Enteric fever imported to the Czech Republic: epidemiology, clinical characteristics and antimicrobial susceptibility

Abstract

The aim of this study was to describe epidemiological and clinical characteristics of imported enteric fever in Czech travellers and to determine the antimicrobial susceptibility of isolated strains. Retrospective descriptive study included adult patients treated with enteric fever at Hospital Na Bulovce during January 2004-December 2012. A case of typhoid or paratyphoid fever was defined as isolation of Salmonella Typhi or Paratyphi from blood or stool. During the study period, there have been diagnosed 19 cases of enteric fever (12 males and 7 females) with age median of 30 years; 14 cases were caused by Salmonella Typhi and 5 cases by S. Paratyphi A. The infection has been acquired in South Asia (16 patients; 84.2 %), in Africa (Egypt, Angola) in two cases (10.5 %), and in Mexico (1; 5.3 %). Symptoms included fever (all patients), diarrhoea (16 cases; 84.2 %), headache (9; 47.4 %), and abdominal pain (7; 36.8 %). Seventeen patients (89.5 %) were treated with fluoroquinolones; however, the treatment failure was observed in seven of them (41.2 %). Decreased ciprofloxacin susceptibility was detected in eight strains (66.7 %), and one strain (8.3 %) was multidrug resistant. Sequence analysis of quinolone resistance-determining regions (QRDR) of the gyrA gene revealed the presence of amino acid substitutions in all tested isolates with decreased ciprofloxacin susceptibility. Typhoid and paratyphoid fevers represent epidemiologically important diseases that may lead to potentially life-threatening complications. Major issue in the management of enteric fever represents the non-susceptibility of Salmonella strains to fluoroquinolones and other antimicrobials.

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

“…Moreover,~66% of isolates in European countries [17], shows decreased susceptibility to ciprofloxacin, although it was considered in the past as first therapeutic choice [61] by the World Health Organization guidelines. In U.S., during 2016-2018, 5/29 cases of typhoid fever in patients who recently traveled to Pakistan were caused by extensively drug resistant strains [18].…”

“…Similarly, a retrospective study conducted in Qatar, between 2005 and 2012, reported 356 cases of typhoid fever, of whom 96.9% had traveled abroad, mainly in the Indian subcontinent [17]. Over 70% of typhoid fever cases in Europe are acquired abroad and frequently caused by strains with marked antibiotic resistance profile [18,19].…”

Fiebre Tifoidea

“…Las medidas terapéuticas adicionales y la administración de antibióticos como las cefalosporinas de tercera generación por vía parenteral, basada en la sensibilidad del cultivo, deben continuarse hasta cinco días después de la recuperación. (41,42,43) AFECCIONES INFRECUENTES EN LA PRÁCTICA QUIRÚRGICA CAP. 3.…”

TYPHOIDYNE : Microspot Multi-Antigen Arrays Enzyme Immunoassay - The synergistic effects of species-specific and genus conserved antigens towards an improved definitive and differential diagnosis of typhoid fever

“…Typhoid scenario in developed countries is usually associated with travelers returning from endemic countries. However, recent report con rmed alarming typhoid cases in developed countries associated with domestic sources and not linked with visit to endemic counties [2][3][4] . Typhoid fever is one of the etiologies for acute undifferentiated fever 5 .…”