scholarly journals Salmonella Typhi Infections and Effect of Fluroquinolones and Third Generation Cephalosporins in Clinical Outcome

1970 ◽  
Vol 31 (3) ◽  
pp. 216-221 ◽  
Author(s):  
UK Singh ◽  
AK Neopane ◽  
M Thapa ◽  
N Aryal ◽  
K Agrawal
Keyword(s):  
Public Health ◽  
Nalidixic Acid ◽  
Health Problem ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Third Generation ◽  
Third Generation Cephalosporins ◽  
Culture Positive

Background: Enteric fever is a common public health problem in Nepal. The emerging fluoroquinolone resistance to Salmonella typhi is a major concern in every hospital and is a public health problem these days. Continuous antibiotic susceptibility patterns surveillance and standard treatment policies need to be established to control MDR typhoid. Objective: To detect the increasing pattern of fluoroquinolone resistant Salmonella typhi and to correlate its clinical response to third generation cephalosporins. Materials and Method: This is a cross- sectional prospective study conducted in the pediatric ward of Birendra Hospital, Kathmandu, from September 2009 to August 2010. Forty seven children aged between 3-14 years with the diagnosis of suspected, probable and confirmed cases of Enteric fever were enrolled in the study. Data was collected and statistical analysis was done using SPSS program. Result: Culture positive enteric fever was found in 21 cases (44.68%) and positive Widal test in 18 (38.29%). Among the culture positive cases, antibiotic sensitivity was highest for Ofloxacin (95.23%), followed by third generation Cephalosporins (Ceftriaxone, Cefixime) (90.47%). A significant number of isolates were resistant to Nalidixic acid (71.42%). All cases were successfully treated with parenteral antibiotics followed by oral third generation cephalosporins without any complications and/or mortality. Conclusion: There is an increasing trend to fluoroquinolone resistant Salmonella typhi. Third generation cephalosporin can be the appropriate antibiotic for treatment.of clinically suspected cases of Enteric fever and to minimize the risk of increasing emergence of MDR enteric fever including Nalidixic acid resistant Typhoid.(NARST). Key words: Cephalosporin; drug resistance; Enteric fever; Fluoroquinolone; Salmonella typhi. DOI: http://dx.doi.org/10.3126/jnps.v31i3.5361 J Nep Paedtr Soc 2011;31(3): 216-221

scholarly journals Is Antimicrobial Resistance Pattern of Enteric Fever Changing in Kathmandu Valley?

2013 ◽  
Vol 32 (3) ◽  
pp. 221-228
Author(s):  
Ganesh Kumar Rai ◽  
Subhana Karki ◽  
Bina Prajapati
Keyword(s):  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Resistance Pattern ◽  
Kathmandu Valley ◽  
Sensitivity Testing ◽  
Antimicrobial Sensitivity ◽  
Sensitivity Pattern

Introduction: Enteric fever is a public health problem in developing countries including Nepal. Antimicrobial sensitivity pattern of Salmonella sp causing enteric fever is changing over time and also differs according to geographical location. Periodic surveillance of antimicrobial resistance of Salmonella sp is mandatory for management of enteric fever rationally. The objective of this study was to analyze the resistance pattern of Salmonella sp to commonly used antimicrobials. Materials and Methods: This was a retrospective study undertaken reviewing the records of blood isolates of Salmonella sp over one year period at Kanti Children’s Hospital, Nepal. Antimicrobial sensitivity testing was done following Kirby Bauer’s disk diffusion technique using Muller Hinton agar. Results: Salmonella typhi was found to be 100% resistance to ampicillin and resistance to nalidixic acid and ciprofloxacin was also high. The resistance to chloramphenicol and ofloxacin was low. No resistance was found to amoxicillin, ceftriaxone, cefotaxime and amikacin. However, among the sensitive isolates of Salmonella typhi intermediate sensitivity to ceftriaxone and ceftazidime was reported to be high. Among the isolates of S paratyphi A, the resistance to nalidixic acid was 100% followed by 75% to ciprofloxacin. No resistance was found to chloramphenicol, ceftriaxone, cefixime, amikacin and low resistance to amoxicillin and ofloxacin. Among the sensitive isolates of S paratyphi A, majority of them were only moderately sensitive to cefotaxime and ceftazidime and about 1/3 of the organisms had only intermediate sensitivity to ceftriaxone. Conclusiion: Commonly used parenteral third generation cephalosporins, first line drugs like chloramphenicol and amoxicillin and ofloxacin among fluoroquinolones were found to be effective in vitro in treating enteric fever. However, Salmonella typhi was found to be highly resistant to the most frequently used drugs like ciprofloxacin and cefixime and Salmonella paratyphi A to ciprofloxacin. A comparative chart of antimicrobial sensitivity of enteric fever in children over 10 year period from different hospitals of Kathmandu valley is also presented in the study. DOI: http://dx.doi.org/10.3126/jnps.v32i3.6625 J. Nepal Paediatr. SocVol.32(3) 2012 221-228

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.

