1921
Volume 95, Issue 1
  • ISSN: 0002-9637
  • E-ISSN: 1476-1645

Abstract

Abstract

Owing to the increase in strains with decreased fluoroquinolone susceptibility in the endemic areas, we have been treating enteric fever with intravenous ceftriaxone empirically since 2007. In this study, we reevaluated our treatment protocol. This retrospective cohort study was conducted at a single institute in Tokyo, Japan, between January 2006 and December 2013. Enteric fever was defined as isolation of Typhi or Paratyphi A, B, and C from the blood and/or stool of patients with fever. Of the 35 patients with imported enteric fever, 28 (80%) had returned from south Asia. Ciprofloxacin-susceptible strains were detected in only 12% of the cases. The isolates showed excellent susceptibility to ampicillin (91%), chloramphenicol (94%), ceftriaxone (97%), and azithromycin (97%). One case of Paratyphi B was excluded, and of the remaining 34 patients, 56% were treated with ceftriaxone alone, 26% with ceftriaxone then fluoroquinolone, and 9% with levofloxacin alone. The overall relapse rate was 6.1%; however, among those receiving ceftriaxone monotherapy, the relapse rate was 11% ( = 2). The relapse group was characterized by longer times to treatment initiation ( = 0.035) and defervescence (> 7 days) after treatment initiation ( = 0.022). In such cases, we recommend that ceftriaxone treatment be continued for > 4 days after defervescence or be changed to fluoroquinolone if the strains are found to be susceptible to prevent relapse. Furthermore, ampicillin and chloramphenicol, which are no longer prescribed, may be reconsidered as treatment options in Asia.

Loading

Article metrics loading...

The graphs shown below represent data from March 2017
/content/journals/10.4269/ajtmh.15-0714
2016-07-06
2018-12-14
Loading full text...

Full text loading...

/deliver/fulltext/14761645/95/1/19.html?itemId=/content/journals/10.4269/ajtmh.15-0714&mimeType=html&fmt=ahah

