The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015.
Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared t...
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ftdoajarticles:oai:doaj.org/article:0b2b2cc728a743bcb5d5120cb7b570c1 2023-05-15T15:14:55+02:00 The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. Laura M F Kuijpers Thong Phe Chhun H Veng Kruy Lim Sovann Ieng Chun Kham Nizar Fawal Laetitia Fabre Simon Le Hello Erika Vlieghe François-Xavier Weill Jan Jacobs Willy E Peetermans 2017-09-01T00:00:00Z https://doi.org/10.1371/journal.pntd.0005964 https://doaj.org/article/0b2b2cc728a743bcb5d5120cb7b570c1 EN eng Public Library of Science (PLoS) http://europepmc.org/articles/PMC5624643?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005964 https://doaj.org/article/0b2b2cc728a743bcb5d5120cb7b570c1 PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005964 (2017) Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 article 2017 ftdoajarticles https://doi.org/10.1371/journal.pntd.0005964 2022-12-31T10:38:56Z Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi.A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.One-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035) and C-reactive protein (CRP) values (47.0 mg/L vs. 36 mg/L; p = 0.034) were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR) (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole).;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS) was observed in 96.9% (62/64) of Salmonella Typhi isolates versus 11.5% (21/183) of Salmonella Paratyphi A isolates (all but one from 2015). All isolates were susceptible to azithromycin and ceftriaxone.In Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and DCS compared to Salmonella Paratyphi A. Article in Journal/Newspaper Arctic Directory of Open Access Journals: DOAJ Articles Arctic PLOS Neglected Tropical Diseases 11 9 e0005964 |
institution |
Open Polar |
collection |
Directory of Open Access Journals: DOAJ Articles |
op_collection_id |
ftdoajarticles |
language |
English |
topic |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
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Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 Laura M F Kuijpers Thong Phe Chhun H Veng Kruy Lim Sovann Ieng Chun Kham Nizar Fawal Laetitia Fabre Simon Le Hello Erika Vlieghe François-Xavier Weill Jan Jacobs Willy E Peetermans The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
topic_facet |
Arctic medicine. Tropical medicine RC955-962 Public aspects of medicine RA1-1270 |
description |
Enteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi.A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.One-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035) and C-reactive protein (CRP) values (47.0 mg/L vs. 36 mg/L; p = 0.034) were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR) (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole).;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS) was observed in 96.9% (62/64) of Salmonella Typhi isolates versus 11.5% (21/183) of Salmonella Paratyphi A isolates (all but one from 2015). All isolates were susceptible to azithromycin and ceftriaxone.In Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and DCS compared to Salmonella Paratyphi A. |
format |
Article in Journal/Newspaper |
author |
Laura M F Kuijpers Thong Phe Chhun H Veng Kruy Lim Sovann Ieng Chun Kham Nizar Fawal Laetitia Fabre Simon Le Hello Erika Vlieghe François-Xavier Weill Jan Jacobs Willy E Peetermans |
author_facet |
Laura M F Kuijpers Thong Phe Chhun H Veng Kruy Lim Sovann Ieng Chun Kham Nizar Fawal Laetitia Fabre Simon Le Hello Erika Vlieghe François-Xavier Weill Jan Jacobs Willy E Peetermans |
author_sort |
Laura M F Kuijpers |
title |
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
title_short |
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
title_full |
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
title_fullStr |
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
title_full_unstemmed |
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015. |
title_sort |
clinical and microbiological characteristics of enteric fever in cambodia, 2008-2015. |
publisher |
Public Library of Science (PLoS) |
publishDate |
2017 |
url |
https://doi.org/10.1371/journal.pntd.0005964 https://doaj.org/article/0b2b2cc728a743bcb5d5120cb7b570c1 |
geographic |
Arctic |
geographic_facet |
Arctic |
genre |
Arctic |
genre_facet |
Arctic |
op_source |
PLoS Neglected Tropical Diseases, Vol 11, Iss 9, p e0005964 (2017) |
op_relation |
http://europepmc.org/articles/PMC5624643?pdf=render https://doaj.org/toc/1935-2727 https://doaj.org/toc/1935-2735 1935-2727 1935-2735 doi:10.1371/journal.pntd.0005964 https://doaj.org/article/0b2b2cc728a743bcb5d5120cb7b570c1 |
op_doi |
https://doi.org/10.1371/journal.pntd.0005964 |
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PLOS Neglected Tropical Diseases |
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11 |
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9 |
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e0005964 |
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