Antimicrobial Resistance of Campylobacter jejuni Isolated from Chicken Carcasses in the Federal District, Brazil

2013 ◽  
Vol 76 (4) ◽  
pp. 691-693 ◽  
Author(s):  
HELENIRA MELO de MOURA ◽  
PATRÍCIA RENAULT SILVA ◽  
PATRÍCIA HELENA CALDEIRA da SILVA ◽  
NARA RÚBIA SOUZA ◽  
ALINE MONDINI C. RACANICCI ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Campylobacter Jejuni ◽  
Health Problem ◽  
Food Processing ◽  
Public Health Problem ◽  
Federal District ◽  
Antimicrobial Drugs ◽  
High Level

The aim of the present study was to perform microbiological isolation of Campylobacter jejuni from chilled chicken carcasses marketed in the Federal District of Brazil and to subject the strains to an antibiogram. A total of 92 samples from chilled chicken carcasses were acquired, 18 of which (19.56%) tested positive for C. jejuni. A total of 16 strains were tested for susceptibility to eight antimicrobial drugs. All 16 strains were resistant to ciprofloxacin, 15 strains to nalidixic acid, streptomycin, tetracycline, and gentamycin, 14 strains to amoxicillin, 11 strains to erythromycin, and 6 strains to chloramphenicol. The present study is the first to report on the presence of C. jejuni in chilled chicken carcasses marketed in the Federal District region of Brazil. These results may indicate flaws in certain steps of this food processing and highlight a possible public health problem due to the high level of resistance exhibited by the isolated strains.

scholarly journals Clinical spectrum of enteric fever in children admitted to a tertiary care hospital

2020 ◽  
Vol 7 (7) ◽  
pp. 1530
Author(s):  
Jawad Nazir Wani ◽  
Abdus Sami Bhat ◽  
Saleem Yusuf ◽  
Umer Amin Qureshi
Keyword(s):  
Public Health ◽  
Blood Culture ◽  
Health Problem ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Public Health Problem ◽  
Clinical Spectrum ◽  
Care Hospital ◽  
Presenting Symptoms ◽  
Normal White Blood Cell

Background: Enteric fever is a common public health problem with variable clinical presentation. The aim of study was to study the clinical spectrum of enteric fever in children.Methods: This was a prospective study conducted over period of one year from January 2019 to January 2020 in the Department of Paediatrics at Govt Medical College Srinagar. It included all patients in the age group of 1-18 years who were clinically suspected to have enteric fever and had either a positive blood culture for Salmonella or a positive Widal test.Results: This study included total of 76 patients out of which 36 were males and 40 were females. The most common presenting symptoms were fever anorexia, vomiting, diarrohea, abdominal pain, headache and constipation. The most common signs were coated tongue, toxic look, hepatomegaly, splenomeagly, pallor, jaundice and abdominal distension. Complications were seen in in 8 (10.5%) patients. Myocarditis was seen in 3 patients. Encephalopathy and hepatitis was seen in 2 patients each. Pneumonia was seen in 1 patient. Majority of patients had normal white blood cell count (4000-11000/cumm). Leukopenia (<4000/cumm) was seen in 10% patients and leukocytosis (>11000/cumm) was seen in 15% patients. Thrombocytopenia was seen in 9% patients. Blood culture was positive in 36 (47.36%) patients. Salmonella typhi was seen in 33 patients whereas Salmonella paratyphi A was seen in 3 patients. All culture positive cases were sensitive to ceftriaxone, cefixime and azithromycin. Ciprofloxacin resistance was seen in 11 (14.4%) patients.Conclusions: Enteric fever is a common public health problem with fever as most common presenting symptom. Culture yield can be increased in enteric fever by drawing blood culture prior to administration of antibiotics. Ceftriaxone is highly efficacious as monotherapy in enteric fever.

scholarly journals Re-emergence of susceptibility to conventional first line drugs in Salmonella isolates from enteric fever patients in Nepal

2014 ◽  
Vol 8 (11) ◽  
pp. 1483-1487 ◽  
Author(s):  
Hari Jung Chand ◽  
Komal Raj Rijal ◽  
Biswas Neupane ◽  
Vijay Kumar Sharma ◽  
Bharat Jha
Keyword(s):  
Nalidixic Acid ◽  
Enteric Fever ◽  
Tertiary Care ◽  
Empirical Therapy ◽  
Salmonella Typhi ◽  
Fluoroquinolone Resistance ◽  
Diffusion Method ◽  
Care Hospital ◽  
First Line ◽  
Isolation And Identification

