A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014-2015: epidemiology, clinical features, treatment and outcome
A retrospective study of patients with blood culture-confirmed typhoid fever in Fiji during 2014-2015: epidemiology, clinical features, treatment and outcome
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DOI：
10.1093/trstmh/trz075
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发表时间：
2019-12-01
影响因子：
2.2
通讯作者：
Strugnell, Richard A.
中科院分区：
文献类型：
--
作者：
Getahun, Aneley;Parry, Christopher M.;Strugnell, Richard A.
背景：伤寒是斐济的地方病。方法：回顾性分析2014年1月至2015年12月上海市血培养确诊伤寒病例的流行病学、临床特征及病死率。结果：在542名患者中，518名（95.6%）为土著斐济人（iTaukei），285名（52.6%）为男性。中位（IQR）年龄为25（16-38）岁。从发病到入院的平均（SD）时间为11.1（6.9）d。在365例有临床信息的患者中，346例（96.9%）有发热，239例（66.9%）有腹泻，113例（33.5%）有呕吐，72例（30.2%）有腹痛。并发症40例（11.0%），其中休克17例（4.7%），肝炎11例（3.0%）。9例患者死亡，病死率风险为1.7%。在544伤寒沙门氏菌菌株测试，没有耐第一线抗菌药物; 3（0.8%）耐环丙沙星和5（1.4%）萘啶酸。结论：在斐济，大多数血培养证实伤寒病例是在年轻人。常见临床表现为发热和消化道症状。需要进一步的研究来阐明与并发症和死亡相关的因素。
Background: Typhoid fever is endemic in Fiji. We sought to describe the epidemiology, clinical features and case fatality risk of blood culture-confirmed typhoid fever from January 2014 through December 2015.Methods: Blood culture-positive patients were identified from a typhoid surveillance line list. A standardised case investigation form was used to record data from patients' medical records.Results: Of 542 patients, 518 (95.6%) were indigenous Fijians (iTaukei) and 285 (52.6%) were male. The median (IQR) age was 25 (16-38) y. Mean (SD) time from the onset of illness to admission was 11.1 (6.9) d. Of 365 patients with clinical information, 346 (96.9%) had fever, 239 (66.9%) diarrhoea, 113 (33.5%) vomiting, and 72 (30.2%) abdominal pain. There were 40 (11.0%) patients with complications, including 17 (4.7%) with shock, and 11 (3.0%) with hepatitis. Nine patients died for a case fatality risk of 1.7%. Of the 544 Salmonella Typhi isolates tested, none were resistant to first line antimicrobials; 3(0.8%) were resistant to ciprofloxacin and 5(1.4%) to nalidixic acid.Conclusions: In Fiji, most blood culture-confirmed typhoid fever cases were in young adults. Common clinical manifestations were fever and gastrointestinal symptoms. Further studies are required to elucidate the factors associated with complications and death.