Epidemiological shift, seasonal variation and antimicrobial susceptibility patterns among enteric fever pathogens in south India

Vidyalakshmi, K; Yashavanth, R; Chakrapani, M; Shrikala, B; Bharathi, B.; Suchitra, U; Dhanashree, B; Dominic, R M Saldanha

doi:10.1258/td.2007.070271

Cited by 6 publications

(7 citation statements)

References 6 publications

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“…Resistance to nalidixic acid among S. Paratyphi isolates was recently found to be more common than among S. Typhi isolates obtained from hospitalized patients in India and Nepal, while MDR was relatively rare among both pathogens. [15][16][17] In contrast, all S. Paratyphi A isolates identified in this study were susceptible to all antimicrobial agents tested, while 40% of S. Typhi isolates were MDR. This study further observed an association between MDR S. Typhi strains and prior antibiotic use, which has been demonstrated previously with other Gram-negative enteric pathogens.…”

Section: Discussionmentioning

confidence: 68%

“…10 Several Asian countries have reported the emergence of fluoroquinolone resistance among S. Paratyphi. [11][12][13][14][15][16][17] The overall situation has heightened the need to identify prevention measures, including vaccines, against a variety of invasive enteric pathogens. 10,18,19 However, a vaccine against paratyphoid fever is not yet available, and immunization with currently available vaccines against typhoid fever does not provide cross-protection against paratyphoid fever.…”

Section: Introductionmentioning

confidence: 99%

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Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

Naheed

Ram

Brooks

et al. 2010

International Journal of Infectious Diseases

106

112

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Section: Discussionmentioning

confidence: 68%

Section: Introductionmentioning

confidence: 99%

Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

Naheed

Ram

Brooks

et al. 2010

International Journal of Infectious Diseases

106

112

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“…Hospital-based studies from India demonstrated great regional variation in proportion of enteric fever attributed to S. Paratyphi A as 38.7 and 54.5% of enteric fever isolates were identified as S. Paratyphi A in South and West India respectively compared to only 21.0 and 24.3% in East and North India respectively [18]–[21]. The proportion of S. Paratyphi A in Pakistan was similar to East and North India, where a prospective country-wide hospital-based study identified 28.9% of enteric fever isolates as S. Paratyphi A between 2001 and 2006 [22].…”

Section: Resultsmentioning

confidence: 99%

Estimating the Burden of Paratyphoid A in Asia and Africa

et al. 2014

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Despite the increasing availability of typhoid vaccine in many regions, global estimates of mortality attributable to enteric fever appear stable. While both Salmonella enterica serovar Typhi (S. Typhi) and serovar Paratyphi (S. Paratyphi) cause enteric fever, limited data exist estimating the burden of S. Paratyphi, particularly in Asia and Africa.We performed a systematic review of both English and Chinese-language databases to estimate the regional burden of paratyphoid within Africa and Asia. Distinct from previous reviews of the topic, we have presented two separate measures of burden; both incidence and proportion of enteric fever attributable to paratyphoid. Included articles reported laboratory-confirmed Salmonella serovar classification, provided clear methods on sampling strategy, defined the age range of participants, and specified the time period of the study.A total of 64 full-text articles satisfied inclusion criteria and were included in the qualitative synthesis. Paratyphoid A was commonly identified as a cause of enteric fever throughout Asia. The highest incidence estimates in Asia came from China; four studies estimated incidence rates of over 150 cases/100,000 person-years. Paratyphoid A burden estimates from Africa were extremely limited and with the exception of Nigeria, few population or hospital-based studies from Africa reported significant Paratyphoid A burden.While significant gaps exist in the existing population-level estimates of paratyphoid burden in Asia and Africa, available data suggest that paratyphoid A is a significant cause of enteric fever in Asia. The high variability in documented incidence and proportion estimates of paratyphoid suggest considerable geospatial variability in the burden of paratyphoid fever. Additional efforts to monitor enteric fever at the population level will be necessary in order to accurately quantify the public health threat posed by S. Paratyphi A, and to improve the prevention and treatment of enteric fever.

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“…[8] The incidence in South Asia is 40–80 cases/100,000 person-years and is increasing where the disease burden is high. [9] In 1975, S. paratyphi was reported to be the third most common, while S. typhi constituted 57% of the 47 human serotypes at that time. [10] The prevalence of paratyphoid fever is most commonly reported with S paratyphi A.…”

Section: Discussionmentioning

confidence: 99%

“…[18] In Karnataka, ≥50% isolates were because of S. paratyphi and a seasonal increase (monsoon) was also observed. [9] In hospital-based studies, 10–54.5% of enteric fever cases are attributable to paratyphoid fever. [15]…”

Section: Discussionmentioning

confidence: 99%

Myositis associated with Salmonella paratyphi A bacteremia appears to be common

Harris

Viswanathan

Aghoram

2019

J Family Med Prim Care

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Background: Fever and severe myalgia in a tropical country like India bring to mind leptospirosis, rickettsioses, dengue, and other viral fevers. Enteric fever is widely prevalent in Asia, but myositis has not been previously described in Salmonella paratyphi A bacteremia. Materials and Methods: Retrospectively, we recruited patients with enteric fever admitted to our treating unit over a 6-month period. Demography, historical, clinical, and laboratory data were obtained. Data of culture-positive S. paratyphi A patients were analyzed and were compared with those patients with culture-negative enteric fever. Results: Forty-three cases were found in total with 19 of S. paratyphi A bacteremia. Elevations in creatine kinase (CK) ranged from one-and-half to six times normal. Forty-seven percent had thrombocytopenia and alanine transaminase elevations, while aspartate transaminase elevations were seen in 17 patients, which corresponded to those with elevated CK levels. Conclusions: Myositis associated with S. typhi and S. paratyphi is very rare and is more often due to non-typhoidal Salmonellae. Elevated creatine kinase was seen in most of our patients with S. paratyphi A bacteremia. Such myositis has not been described previously and hence, myalgia with fever in a tropical country could be a harbinger of paratyphoid fever.

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Epidemiological shift, seasonal variation and antimicrobial susceptibility patterns among enteric fever pathogens in south India

Cited by 6 publications

References 6 publications

Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

Burden of typhoid and paratyphoid fever in a densely populated urban community, Dhaka, Bangladesh

Estimating the Burden of Paratyphoid A in Asia and Africa

Myositis associated with Salmonella paratyphi A bacteremia appears to be common

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