Document Detail


Increasing rates and clinical consequences of nalidixic acid-resistant isolates causing enteric fever in returned travellers: an 18-year experience.
MedLine Citation:
PMID:  19357879     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
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:
S Hume; T Schulz; P Vinton; T Korman; J Torresi
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Publication Detail:
Type:  Journal Article     Date:  2009-04-09
Journal Detail:
Title:  European journal of clinical microbiology & infectious diseases : official publication of the European Society of Clinical Microbiology     Volume:  28     ISSN:  1435-4373     ISO Abbreviation:  Eur. J. Clin. Microbiol. Infect. Dis.     Publication Date:  2009 Aug 
Date Detail:
Created Date:  2009-08-11     Completed Date:  2009-10-01     Revised Date:  -    
Medline Journal Info:
Nlm Unique ID:  8804297     Medline TA:  Eur J Clin Microbiol Infect Dis     Country:  Germany    
Other Details:
Languages:  eng     Pagination:  963-70     Citation Subset:  IM    
Affiliation:
Victorian Infectious Diseases Service, Royal Melbourne Hospital, Grattan Street, Parkville, VIC 3050, Australia. sam.hume@mh.org.au
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MeSH Terms
Descriptor/Qualifier:
Adolescent
Adult
Aged
Animals
Anti-Bacterial Agents / pharmacology*
Australia
Drug Resistance, Bacterial*
Female
Hospitalization
Humans
Length of Stay / statistics & numerical data
Male
Middle Aged
Nalidixic Acid / pharmacology*
Paratyphoid Fever / microbiology*,  physiopathology
Rats
Salmonella paratyphi A / drug effects*,  isolation & purification
Salmonella paratyphi B / drug effects*,  isolation & purification
Salmonella typhi / drug effects*,  isolation & purification
Travel*
Typhoid Fever / microbiology*,  physiopathology
Young Adult
Chemical
Reg. No./Substance:
0/Anti-Bacterial Agents; 389-08-2/Nalidixic Acid

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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