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Indian Journal of Medical Microbiology 2011Infections with Salmonella are an important public health problem worldwide. On a global scale, it has been appraised that Salmonella is responsible for an estimated 3... (Review)
Review
Infections with Salmonella are an important public health problem worldwide. On a global scale, it has been appraised that Salmonella is responsible for an estimated 3 billion human infections each year. The World Health Organization (WHO) has estimated that annually typhoid fever accounts for 21.7 million illnesses (217,000 deaths) and paratyphoid fever accounts for 5.4 million of these cases. Infants, children, and adolescents in south-central and South-eastern Asia experience the greatest burden of illness. In cases of enteric fever, including infections with S. Typhi and S. Paratyphi A and B, it is often necessary to commence treatment before the results of laboratory sensitivity tests are available. Hence, it is important to be aware of options and possible problems before beginning treatment. Ciprofloxacin has become the first-line drug of choice since the widespread emergence and spread of strains resistant to chloramphenicol, ampicillin, and trimethoprim. There is increase in the occurrence of strains resistant to ciprofloxacin. Reports of typhoidal salmonellae with increasing minimum inhibitory concentration (MIC) and resistance to newer quinolones raise the fear of potential treatment failures and necessitate the need for new, alternative antimicrobials. Extended-spectrum cephalosporins and azithromycin are the options available for the treatment of enteric fever. The emergence of broad spectrum β-lactamases in typhoidal salmonellae constitutes a new challenge. Already there are rare reports of azithromycin resistance in typhoidal salmonellae leading to treatment failure. This review is based on published research from our centre and literature from elsewhere in the world. This brief review tries to summarize the history and recent trends in antimicrobial resistance in typhoidal salmonellae.
Topics: Anti-Bacterial Agents; Asia, Southeastern; Drug Resistance, Bacterial; Humans; Salmonella paratyphi A; Salmonella paratyphi B; Salmonella typhi; Typhoid Fever
PubMed: 21860101
DOI: 10.4103/0255-0857.83904 -
Revue Scientifique Et Technique... Aug 2000The paratyphoid Salmonella bacteria, comprising more than 2,000 serovars or serotypes, are a major problem to the poultry industry. This is largely the result of entry... (Review)
Review
The paratyphoid Salmonella bacteria, comprising more than 2,000 serovars or serotypes, are a major problem to the poultry industry. This is largely the result of entry of the bacteria into the human food chain. Human infection takes the form of a gastroenteritis, which in highly susceptible individuals can result in death. Some strains of certain serotypes have the capacity to produce morbidity and mortality in very young chickens. In adult birds, some serovars become localised in the reproductive tract with concomitant vertical transmission. The association between S. Enteritidis and table eggs has produced a great deal of publicity and concern with resulting national and international attempts at controlling the major serotypes, S. Typhimurium and S. Enteritidis, at the breeder and layer level. Control is possible through rigorous hygiene and management procedures, but is not always economically viable. As a result, control by serological and bacteriological testing and slaughter may also not be feasible. Antibiotics have been used to reduce carriage but can cause problems of resistance and increased susceptibility. The use of growth promoting antibiotics can also increase susceptibility to infection. Other means of increasing the resistance of poultry to infection are therefore being sought. These include the use of intestinal flora preparations for competitive exclusion of Salmonella from newly hatched chicks. Killed and live vaccines are used, both with some success. However, the safety of some live vaccines is still uncertain.
Topics: Animals; Chickens; Drug Resistance, Bacterial; Humans; Paratyphoid Fever; Poultry Diseases; Salmonella Food Poisoning; Salmonella enterica; Turkeys; Zoonoses
PubMed: 10935268
DOI: 10.20506/rst.19.2.1225 -
The American Journal of Tropical... Sep 2018Typhoid and paratyphoid fever remain endemic diseases in Thailand with wide variation in subnational incidence trends. We examined these trends alongside contextual...