References

  1. Mogasale V, Maskery B, Ochiai RL, Lee JS, Mogasale VV, Ramani E, Kim YE, Park JK, Wierzba TF, , 2014. Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment. Lancet Glob Health 2: e570e580.[Crossref] [Google Scholar]
  2. Ochiai RL, Acosta CJ, Danovaro-Holliday MC, Baiqing D, Bhattacharya SK, Agtini MD, Bhutta ZA, Canh do G, Ali M, Shin S, Wain J, Page AL, Albert MJ, Farrar J, Abu-Elyazeed R, Pang T, Galindo CM, von Seidlein L, Clemens JD, Domi Typhoid Study Group, , 2008. A study of typhoid fever in five Asian countries: disease burden and implications for controls. Bull World Health Organ 86: 260268.[Crossref] [Google Scholar]
  3. Jensenius M, Han PV, Schlagenhauf P, Schwartz E, Parola P, Castelli F, von Sonnenburg F, Loutan L, Leder K, Freedman DO, GeoSentinel Surveillance Network; , 2013. Acute and potentially life-threatening tropical diseases in western travelers—a GeoSentinel multicenter study, 1996–2011. Am J Trop Med Hyg 88: 397404.[Crossref] [Google Scholar]
  4. Effa EE, Lassi ZS, Critchley JA, Garner P, Sinclair D, Olliaro PL, Bhutta ZA, , 2011. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever). Cochrane Database Syst Rev 5: CD004530. [Google Scholar]
  5. Patel TA, Armstrong M, Morris-Jones SD, Wright SG, Doherty T, , 2010. Imported enteric fever: case series from the hospital for tropical diseases, London, United Kingdom. Am J Trop Med Hyg 82: 11211126.[Crossref] [Google Scholar]
  6. Hassing RJ, Goessens WH, Mevius DJ, van Pelt W, Mouton JW, Verbon A, van Genderen PJ, , 2013. Decreased ciprofloxacin susceptibility in Salmonella Typhi and Paratyphi infections in ill-returned travellers: the impact on clinical outcome and future treatment options. Eur J Clin Microbiol Infect Dis 32: 12951301.[Crossref] [Google Scholar]
  7. Dellinger RP, Levy MM, Rhodes A, Annane D, Gerlach H, Opal SM, Sevransky JE, Sprung CL, Douglas IS, Jaeschke R, Osborn TM, Nunnally ME, Townsend SR, Reinhart K, Kleinpell RM, Angus DC, Deutschman CS, Machado FR, Rubenfeld GD, Webb SA, Beale RJ, Vincent JL, Moreno R, Surviving Sepsis Campaign Guidelines Committee including the Pediatric Subgroup, , 2013. Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012. Crit Care Med 41: 580637.[Crossref] [Google Scholar]
  8. Cunha BA, , 2000. The diagnostic significance of relative bradycardia in infectious disease. Clin Microbiol Infect 6: 633634.[Crossref] [Google Scholar]
  9. Hassing RJ, Goessens WH, van Pelt W, Mevius DJ, Stricker BH, Molhoek N, Verbon A, van Genderen PJ, , 2014. Salmonella subtypes with increased MICs for azithromycin in travelers returned to The Netherlands. Emerg Infect Dis 20: 705708.[Crossref] [Google Scholar]
  10. Mawatari M, Kato Y, Hayakawa K, Morita M, Yamada K, Mezaki K, Kobayashi T, Fujiya Y, Kutsuna S, Takeshita N, Kanagawa S, Ohnishi M, Izumiya H, Ohmagari N, , 2013. Salmonella enterica serotype Paratyphi A carrying CTX-M-15 type extended-spectrum beta-lactamase isolated from a Japanese traveller returning from India, Japan, July 2013. Euro Surveill 18: 20632.[Crossref] [Google Scholar]
  11. Tourdjman M, Le Hello S, Gossner C, Delmas G, Tubiana S, Fabre L, Kerléguer A, Tarantola A, Fruth A, Friesema I, Thorstensen Brandal L, Lawrence J, Fisher I, Dufour M, Weill FX, de Valk H, , 2013. Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia, January to September 2013. Euro Surveill 18: 20594.[Crossref] [Google Scholar]
  12. Saitoh T, Morita M, Shimada T, Izumiya H, Kanayama A, Oishi K, Ohnishi M, Sunagawa T, , 2015. Increase in paratyphoid fever cases in Japanese travellers returning from Cambodia in 2013. Epidemiol Infect 144: 602606.[Crossref] [Google Scholar]
  13. Ackers ML, Puhr ND, Tauxe RV, Mintz ED, , 2000. Laboratory-based surveillance of Salmonella serotype Typhi infections in the United States: antimicrobial resistance on the rise. JAMA 283: 26682673.[Crossref] [Google Scholar]
  14. Angell SY, Cetron MS, , 2005. Health disparities among travelers visiting friends and relatives abroad. Ann Intern Med 142: 6772.[Crossref] [Google Scholar]
  15. Kuvandik C, Karaoglan I, Namiduru M, Baydar I, , 2009. Predictive value of clinical and laboratory findings in the diagnosis of the enteric fever. New Microbiol 32: 2530. [Google Scholar]
  16. Lutterloh E, Likaka A, Sejvar J, Manda R, Naiene J, Monroe SS, Khaila T, Chilima B, Mallewa M, Kampondeni SD, Lowther SA, Capewell L, Date K, Townes D, Redwood Y, Schier JG, Nygren B, Tippett Barr B, Demby A, Phiri A, Lungu R, Kaphiyo J, Humphrys M, Talkington D, Joyce K, Stockman LJ, Armstrong GL, Mintz E, , 2012. Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border. Clin Infect Dis 54: 11001106.[Crossref] [Google Scholar]
  17. Parry CM, Thompson C, Vinh H, Chinh NT, Phuong le T, Ho VA, Hien TT, Wain J, Farrar JJ, Baker S, , 2014. Risk factors for the development of severe typhoid fever in Vietnam. BMC Infect Dis 14: 73.[Crossref] [Google Scholar]
  18. Klotz SA, Jorgensen JH, Buckwold FJ, Craven PC, , 1984. Typhoid fever. An epidemic with remarkably few clinical signs and symptoms. Arch Intern Med 144: 533537.[Crossref] [Google Scholar]
  19. Connor BA, Schwartz E, , 2005. Typhoid and paratyphoid fever in travellers. Lancet Infect Dis 5: 623628.[Crossref] [Google Scholar]
  20. Vollaard AM, Ali S, van Asten HA, Widjaja S, Visser LG, Surjadi C, van Dissel JT, , 2004. Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia. JAMA 291: 26072615.[Crossref] [Google Scholar]
  21. Basnyat B, Maskey AP, Zimmerman MD, Murdoch DR, , 2005. Enteric (typhoid) fever in travelers. Clin Infect Dis 41: 14671472.[Crossref] [Google Scholar]
  22. Wain J, Hendriksen RS, Mikoleit ML, Keddy KH, Ochiai RL, , 2015. Typhoid fever. Lancet 385: 11361145.[Crossref] [Google Scholar]
  23. Frenck RW, Nakhla I, Sultan Y, Bassily SB, Girgis YF, David J, Butler TC, Girgis NI, Morsy M, , 2000. Azithromycin versus ceftriaxone for the treatment of uncomplicated typhoid fever in children. Clin Infect Dis 31: 11341138.[Crossref] [Google Scholar]
  24. Thaver D, Zaidi AK, Critchley J, Azmatullah A, Madni SA, Bhutta ZA, , 2009. A comparison of fluoroquinolones versus other antibiotics for treating enteric fever: meta-analysis. BMJ 338: b1865.[Crossref] [Google Scholar]
  25. Butler T, , 2011. Treatment of typhoid fever in the 21st century: promises and shortcomings. Clin Microbiol Infect 17: 959963.[Crossref] [Google Scholar]
  26. Chinh NT, Parry CM, Ly NT, Ha HD, Thong MX, Diep TS, Wain J, White NJ, Farrar JJ, , 2000. A randomized controlled comparison of azithromycin and ofloxacin for treatment of multidrug-resistant or nalidixic acid-resistant enteric fever. Antimicrob Agents Chemother 44: 18551859.[Crossref] [Google Scholar]
  27. Tatli MM, Aktas G, Kosecik M, Yilmaz A, , 2003. Treatment of typhoid fever in children with a flexible-duration of ceftriaxone, compared with 14-day treatment with chloramphenicol. Int J Antimicrob Agents 21: 350353.[Crossref] [Google Scholar]
http://instance.metastore.ingenta.com/content/journals/10.4269/ajtmh.15-0714
Loading
/content/journals/10.4269/ajtmh.15-0714
Loading

Data & Media loading...

  • Received : 02 Oct 2015
  • Accepted : 02 Feb 2016

Most Cited This Month

This is a required field
Please enter a valid email address
Approval was a Success
Invalid data
An Error Occurred
Approval was partially successful, following selected items could not be processed due to error