Pediatric Infectious Disease

Register      Login

VOLUME 1 , ISSUE 2 ( April-June, 2019 ) > List of Articles

CASE REPORT

Cephalosporin-resistant Typhoid Fever: A Report of Two Cases with a Unique Isolate from a Tertiary Care Hospital in Delhi

Shyam Kukreja, Tapisha Gupta

Keywords : Blood culture, Drug-resistant typhoid, Enteric fever, Indian report

Citation Information : Kukreja S, Gupta T. Cephalosporin-resistant Typhoid Fever: A Report of Two Cases with a Unique Isolate from a Tertiary Care Hospital in Delhi. Pediatr Inf Dis 2019; 1 (2):70-71.

DOI: 10.5005/jp-journals-10081-1205

License: CC BY-NC 4.0

Published Online: 01-06-2019

Copyright Statement:  Copyright © 2019; Jaypee Brothers Medical Publishers (P) Ltd.


Abstract

Typhoid fever is endemic in our country and is the commonest bacterial bloodstream infection in South Asia.1 Multidrug-resistant typhoid fever (MDRTF) is defined as typhoid fever caused by Salmonella enterica serovar Typhi strains (S. Typhi), which are resistant to the first-line recommended drugs, i.e., chloramphenicol, ampicillin, and trimethoprim–sulfamethoxazole. Extensively drug-resistant typhoid fever (XDRTF) is defined as Salmonella Typhi/Paratyphi resistant to first line antibiotics (ampicillin, chloramphenicol and cotrimoxazole) and also to fluoroquinolone and ceftriaxone. Pakistan has an ongoing epidemic of extensively drug resistant (XDR) typhoid, which is a cause for alarm. Prior to this XDR typhoid epidemic, which started in 2016, only 17 cases of ceftriaxone resistance were reported in the world literature. Four out of these 17 were cases of XDR typhoid reported in Iraq, Bangladesh, India, and Pakistan.2 We report two cases of cephalosporin resistant typhoid fever from North India in the pediatric age group and discuss the clinical presentation and treatment. These two isolates were resistant to four drugs (ampicillin, chloramphenicol, fluoroquinolone, and ceftriaxone) but sensitive to chloramphenicol.


PDF Share
  1. Deen J, Von Seidlein L, Andersen F, et al. Community-acquired bacterial bloodstream infections in developing countries in south and southeast Asia: a systematic review. Lancet Infect Dis 2012;12(6): 480–487. DOI: 10.1016/S1473-3099(12)70028-2.
  2. Klemm EJ, Shakoor S, Page AJ, et al. Emergence drug Resistant Salmonella enterica serovar Typhi clone harbouring a promiscuous plasmid encoding resistance to fluoroquinolones and third generation cephalosporins. MBio 2018;9(1):e00105–e00118. DOI: 10.1128/mBio.00105-18.
  3. Qamar FN, Yousafzai MT, Khalid M, et al. Outbreak investigation of ceftriaxone-Resistant Salmonella enterica serotype Typhi and its risk factors among the general population in Hyderabad, Pakistan: a matched case-control study. Lancet Infect Dis 2018;18(12):1368–1376. DOI: 10.1016/S1473-3099(18)30483-3.
  4. World Health Organization. Typhoid Fever – Islamic Republic of Pakistan; 2018. https://www.who.int/csr/don/27-december-2018-typhoid-pakistan/en/.
  5. Sharma P, Kumari B, Dahiya S, et al. Azithromycin resistance mechanisms in typhoidal Salmonellae in India: a 25 years analysis. Indian J Med Res 2019;149(3):404–411. DOI: 10.4103/ijmr.IJMR_1302_17.
  6. Chatham-Stephens K, Medalla F, Hughes M, et al., Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan—United States, 2016–2018 https://www.cdc.gov/mmwr/volumes/68/wr/mm6801a3.htm.
PDF Share
PDF Share

© Jaypee Brothers Medical Publishers (P) LTD.