Typhoid and paratyphoid fever remain endemic diseases in Thailand with wide variation in subnational incidence trends. We examined these trends alongside contextual factors to study potential interactions and guide control strategies for this disease. Culture-confirmed typhoid and paratyphoid fever data from 2003 to 2014 were collected from the Ministry of Public Health website. Contextual factor data were collected from various sources including World Health Organization/United Nations Children's Fund Joint Monitoring Program, United Education Statistical World Bank database, World Bank, Development Research group, and global child mortality estimates published in the Lancet. Typhoid fever exhibited a declining trend with peak incidence reported in 2003 at 8.6 cases per 100,000 persons per year. Incidence dropped to three cases per 100,000 persons in 2014. The trend in paratyphoid fever remained stable with the peak incidence of 0.77 cases per 100,000 persons observed in 2009. Subnational variations of typhoid were seen throughout the study period with the highest incidence observed in the northwestern region of Thailand. Increases in female literacy, and access to improved water and sanitation were observed with decreases in poverty head count ratio and diarrheal mortality rate per 1,000 live births. Case fatality remained consistently low at 0.4% or less in all years with reported deaths. At the national level, typhoid fever incidence has shown a notable decline; however, incidence appears to have plateaued since 2007 with access to improved water supply and sanitation above 80%. Eliminating this disease will require strong disease prevention measures in conjunction with effective treatment interventions.
Topics: Adolescent; Adult; Aged; Child; Child, Preschool; Female; Humans; Incidence; Middle Aged; Paratyphoid Fever; Population Surveillance; Salmonella paratyphi A; Salmonella typhi; Thailand; Typhoid Fever; Young Adult
PubMed: 30047363
DOI: 10.4269/ajtmh.18-0046 -
Vaccine May 2006Because of high infectivity and significant disease burden, typhoid fever constitutes a major global health problem. Implementation of adequate food handling practices... (Review)
Review
Because of high infectivity and significant disease burden, typhoid fever constitutes a major global health problem. Implementation of adequate food handling practices and establishment of safe water supplies are the cornerstone for the development of an effective prevention program. However, vaccination against typhoid fever remains an essential tool for the effective management of this disease. Currently, there are two well tolerated and effective licensed vaccines. One is based on defined subunit virulence (Vi) polysaccharide antigen and can be administered either intramuscularly or subcutaneously and the other is based on the use of live attenuated bacteria for oral administration. The advantages and disadvantages of the various approaches taken in the development of a vaccine against typhoid fever are discussed, along with the potential for future vaccine candidates.
Topics: Antigens, Bacterial; Cross Reactions; Humans; Paratyphoid Fever; Polysaccharides, Bacterial; Salmonella paratyphi A; Salmonella typhi; Typhoid Fever; Typhoid-Paratyphoid Vaccines; Vaccines, Attenuated; Vaccines, Inactivated; Vaccines, Subunit
PubMed: 16278037
DOI: 10.1016/j.vaccine.2005.07.111 -
Heliyon Nov 2022is a Gram-negative, rod-shaped, facultative anaerobic, and non-spore-forming bacterium that belongs to the family of Enterobacteriaceae and is the causative agent for... (Review)
Review
is a Gram-negative, rod-shaped, facultative anaerobic, and non-spore-forming bacterium that belongs to the family of Enterobacteriaceae and is the causative agent for typhoid/paratyphoid fever and salmonellosis. causes the highest amount of foodborne illness among bacteria at 15.5 cases per 100,000 and causes an estimated 410,000 antibiotic-resistant infections each year in the U.S. The use of antibiotics has been a staple in poultry production for the prevention of diseases and growth promotion for the last 70 years. Due to the over-and misusage of antibiotics, there has been an emerging public health crisis. is developing resistance and may render antibiotics inoperative in a foodborne outbreak. Poultry, when not handled properly, is a major carrier and transmitter of causing human illness and fatality. This review summarizes the major outbreaks over the past three decades, the prevalence of Antimicrobial Resistant (AMR) related to poultry, and the control measures being implemented to reduce and prevent AMR in poultry.
