Typhoid fever

Abstract

Typhoid fever is caused by infection with Salmonella enterica serovar Typhi. The completion of the genome sequence of two Salmonella enterica serovar Typhi isolates is leading to new insights into the biology of this pathogen. Approximately 16 million cases occur worldwide each year. The lack of culture facilities in endemic areas and the poor performance of the Widal test means the disease is frequently unconfirmed. Simple new serologic tests are being developed and show promise. Resistance to chloramphenicol, ampicillin, and trimethoprim/sulfamethoxazole is widespread in Asia and some areas of Africa, although fully susceptible isolates have re-emerged in some countries. Fluoroquinolones, third-generation cephalosporins, and azithromycin are effective alternatives. Low-level fluoroquinolone resistance (indicated by resistance to nalidixic acid) is now common in Asia and results in a suboptimal response to fluoroquinolones. Two vaccines are licensed and others are being developed, but neither licensed vaccine is used in endemic areas as a public health measure.

SalmonellaSubtypes with Increased MICs for Azithromycin in Travelers Returned to the Netherlands

“…Enteric fever caused by Salmonella enterica serotypes Typhi and Paratyphi A, B, and C is mainly a disease of the developing world, and it is occasionally diagnosed as an imported disease in countries where the disease is not endemic ( 1 ). Its empirical treatment has been hampered by resistance to ampicillin, chloramphenicol, and trimethoprim and by decreased ciprofloxacin susceptibility (MIC for ciprofloxacin 0.125–1.0 µg/mL), and ciprofloxacin resistance (MIC for ciprofloxacin >1.0 µg/mL) ( 2 , 3 ).…”

Twenty‐six years of enteric fever in Australia: an epidemiological analysis of antibiotic resistance

“…Enteric fever is estimated to affect 27 million people annually worldwide, and has an estimated annual mortality of around 216 000 1 . It causes epidemics in Central America, Asia, Africa and the Middle East 2 . Over the past 20 years, the development of antibiotic resistance has compromised the therapy of this infection.…”

High-Throughput Genotyping of Salmonella enterica Serovar Typhi Allowing Geographical Assignment of Haplotypes and Pathotypes within an Urban District of Jakarta, Indonesia

“…Salmonella enterica serovar Typhi remains a major public health problem in many developing countries with approximately 22 million cases of typhoid fever reported annually (3,22). After primary culture, serovar Typhi is identified using serotyping, and strains are subsequently differentiated using phage typing, pulsedfield gel electrophoresis (30), or assays based on PCR including IS200 fingerprinting (31), RAPD [random(ly) amplified polymorphic DNA]-PCR (26), variable number tandem repeat scanning (18), and amplified fragment length polymorphisms (20).…”