Archibald LK, Reller LB, 2001. Clinical microbiology in developing countries. Emerg Infect Dis 7 :302–305.
Archibald LK, den Dulk MO, Pallangyo KJ, Reller LB, 1998. Fatal Mycobacterium tuberculosis bloodstream infections in febrile hospitalized adults in Dar es Salaam, Tanzania. Clin Infect Dis 26 :290–296.
Ssali FN, Kamya MR, Wabwire-Mangen F, Kasasa S, Joloba M, Williams D, Mugerwa RD, Ellner JJ, Johnson JL, 1998. A prospective study of community-acquired bloodstream infections among febrile adults admitted to Mulago Hospital in Kampala, Uganda. J Acquir Immune Defic Syndr Hum Retrovirol 19 :484–489.
Archibald LK, McDonald LC, Rheanpumikankit S, Tansuphaswadikul S, Chaovanich A, Eampokalap B, Banerjee SN, Reller LB, Jarvis WR, 1999. Fever and human immunodeficiency virus infection as sentinels for emerging mycobacterial and fungal bloodstream infections in hospitalized patients ≥ 15 years old, Bangkok. J Infect Dis 180 :87–92.
Archibald LK, McDonald LC, Nwanyanwu O, Kazembe P, Dobbie H, Tokars J, Reller LB, Jarvis WR, 2000. A hospital-based prevalence survey of bloodstream infections in febrile patients in Malawi: implications for diagnosis and therapy. J Infect Dis 181 :1414–1420.
Bell M, Archibald LK, Nwanyanwu O, Dobbie H, Tokars J, Kazembe PN, Reller LB, Jarvis WR, 2001. Seasonal variation in the etiology of bloodstream infections in a febrile inpatient population in a developing country. Int J Infect Dis 5 :63–69.
McDonald LC, Archibald LK, Rheanpumikankit S, Tansuphaswadikul S, Eampokalap B, Nwanyanawu O, Kazembe P, Dobbie H, Reller LB, Jarvis WR, 1999. Unrecognised Mycobacterium tuberculosis bacteraemia among hospital inpatients in less developed countries. Lancet 354 :1159–1163.
Reller LB, Archibald LK, Jarvis WR, Grohskopf LA, 2002. Disseminated infection with simiaeavium group mycobacteria in persons with AIDS - Thailand and Malawi, 1997. MMWR Morb Mortal Wkly Rep 51 :501–502.
National Committee for Clinical Laboratory Standards, 2000. Performance Standards for Antimicrobial Disk Susceptibility Tests. Seventh edition. Approved Standard M2-A7. Wayne, PA: NCCLS.
National Committee for Clinical Laboratory Standards, 2001. Performance Standards for Antimicrobial Susceptibility Testing. 11th Information Supplement M100-S11. Wayne, PA: NCCLS.
Liu Y-C, Huang W-K, Huang T-S, Kunin CM, 1999. Detection of antimicrobial activity in urine for epidemiologic studies of antibiotic use. J Clin Epidemiol 52 :539–545.
Mérien F, Amouriaux P, Perolat P, Baranton G, Saint Girons I, 1992. Polymerase chain reaction for detection of Leptospira spp. in clinical samples. J Clin Microbiol 30 :2219–2224.
Shlim DR, Schwartz E, Eaton M, 1995. Clinical importance of Salmonella Paratyphi A infection to enteric fever in Nepal. J Travel Med 2 :165–168.
Sood S, Kapil A, Dash N, Das BK, Goel V, Seth P, 1999. Paratyphoid fever in India: an emerging problem. Emerg Infect Dis 5 :483–484.
Rodrigues C, Shenai S, Mehta A, 2003. Enteric fever in Mumbai, India: the good news and the bad news (letter). Clin Infect Dis 36 :535.
Thong K-L, Nair S, Chaudhry R, Seth P, Kapil A, Kumar D, Kapoor H, Puthucheary S, Pang T, 1998. Molecular analysis of Salmonella paratyphi A from an outbreak in New Delhi, India. Emerg Infect Dis 4 :507–508.
Chandel DS, Nisar N, Thong KL, Pang T, Chaudhry R, 2000. Role of molecular typing in an outbreak of Salmonella paratyphi A. Trop Gastroenterol 21 :121–123.
Goh Y-L, Puthucheary SD, Chaudhry R, Bhutta ZA, Lesmana M, Oyofo BA, Punjabi NH, Ahmed A, Thong KL, 2002. Genetic diversity of Salmonella enterica serovar Paratyphi A from different geographical regions in Asia. J Appl Microbiol 92 :1167–1171.
Dorman J, Dickinson J, 1972. Experience with typhoid fever at Shanta Bhawan. J Nepal Med Assoc 10 :155–160.
Thapa JB, 1991. Drug sensitivity of enteric fever organisms. J Inst Med (Nepal) 13 :327–330.
Sharma S, Zimmerman M, 1997. Enteric fever in outpatients. J Nepal Med Assoc 35 :70–74.
Ansari I, Adhikari N, Pandey R, Dangal MM, Karanjit R, Acharya A, 2002. Enteric fever: is ciprofloxacin failing? J Nepal Paed Soc 20 :6–16.
Crump JA, Barrett TJ, Nelson JT, Angulo FJ, 2003. Reevaluating fluoroquinolone breakpoints for Salmonella enterica sero-type Typhi and for non-Typhi salmonellae. Clin Infect Dis 37 :75–81.
