Global trends in typhoid and paratyphoid Fever.
Global trends in typhoid and paratyphoid Fever.
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DOI：
10.1086/649541
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发表时间：
2010-01-15
期刊：
影响因子：
--
通讯作者：
Mintz ED
中科院分区：
文献类型：
--
作者：
Crump JA;Mintz ED
伤寒和副伤寒仍然是疾病和死亡的重要原因，尤其是在南亚、中亚和东南亚的儿童和青少年中，在这些地区，肠热病与恶劣的卫生条件和不安全的食物和水有关。来自亚洲的高质量发病率数据正在为扩大获得伤寒疫苗的努力奠定基础。目前正在努力开发在单剂接种后对婴儿具有免疫原性的疫苗，并可在流行国家当地生产。甲型副伤寒沙门氏菌在亚洲日益增长的重要性令人担忧。对传统的一线药物氟喹诺酮类药物和现在的第三代头孢菌素类药物相继出现了耐药性，这给患者管理带来了挑战。阿奇霉素已被证明是治疗单纯伤寒的有效替代品。伤寒沙门氏菌和甲型副伤寒沙门氏菌全基因组序列的可获得性证实，如果能够加倍国际努力，它们是单形的、人类适应的病原体，容易受到控制措施的影响。
Typhoid and paratyphoid fever continue to be important causes of illness and death, particularly among children and adolescents in south-central and southeast Asia where enteric fever is associated with poor sanitation and unsafe food and water. High quality incidence data from Asia are underpinning efforts to expand access to typhoid vaccines. Efforts are underway to develop vaccines that are immunogenic in infants following a single dose and that can be produced locally in endemic countries. The growing importance of S. Paratyphi A in Asia is concerning. Antimicrobial resistance has sequentially emerged to traditional first-line drugs, fluoroquinolones, and now to third generation cephalosporins, posing patient management challenges. Azithromycin has proven to be effective alternatives for uncomplicated typhoid fever. The availability of full genome sequences for S. Typhi and S. Paratyphi A confirms their place as monomorphic, human-adapted pathogens vulnerable to control measures if international efforts can be redoubled.
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