PubMed: 36406693
DOI: 10.1016/j.heliyon.2022.e11571 -
Vaccine Nov 2023In Asia, there are an estimated 12 million annual cases of enteric fever, a potentially fatal systemic bacterial infection caused by Salmonella enterica serovars Typhi...
In Asia, there are an estimated 12 million annual cases of enteric fever, a potentially fatal systemic bacterial infection caused by Salmonella enterica serovars Typhi (STy) and Paratyphi A (SPA). The recent availability of typhoid conjugate vaccines (TCV), an increasing incidence of disease caused by SPA and growing antimicrobial resistance (AMR) across the genus Salmonella makes a bivalent STy/SPA vaccine a useful public health proposition. The uptake of a stand-alone paratyphoid vaccine is likely low thus, there is a pipeline of bivalent STy/SPA candidate vaccines. Several candidates are close to entering clinical trials, which if successful should facilitate a more comprehensive approach for enteric fever control. Additionally, the World Health Organization (WHO) has made advancing the development of vaccines that protect young children and working aged adults against both agents of enteric fever a priority objective. This "Vaccine Value Profile" (VVP) addresses information related predominantly to invasive disease caused by SPA prevalent in Asia. Information is included on stand-alone SPA candidate vaccines and candidate vaccines targeting SPA combined with STy. Out of scope for the first version of this VVP is a wider discussion on the development of a universal Salmonella combination candidate vaccine, addressing both enteric fever and invasive non-typhoidal Salmonella disease, for use globally. This VVP is a detailed, high-level assessment of existing, publicly available information to inform and contextualize the public health, economic, and societal potential of pipeline vaccines and vaccine-like products for SPA. Future versions of this VVP will be updated to reflect ongoing activities such as vaccine development strategies and "Full Vaccine Value Assessment" that will inform the value proposition of an SPA vaccine. This VVP was developed by an expert working group from academia, non-profit organizations, public-private partnerships, and multi-lateral organizations as well as in collaboration with stakeholders from the WHO South-East Asian Region. All contributors have extensive expertise on various elements of the VVP for SPA and collectively aimed to identify current research and knowledge gaps.
Topics: Adult; Child; Humans; Child, Preschool; Middle Aged; Typhoid Fever; Salmonella paratyphi A; Paratyphoid Fever; Salmonella typhi; Typhoid-Paratyphoid Vaccines; Salmonella Vaccines
PubMed: 37951691
DOI: 10.1016/j.vaccine.2023.01.054 -
PLoS Neglected Tropical Diseases 2013Typhoid and paratyphoid fever are endemic in Hongta District and their prevalence, at 113 per 100,000 individuals, remains the highest in China. However, the exact...
BACKGROUND
Typhoid and paratyphoid fever are endemic in Hongta District and their prevalence, at 113 per 100,000 individuals, remains the highest in China. However, the exact sources of the disease and its main epidemiological characteristics have not yet been clearly identified.
METHODS AND FINDINGS
Numbers of typhoid and paratyphoid cases per day during the period 2006 to 2010 were obtained from the Chinese Center of Disease Control (CDC). A number of suspected disease determinants (or their proxies), were considered for use in spatiotemporal analysis: these included locations of discharge canals and food markets, as well as socio-economic and environmental factors. Results showed that disease prevalence was spatially clustered with clusters decreasing with increasing distance from markets and discharge canals. More than half of the spatial variance could be explained by a combination of economic conditions and availability of health facilities. Temporal prevalence fluctuations were positively associated with the monthly precipitation series. Polluted hospital and residential wastewater was being discharged into rainwater canals. Salmonella bacteria were found in canal water, on farmland and on vegetables sold in markets.
CONCLUSION
DISEASE TRANSMISSION IN HONGTA DISTRICT IS DRIVEN PRINCIPALLY BY TWO SPATIOTEMPORALLY COUPLED CYCLES: one involving seasonal variations and the other the distribution of polluted farmland (where vegetables are grown and sold in markets). Disease transmission was exacerbated by the fact that rainwater canals were being used for disposal of polluted waste from hospitals and residential areas. Social factors and their interactions also played a significant role in disease transmission.