Introduction: Enteric fever is endemic in Nepal and poses a significant public health burden. The first-line drugs ampicillin, chloramphenicol, and cotrimoxazole have not been part of empirical therapy for two decades due to the development of multidrug-resistant Salmonella strains. The objective of this study was to determine the antibiogram pattern of Salmonella serovars isolated from the blood of clinically suspected enteric fever patients. Methodology: A cross sectional study was carried out in a tertiary care hospital in Lalitpur, Nepal, between July 2011 and February 2012. Standard microbiological procedures were followed during collection and processing of blood samples, isolation and identification of Salmonella serotypes. The antimicrobial sensitivity of ampicillin, chloramphenicol, cotrimoxazole, nalidixic acid, and ciprofloxacin was determined using a modified Kirby-Bauer disk diffusion method as per the guidelines of the Clinical and Laboratory Standards Institute. Results: Out of 86 Salmonella isolates, 56 (65.1%) were Salmonella Typhi and 30 (34.9%) were Salmonella Paratyphi A. Salmonella Typhi were 100% sensitive to chloramphenicol, cotrimoxazole, and ciprofloxacin and 98.2% sensitive to ampicillin. Similarly, Salmonella Paratyphi A isolates were 100% sensitive to ampicillin and cotrimoxazole and 96.7% sensitive to chloramphenicol and ciprofloxacin. More than 90.0% of isolates were nalidixic acid resistant and none of the Salmonella isolates were multi-drug resistant. Conclusions: This study revealed the increasing frequency of nalidixic acid-resistant Salmonella isolates, indicating the possibility of fluoroquinolone resistance in near future. Furthermore, re-emergence of susceptibility to conventional first-line drugs ampicillin, chloramphenicol, and cotrimoxazole supports the possibility of using these drugs in empirical therapy.

scholarly journals Antimicrobial susceptibility of Salmonella Typhi in India

2009 ◽  
Vol 4 (02) ◽  
pp. 070-073 ◽  
Author(s):  
Kavita Nagshetty ◽  
Shivannavar T. Channappa ◽  
Subhashchandra M. Gaddad
Keyword(s):  
Public Health ◽  
Typhoid Fever ◽  
Antimicrobial Susceptibility ◽  
Enteric Fever ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Personal Hygiene ◽  
Public Health Issue ◽  
Dilution Method ◽  
Major Public Health Problem

Background: Typhoid fever continues to remain a major public health problem, especially in regions such as Gulbarga, due to poor sanitation and personal hygiene. Gulbarga region is often prone to enteric fever outbreaks and is an endemic region of typhoid fever. Enteric fever caused by Salmonella Typhi has not been adequately explored in this region. Methodology: A total of 95 isolates of S. Typhi collected from different clinical and environmental sources were tested for antimicrobial susceptibility according to the CLSI guidelines. MIC of resistant isolates to various antibiotics was performed by agar dilution method. Results: Of the total isolates studied, 10% were found to be multidrug resistant (MDR) (defined as resistance to ampicillin, chloramphenicol and co-trimoxazole). There was a decrease in the susceptibility to ciprofloxacin of S. Typhi with MIC showing an upward trend (0.125-4µg/mL). Concurrently, there has been an increase in the number of isolates sensitive to all antibiotics except nalidixic acid. Conclusion: MDR S. Typhi continues to be an important public health issue in Gulbarga. Presence of quinolone resistance and associated low-level ciprofloxacin resistance is a concern and requires further study.

scholarly journals Phylogenomics and antimicrobial resistance of Salmonella Typhi and Paratyphi A, B and C in England, 2016–2019

2021 ◽  
Vol 7 (8) ◽  
Author(s):  
Marie Anne Chattaway ◽  
Amy Gentle ◽  
Satheesh Nair ◽  
Laura Tingley ◽  
Martin Day ◽  
...  
Keyword(s):  
Public Health ◽  
Antimicrobial Resistance ◽  
Enteric Fever ◽  
Health Management ◽  
Public Health Problem ◽  
Salmonella Typhi ◽  
Multidrug Resistant ◽  
Global Public Health ◽  
Content Type ◽  
Recent Emergence

