recovered on a combination of meropenem and azithromycin, 72 (27%) got cured on azithromycin alone, while 15 (6%) responded to meropenem alone. Conclusion Our review indicated that children under 5 years of age were affected more with XDR S.Typhi. Azithromycin alone or in combination with meropenem were effective antibiotics for treating XDR S.Typhi in children.

scholarly journals Tebipenem as an oral alternative for the treatment of typhoid caused by extensively drug resistant (XDR) Salmonella Typhi

2021 ◽  
Author(s):  
Elli Mylona ◽  
Phat Voong Vinh ◽  
Sonia Qureshi ◽  
Abhilasha Karkey ◽  
Sabina Dongol ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Salmonella Typhi ◽  
Drug Resistant ◽  
Extensively Drug Resistant ◽  
Extensive Drug Resistance ◽  
Spectrum Activity ◽  
Fever Treatment ◽  
Emergence Of Resistance ◽  
Broad Spectrum Activity

Abstract The emergence of multi-drug (MDR) and extensive-drug resistance (XDR) in Salmonella Typhi and Paratyphi A hinder efficacious out-patient enteric fever treatment. We show that non-XDR and XDR S. Typhi and S. Paratyphi A are susceptible to the carbapenem tebipenem in vitro. Tebipenem demonstrated partial synergy with antimicrobials including azithromycin, signifying combination therapy may limit the emergence of resistance. Given recent evidence on tebipenem inhibitory activity against MDR Shigella, its broad-spectrum activity against MDR/XDR organisms renders it a good clinical trial candidate.

scholarly journals Enteric fever with severe pancytopenia in a four year girl

2010 ◽  
Vol 50 (180) ◽  
Author(s):  
R Pathak ◽  
A Sharma ◽  
A Khanal
Keyword(s):  
Bone Marrow ◽  
Enteric Fever ◽  
Hemophagocytic Syndrome ◽  
Systemic Infection ◽  
Salmonella Typhi ◽  
Bone Marrow Suppression ◽  
Major Health Problem ◽  
Major Health ◽  
Severe Pancytopenia ◽  
Paratyphoid Fever

Typhoid fever and paratyphoid fever (also known as enteric fever) are severe systemic illnesses caused by salmonella typhi and S. paratyphi respectively. Enteric fever is prevalent in developing countries including Nepal, where it still remains as a major health problem. There have been reports of pancytopenia with enteric fever which has been attributed to mechanisms like bone marrow suppression, infection associated hemophagocytic syndrome and disseminated intravascular coagulation. We report here a case of severe pancytopenia in enteric fever as a result of bone marrow suppression due to systemic infection. Keywords: enteric fever, pancytopenia, bone marrow suppression

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 Carbapenemases: Transforming Acinetobacter baumannii into a Yet More Dangerous Menace

Biomolecules ◽  
2020 ◽  
Vol 10 (5) ◽  
pp. 720 ◽  
Author(s):  
Maria Soledad Ramirez ◽  
Robert A. Bonomo ◽  
Marcelo E. Tolmasky
Keyword(s):  
Acinetobacter Baumannii ◽  
Nosocomial Infections ◽  
Acquired Resistance ◽  
Clinical Manifestations ◽  
High Capacity ◽  
Bloodstream Infections ◽  
Multidrug Resistant ◽  
Drug Resistant ◽  
Wound Infections ◽  
Extensively Drug Resistant

Acinetobacter baumannii is a common cause of serious nosocomial infections. Although community-acquired infections are observed, the vast majority occur in people with preexisting comorbidities. A. baumannii emerged as a problematic pathogen in the 1980s when an increase in virulence, difficulty in treatment due to drug resistance, and opportunities for infection turned it into one of the most important threats to human health. Some of the clinical manifestations of A. baumannii nosocomial infection are pneumonia; bloodstream infections; lower respiratory tract, urinary tract, and wound infections; burn infections; skin and soft tissue infections (including necrotizing fasciitis); meningitis; osteomyelitis; and endocarditis. A. baumannii has an extraordinary genetic plasticity that results in a high capacity to acquire antimicrobial resistance traits. In particular, acquisition of resistance to carbapenems, which are among the antimicrobials of last resort for treatment of multidrug infections, is increasing among A. baumannii strains compounding the problem of nosocomial infections caused by this pathogen. It is not uncommon to find multidrug-resistant (MDR, resistance to at least three classes of antimicrobials), extensively drug-resistant (XDR, MDR plus resistance to carbapenems), and pan-drug-resistant (PDR, XDR plus resistance to polymyxins) nosocomial isolates that are hard to treat with the currently available drugs. In this article we review the acquired resistance to carbapenems by A. baumannii. We describe the enzymes within the OXA, NDM, VIM, IMP, and KPC groups of carbapenemases and the coding genes found in A. baumannii clinical isolates.

scholarly journals Outbreak of Multi-drug Resistant Salmonella Typhi Enteric Fever in Mumbai Garrison

2005 ◽  
Vol 61 (2) ◽  
pp. 148-150 ◽  
Author(s):  
RN Misra ◽  
KS Bawa ◽  
SK Magu ◽  
S Bhandari ◽  
A Nagendra ◽  
...  
Keyword(s):  
Enteric Fever ◽  
Salmonella Typhi ◽  
Drug Resistant

scholarly journals Antibacterial Activity of Manuka Honey Against Azithromycin Resistant Extensively Drug Resistant Salmonella Typhi Clinical Isolates: In-Vitro Study

2022 ◽  
Author(s):  
Kokab Jabeen ◽  
Sidrah Saleem ◽  
Faiqa Arshad ◽  
Zill-e-Huma ◽  
Shah Jahan ◽  
...  
Keyword(s):  
Antibacterial Activity ◽  
Alternative Treatment ◽  
Therapeutic Potential ◽  
Salmonella Typhi ◽  
Drug Resistant ◽  
Manuka Honey ◽  
Extensively Drug Resistant ◽  
Alternative Treatment Option ◽  
Wide Range

Abstract Typhoid fever is a significant health problem in developing countries like Pakistan. Salmonella Typhi the causative agent of typhoid has developed resistant to almost all recommended antibiotics. Emergence of resistance to third generation cephalosporins has further complicated the situation and such strains are called as extensively drug resistant (XDR) Salmonella Typhi. Currently only available options are azithromycin and cabapenems. Recently few reports of azithromycin resistance have emerged from countries like Pakistan, India, Bangladesh and Nepal. As azithromycin is the only oral option available to treat XDR Typhoid, development of resistance may change treatment strategy altogether from out patient management to hospitalization of every patient. This may increase the burden on already weak health care system of countries like Pakistan. So there is dire need to look for the alternative treatment options. Manuka honey is well known for its therapeutic potential against wide range of bacteria including Salmonella Typhimurium. In this study 3 azithromycin resistant isolates were isolated and identified using disc diffusion, E-test and broth micro dilution methods and antibacterial activity, MIC and MBC of manuka honey was performed by agar well diffusion assay and broth micro dilution assay respectively. Manuka honey manifested significant antibacterial activity against all test isolates with zone of inhibition ranging from 7.3mm to 7.5mm, MIC and MBC values were between 10 to 15% v/v Here, we conclude that Manuka honey possess potent antibacterial activity and might be used as an alternative treatment option against azithromycin resistant XDR Typhid. However, further clinical trials are mandatory to validate our initial findings.

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