Shedding Light on Drug-resistant Enteric Fever: A Case Series
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Abstract
Enteric fever, an acute generalized bloodstream infection of the reticuloendothelial system caused by the human-restricted bacterial pathogens Salmonella enterica serovars Typhi (S. typhi) and Paratyphi A, is an important cause of morbidity and mortality in the developing world.1 Aggressive use of antibiotics empirically has resulted in the development of multi-drug resistant organisms (MDR) – (resistant to ampicillin, co-trimoxazole, and chloramphenicol) followed by extensively drug-resistant (XDR) S. typhi strains (resistant to chloramphenicol, ampicillin, co-trimoxazole, fluoroquinolones, and third-generation cephalosporin).2 In this case series, we report three blood culture-positive cases, out of which one was a culture-proven extensively resistant case that did not respond to ceftriaxone (3rd generation cephalosporin) but showed clinical response to cefepime (4th generation cephalosporin) while the other two were clinically resistant cases that showed no response to cephalosporins but responded to meropenem while the organism was sensitive to both drugs.
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References
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Pustake M, Giri P, Tambolkar S, Nayak S. Extensively Drug-Resistant Typhoid Fever: A Call to Action. Indian J Community Med. 2022 Jan-Mar;47(1):153-154. doi: 10.4103/ijcm.ijcm_1008_21. Epub 2022 Mar 16. PMID: 35368492; PMCID: PMC8971857.
Drug-resistant typhoid needs to be treated as a global problem (news-medical.net)