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Enteric fever in Barcelona: Changing patterns of importation and antibiotic resistance.
Travel Med Infect Dis. 2016 Nov - Dec; 14(6):577-582.TM

Abstract

BACKGROUND

Enteric fever's incidence is decreasing among residents of high-income countries, although it's rising in travelers coming from low-resource endemic settings. The study's aim is to describe epidemiological, clinical and laboratory features of patients with enteric fever.

METHODS

Retrospective descriptive study of enteric fever cases diagnosed at a Tropical Medicine Unit in Barcelona, 1993-2012.

RESULTS

Out of 40 patients, 31(77,5%) were returning travelers, and 70% of them had been in Southern Asia. In the rest of patients without an antecedent of a recent travel, the infection occurred mainly before year 2000. The more frequently reported symptoms were fever and diarrhea, lacking significant differences between S. typhi and S. paratyphi infections. Quinolones were used as empiric treatment in 47.2% of patients, 36.1% received 3rd generation cephalosporins, 2.78% azithromycin and 13.89% other combinations. Resistance to quinolones in the S. paratyphi group (66.7%) was significantly higher compared with the S. typhi group (20%) (p:0.02). 22.5% of patients had treatment failure and 23.6% patients presented complications, none of them had been previously vaccinated.

CONCLUSIONS

The diagnosis of enteric fever was more frequent among travelers coming from Southern-East Asia. Quinolone resistance is widely spread, particularly in S. paratyphi serotypes and should not be considered as first choice treatment anymore.

Authors+Show Affiliations

Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Spain. Electronic address: ana.requena@isglobal.org.Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Spain.Department of Microbiology (CDB), Hospital Clínic, Barcelona, Spain.Department of Infectious Diseases, Hospital Clinic, Barcelona, Spain.Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Spain.Barcelona Institute for Global Health, ISGlobal-CRESIB, Universitat de Barcelona, Spain.

Pub Type(s)

Journal Article

Language

eng

PubMed ID

27890811

Citation

Requena-Méndez, Ana, et al. "Enteric Fever in Barcelona: Changing Patterns of Importation and Antibiotic Resistance." Travel Medicine and Infectious Disease, vol. 14, no. 6, 2016, pp. 577-582.
Requena-Méndez A, Berrocal M, Almela M, et al. Enteric fever in Barcelona: Changing patterns of importation and antibiotic resistance. Travel Med Infect Dis. 2016;14(6):577-582.
Requena-Méndez, A., Berrocal, M., Almela, M., Soriano, A., Gascón, J., & Muñoz, J. (2016). Enteric fever in Barcelona: Changing patterns of importation and antibiotic resistance. Travel Medicine and Infectious Disease, 14(6), 577-582. https://doi.org/10.1016/j.tmaid.2016.11.009
Requena-Méndez A, et al. Enteric Fever in Barcelona: Changing Patterns of Importation and Antibiotic Resistance. Travel Med Infect Dis. 2016 Nov - Dec;14(6):577-582. PubMed PMID: 27890811.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Enteric fever in Barcelona: Changing patterns of importation and antibiotic resistance. AU - Requena-Méndez,Ana, AU - Berrocal,Monica, AU - Almela,Manuel, AU - Soriano,Alex, AU - Gascón,Joaquim, AU - Muñoz,José, Y1 - 2016/11/24/ PY - 2016/06/29/received PY - 2016/11/21/revised PY - 2016/11/22/accepted PY - 2016/11/29/pubmed PY - 2017/5/4/medline PY - 2016/11/29/entrez KW - Azithromycin KW - Cephalosporins KW - Enteric fever KW - Paratyphoid fever KW - Quinolones KW - Salmonella paratyphi KW - Salmonella typhi KW - Typhoid fever SP - 577 EP - 582 JF - Travel medicine and infectious disease JO - Travel Med Infect Dis VL - 14 IS - 6 N2 - BACKGROUND: Enteric fever's incidence is decreasing among residents of high-income countries, although it's rising in travelers coming from low-resource endemic settings. The study's aim is to describe epidemiological, clinical and laboratory features of patients with enteric fever. METHODS: Retrospective descriptive study of enteric fever cases diagnosed at a Tropical Medicine Unit in Barcelona, 1993-2012. RESULTS: Out of 40 patients, 31(77,5%) were returning travelers, and 70% of them had been in Southern Asia. In the rest of patients without an antecedent of a recent travel, the infection occurred mainly before year 2000. The more frequently reported symptoms were fever and diarrhea, lacking significant differences between S. typhi and S. paratyphi infections. Quinolones were used as empiric treatment in 47.2% of patients, 36.1% received 3rd generation cephalosporins, 2.78% azithromycin and 13.89% other combinations. Resistance to quinolones in the S. paratyphi group (66.7%) was significantly higher compared with the S. typhi group (20%) (p:0.02). 22.5% of patients had treatment failure and 23.6% patients presented complications, none of them had been previously vaccinated. CONCLUSIONS: The diagnosis of enteric fever was more frequent among travelers coming from Southern-East Asia. Quinolone resistance is widely spread, particularly in S. paratyphi serotypes and should not be considered as first choice treatment anymore. SN - 1873-0442 UR - https://www.unboundmedicine.com/medline/citation/27890811/Enteric_fever_in_Barcelona:_Changing_patterns_of_importation_and_antibiotic_resistance_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S1477-8939(16)30187-9 DB - PRIME DP - Unbound Medicine ER -