Topics: Adolescent; Adult; Aged; Aged, 80 and over; Child; Child, Preschool; China; Cluster Analysis; Female; Geography; Humans; Infant; Infant, Newborn; Male; Middle Aged; Paratyphoid Fever; Prevalence; Seasons; Socioeconomic Factors; Soil Microbiology; Typhoid Fever; Vegetables; Wastewater; Young Adult
PubMed: 23516653
DOI: 10.1371/journal.pntd.0002112 -
British Medical Journal May 1963
Topics: Chloramphenicol; Humans; Typhoid Fever; Typhoid-Paratyphoid Vaccines
PubMed: 13955431
DOI: 10.1136/bmj.1.5341.1347 -
MBio Feb 2021The rising prevalence of antimicrobial resistance in serovars Typhi and Paratyphi A, causative agents of typhoid and paratyphoid, have led to fears of untreatable...
The rising prevalence of antimicrobial resistance in serovars Typhi and Paratyphi A, causative agents of typhoid and paratyphoid, have led to fears of untreatable infections. Of specific concern is the emerging resistance against azithromycin, the only remaining oral drug to treat extensively drug resistant (XDR) typhoid. Since the first report of azithromycin resistance from Bangladesh in 2019, cases have been reported from Nepal, India, and Pakistan. The genetic basis of this resistance is a single point mutation in the efflux pump AcrB (R717Q/L). Here, we report 38 additional cases of azithromycin-resistant (AzmR) Typhi and Paratyphi A isolated in Bangladesh between 2016 and 2018. Using genomic analysis of 56 AzmR isolates from South Asia with AcrB-R717Q/L, we confirm that this mutation has spontaneously emerged in different Typhi and Paratyphi A genotypes. The largest cluster of AzmR Typhi belonged to genotype 4.3.1.1; Bayesian analysis predicts the mutation to have emerged sometime in 2010. A travel-related Typhi isolate with AcrB-R717Q belonging to 4.3.1.1 was isolated in the United Kingdom, increasing fears of global spread. For real-time detection of AcrB-R717Q/L, we developed an extraction-free, rapid, and low-cost mismatch amplification mutation assay (MAMA). Validation of MAMA using 113 AzmR and non-AzmR isolates yielded >98% specificity and sensitivity versus phenotypic and whole-genome sequencing assays currently used for azithromycin resistance detection. With increasing azithromycin use, AcrB-R717Q/L is likely to be acquired by XDR strains. The proposed tool for active detection and surveillance of this mutation may detect pan-oral drug resistance early, giving us a window to intervene. In the early 1900s, with mortality of ∼30%, typhoid and paratyphoid ravaged parts of the world; with improved water, sanitation, and hygiene in resource-rich countries and the advent of antimicrobials, mortality dwindled to <1%. Today, the burden rests disproportionately on South Asia, where the primary means for combatting the disease is antimicrobials. However, prevalence of antimicrobial resistance is rising and, in 2016, an extensively drug resistant Typhi strain triggered an ongoing outbreak in Pakistan, leaving only one oral drug, azithromycin, to treat it. Since the description of emergence of azithromycin resistance, conferred by a point mutation in (AcrB-R717Q/L) in 2019, there have been increasing numbers of reports. Using genomics and Bayesian analysis, we illustrate that this mutation emerged in approximately 2010 and has spontaneously arisen multiple times. Emergence of pan-oral drug resistant Typhi is imminent. We developed a low-cost, rapid PCR tool to facilitate real-time detection and prevention policies.
Topics: Anti-Bacterial Agents; Azithromycin; Bayes Theorem; Drug Resistance, Bacterial; Genotype; Humans; Microbial Sensitivity Tests; Point Mutation; Salmonella enterica; Salmonella typhi; Whole Genome Sequencing
PubMed: 33593966
DOI: 10.1128/mBio.03481-20 -
Archives of Disease in Childhood Mar 1949
Topics: Disease; Humans; Hypoparathyroidism; Paratyphoid Fever
PubMed: 18124782
DOI: 10.1136/adc.24.117.77