Parry CM, Hien TT, Dougan G, White NJ, Farrar JJ, 2002. Typhoid fever. N Engl J Med 347 :1770–1782.
Brown GW, Shirai A, Gan E, Bernthal P, 1981. Antibodies to typhus in Eastern Nepal. Trans Roy Soc Trop Med Hyg 75 :586–587.
Eaton M, Cohen MT, Shlim DR, Innes B, 1989. Ciprofloxacin treatment of typhus. JAMA 262 :772–773.
Halle S, Dasch GA, 1980. Use of a sensitive microplate enzyme-linked immunosorbent assay in a retrospective serological analysis of a laboratory population at risk to infection with typhus group rickettsiae. J Clin Microbiol 12 :343–350.
Brown GW, Madasamy M, Bernthal P, Groves MG, 1981. Leptospirosis in Nepal. Trans R Soc Trop Med Hyg 75 :572–573.
Silva MV, Camargo ED, Batista L, Vaz AJ, Brandao AP, Nakamura PM, Negrao JM, 1995. Behaviour of specific IgM, IgG and IgA class antibodies in human leptospirosis during the acute phase of the disease and during convalescence. J Trop Med Hyg 98 :268–272.
Murdoch DR, Laing RTR, Mills GD, Karalus NC, Town GI, Mirrett S, Reller LB, 2001. Evaluation of a rapid immunochromatographic test for detection of Streptococcus pneumoniae antigen in urine samples from adults with community-acquired pneumonia. J Clin Microbiol 39 :3495–3498.
Suvedi BK, 1999. Mapping the trend of HIV/AIDS in Nepal. J Inst Med (Nepal) 21 :236–242.
Hawkes S, Santhya KG, 2002. Diverse realities: sexually transmitted infections and HIV in India. Sex Transm Infect 78 (Suppl 1):i31–i39.
UNAIDS/WHO, 2002. Epidemiological Fact Sheets on HIV/AIDS and Sexually Transmitted Infections: Nepal. Geneva: UNAIDS/WHO.
Shrestha IL, 1999. Seroprevalence of antibodies to HIV among injecting drug users in Kathmandu and HIV subtyping. J Inst Med (Nepal) 21 :11–14.
Sherchand JB, Pandey BD, Haruki K, Jimba M, 2001. Sero-diagnosis of Japanese encephalitis and dengue virus infection from clinically suspected patients of Nepal. J Inst Med (Nepal) 23 :26–31.
Crump JA, Youssef FG, Luby SP, Wasfy MO, Rangel JM, Taalat M, Oun SA, Mahoney FJ, 2003. Estimating the incidence of typhoid fever and other febrile illnesses in developing countries. Emerg Infect Dis 9 :539–544.
Zimmerman MD, Scott RM, Vaughn DW, Rajbhandari S, Nisalak A, Shrestha MP, 1997. An outbreak of Japanese encephalitis in Kathmandu, Nepal. Am J Trop Med Hyg 57 :283–284.
Basnyat B, Zimmerman MD, Shrestha Y, McNair Scott R, Endy TP, 2001. Persistent Japanese encephalitis in Kathmandu: the need for immunization. J Travel Med 8 :270–271.
Rolain JM, Maurin M, Vestris G, Raoult D, 1998. In vitro susceptibilities of 27 rickettsiae to 13 antimicrobials. Antimicrob Agents Chemother 42 :1537–1541.
Strand O, Stromberg A, 1990. Ciprofloxacin treatment of murine typhus. Scand J Infect Dis 22 :503–504.
van der Kleij FGH, Gansevoort RT, Kreeftenberg HG, Reitsma WD, 1998. Imported rickettsioses: think of murine typhus. J Intern Med 243 :177–179.
Laferl H, Fournier PE, Seiberl G, Pichler H, Raoult D, 2002. Murine typhus poorly responsive to ciprofloxacin: a case report. J Travel Med 9 :103–104.
Shalit I, Barnea A, Shahar A, 1989. Efficacy of ciprofloxacin against Leptospira interrogans serogroup ictohaemorrhagiae. Antimicrob Agents Chemother 33 :788–789.
Takashima I, Ngoma M, Hashimoto N, 1993. Antimicrobial effects of a new carboxyquinolone drug, Q-35, on five sero-groups of Leptospira interrogans.Antimicrob Agents Chemother 37 :901–902.
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In Nepal, many infections remain poorly characterized, partly due to limited diagnostic facilities. We studied consecutive febrile adults presenting to a general hospital in Kathmandu, Nepal. Of the 876 patients enrolled, enteric fever and pneumonia were the most common clinical diagnoses. Putative pathogens were identified in 323 (37%) patients, the most common being Salmonella enterica serotype Typhi and S. enterica serotype Paratyphi A (117), Rickettsia typhi (97), Streptococcus pneumoniae (53), Leptospira spp. (36), and Orientia tsutsugamushi (28). Approximately half of the Salmonella isolates were resistant to nalidixic acid. No clinical predictors were identified to reliably distinguish between the different infections. These findings confirm the heavy burden of enteric fever and pneumonia in Kathmandu, and highlight the importance of murine typhus, scrub typhus, and leptospirosis. Given the lack of reliable clinical predictors, the development of cheap and accurate diagnostic tests are likely to be of great clinical utility in this setting.