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Increasing rates and clinical consequences of nalidixic acid-resistant isolates causing enteric fever in returned travellers: an 18-year experience.
Eur J Clin Microbiol Infect Dis. 2009 Aug; 28(8):963-70.EJ

Abstract

The purpose of this study was to examine the rate and clinical consequences of nalidixic acid-resistant (NAR) isolates in travellers with enteric fever presenting to a hospital in a developed country. We retrospectively examined microbiologically confirmed cases of enteric fever in adult returned travellers over an 18-year period presenting to two tertiary referral hospitals in Melbourne, Australia. There were 59 cases of Salmonella typhi infection, 43 cases of S. paratyphi A infection and two cases of S. paratyphi B infection. Most patients reported recent travel to India (36%) or Indonesia (29%). NAR isolates were commonly encountered (41% of all isolates), particularly from India (75%), Pakistan (80%) and Bangladesh (60%). The number of NAR isolates increased progressively after 2003. Patients with NAR isolates had prolonged mean fever clearance time (5.6 vs. 3.3 days, P = 0.03) and prolonged hospital stay (7.9 vs. 5.7 days, P = 0.02) compared to non-resistant isolates. This represents the largest report of NAR enteric fever in returned travellers. NAR isolates predominate in cases of enteric fever from South Asia and result in prolonged fever clearance time and hospital stay. Empiric therapy with alternative antibiotics such as ceftriaxone or azithromycin should be considered in patients with suspected enteric fever from this region.

Authors+Show Affiliations

Victorian Infectious Diseases Service, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia. sam.hume@mh.org.auNo affiliation info availableNo affiliation info availableNo affiliation info availableNo affiliation info available

Pub Type(s)

Journal Article

Language

eng

PubMed ID

19357879

Citation

Hume, S, et al. "Increasing Rates and Clinical Consequences of Nalidixic Acid-resistant Isolates Causing Enteric Fever in Returned Travellers: an 18-year Experience." European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, vol. 28, no. 8, 2009, pp. 963-70.
Hume S, Schulz T, Vinton P, et al. Increasing rates and clinical consequences of nalidixic acid-resistant isolates causing enteric fever in returned travellers: an 18-year experience. Eur J Clin Microbiol Infect Dis. 2009;28(8):963-70.
Hume, S., Schulz, T., Vinton, P., Korman, T., & Torresi, J. (2009). Increasing rates and clinical consequences of nalidixic acid-resistant isolates causing enteric fever in returned travellers: an 18-year experience. European Journal of Clinical Microbiology & Infectious Diseases : Official Publication of the European Society of Clinical Microbiology, 28(8), 963-70. https://doi.org/10.1007/s10096-009-0732-6
Hume S, et al. Increasing Rates and Clinical Consequences of Nalidixic Acid-resistant Isolates Causing Enteric Fever in Returned Travellers: an 18-year Experience. Eur J Clin Microbiol Infect Dis. 2009;28(8):963-70. PubMed PMID: 19357879.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Increasing rates and clinical consequences of nalidixic acid-resistant isolates causing enteric fever in returned travellers: an 18-year experience. AU - Hume,S, AU - Schulz,T, AU - Vinton,P, AU - Korman,T, AU - Torresi,J, Y1 - 2009/04/09/ PY - 2008/11/05/received PY - 2009/03/18/accepted PY - 2009/4/10/entrez PY - 2009/4/10/pubmed PY - 2009/10/2/medline SP - 963 EP - 70 JF - European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology JO - Eur J Clin Microbiol Infect Dis VL - 28 IS - 8 N2 - The purpose of this study was to examine the rate and clinical consequences of nalidixic acid-resistant (NAR) isolates in travellers with enteric fever presenting to a hospital in a developed country. We retrospectively examined microbiologically confirmed cases of enteric fever in adult returned travellers over an 18-year period presenting to two tertiary referral hospitals in Melbourne, Australia. There were 59 cases of Salmonella typhi infection, 43 cases of S. paratyphi A infection and two cases of S. paratyphi B infection. Most patients reported recent travel to India (36%) or Indonesia (29%). NAR isolates were commonly encountered (41% of all isolates), particularly from India (75%), Pakistan (80%) and Bangladesh (60%). The number of NAR isolates increased progressively after 2003. Patients with NAR isolates had prolonged mean fever clearance time (5.6 vs. 3.3 days, P = 0.03) and prolonged hospital stay (7.9 vs. 5.7 days, P = 0.02) compared to non-resistant isolates. This represents the largest report of NAR enteric fever in returned travellers. NAR isolates predominate in cases of enteric fever from South Asia and result in prolonged fever clearance time and hospital stay. Empiric therapy with alternative antibiotics such as ceftriaxone or azithromycin should be considered in patients with suspected enteric fever from this region. SN - 1435-4373 UR - https://www.unboundmedicine.com/medline/citation/19357879/Increasing_rates_and_clinical_consequences_of_nalidixic_acid_resistant_isolates_causing_enteric_fever_in_returned_travellers:_an_18_year_experience_ L2 - https://dx.doi.org/10.1007/s10096-009-0732-6 DB - PRIME DP - Unbound Medicine ER -