The emergence of antimicrobial resistance (AMR) to first- and second-line treatment regimens of enteric fever is a global public-health problem, and routine genomic surveillance to inform clinical and public-health management guidance is essential. Here, we present the prospective analysis of genomic data to monitor trends in incidence, AMR and travel, and assess hierarchical clustering (HierCC) methodology of 1742 isolates of typhoidal salmonellae. Trend analysis of Salmonella Typhi and S. Paratyphi A cases per year increased 48 and 17.3%, respectively, between 2016 and 2019 in England, mainly associated with travel to South Asia. S. Paratyphi B cases have remained stable and are mainly associated with travel to the Middle East and South America. There has been an increase in the number of S. Typhi exhibiting a multidrug-resistant (MDR) profile and the emergence of extensively drug resistant (XDR) profiles. HierCC was a robust method to categorize clonal groups into clades and clusters associated with travel and AMR profiles. The majority of cases that had XDR S. Typhi reported recent travel to Pakistan (94 %) and belonged to a subpopulation of the 4.3.1 (H58) clone (HC5_1452). The phenotypic and genotypic AMR results showed high concordance for S. Typhi and S. Paratyphi A, B and C, with 99.99 % concordance and only three (0.01 %) discordant results out of a possible 23 178 isolate/antibiotic combinations. Genomic surveillance of enteric fever has shown the recent emergence and increase of MDR and XDR S. Typhi strains, resulting in a review of clinical guidelines to improve management of imported infections.

scholarly journals Prevalence study of Salmonella spp. in milk and milk products

2018 ◽  
Author(s):  
Pooja Singh ◽  
R. V. Singh ◽  
Bhavana Gupta ◽  
Sabya Sanchi Tripathi ◽  
Kewal Singh Tomar ◽  
...  
Keyword(s):  
Public Health ◽  
Nalidixic Acid ◽  
Health Problem ◽  
Dairy Products ◽  
Public Health Problem ◽  
Ice Cream ◽  
Raw Milk ◽  
Molecular Study ◽  
Salmonella Spp ◽  
Milk Products

The present study was carried out to observe the presence of Salmonella in milk and milk products. The investigation of 210 samples revealed presence of 7.61% Salmonella spp. with higher prevalence in raw milk and dahi - 11.9% each , followed by ice-cream -9.52% and khoa - 4.76%. None of the sample of flavored milk showed Salmonella. In molecular study, 5 (31.2%) isolates were found positive for invA gene. The gene was present in raw milk - 18.75% and 6.25% in khoa and ice-cream each. Salmonella isolates were found sensitive to netillin - 100%, ofloxacin - 87.5%, norfloxacin, ciprofloxacin and nalidixic acid – (62.5% each), streptomycin and amikacin – (56.2% each). The isolates were resistant to nitrofurantoin- 81.2%, tetracycline -75.0%, co-trimoxazole - 68.7%, ampicilline - 56.2% and cefotaxime - 50.0%. The observation displayed unhygienic atmosphere prevailing during production of dairy products which lead to contamination of Salmonella and thus may cause public health problem to the consumers.

Kindesmisshandlung und deren Langzeitfolgen – Analyse einer repräsentativen deutschen Stichprobe

2019 ◽  
Vol 67 (2) ◽  
pp. 100-111 ◽  
Author(s):  
Andreas Witt ◽  
Rebecca Brown ◽  
Paul L. Plener ◽  
Elmar Brähler ◽  
Jörg M. Fegert ◽  
...  
Keyword(s):  
Public Health ◽  
Health Problem ◽  
Public Health Problem ◽  
Nachhaltige Entwicklung

Zusammenfassung. Kindesmisshandlung stellt einen bedeutenden Risikofaktor für die Entwicklung dar. Einzelne Formen von Kindesmisshandlung treten häufig nicht isoliert auf, sondern das gemeinsame Auftreten verschiedener Formen von Kindesmisshandlung stellt eher die Regel als die Ausnahme dar. Neben den langfristigen und vielfältigen individuellen Folgen führt Kindesmisshandlung jährlich zu einer hohen gesamtgesellschaftlichen Belastung. Die WHO hat Kindesmisshandlung als großes Public Health Problem identifiziert und die Vereinten Nationen haben den Kampf gegen Kindesmisshandlung zum Ziel in ihrer Agenda für nachhaltige Entwicklung gemacht. In dem vorliegenden Beitrag werden die Häufigkeit sowie das gemeinsame Auftreten unterschiedlicher Formen von Kindesmisshandlung sowie deren Assoziation mit psychischen und somatischen Folgen auf Basis einer bevölkerungsrepräsentativen Stichprobe untersucht und dargestellt. Die Ergebnisse verdeutlichen den Zusammenhang zwischen der Kumulation verschiedener Formen von Misshandlung und negativen Folgen für die Betroffenen. So ist das Risiko für negative Konsequenzen beim Erleben von vier oder mehr Formen von Misshandlung um das bis zu 10-fache erhöht. Viel zu selten werden die kumulativen Effekte von mehreren Belastungen berücksichtigt. Gerade weil die Wirkweisen über die Misshandlung, die Gesundheit beeinflusst, zunehmend gut untersucht sind, muss dieses Wissen im Gesundheitswesen stärker bei der Konzeption von Präventions- und Interventionsmaßnahmen berücksichtigt werden.

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