Factors associated with typhoid relapse in the era of multiple drug resistant strains
Factors associated with typhoid relapse in the era of multiple drug resistant strains
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DOI：
10.3855/jidc.1192
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发表时间：
2011-10-01
影响因子：
1.9
通讯作者：
Bhutta, Zulfiqar A.
中科院分区：
文献类型：
--
作者：
Ahmad, Kaashif Aqeeb;Khan, Liaqat Hayat;Bhutta, Zulfiqar A.
简介：伤寒估计每年在全球造成的负担超过2700万例，临床复发率为5%至20%。尽管大复发负担，复发的相关因素在很大程度上是unknow.Methodology：我们遵循了自1988年以来的儿科伤寒的诊断和管理协议。我们报告的因素与复发的文化证实的肠热病在1,650名儿童提出的阿加汗大学医学中心，卡拉奇，巴基斯坦，超过15 years period.Results：在那些感染了多重耐药（MDR）菌株，与随后复发的因素包括便秘在介绍和介绍发热发病14天内。腹泻感染药物敏感菌株的儿童与随后的复发减少，是喹诺酮therapy.Conclusions：多重临床因素在介绍与随后的伤寒复发。这些因素可能被假定为与随后的复发，由于在网状内皮系统微生物负荷的改变。这些数据将是有价值的，在开发算法的临床随访感染MDR肠热病的儿童。
Introduction: Typhoid has an estimated global burden of greater than 27 million cases per annum with a clinical relapse rate of 5% to 20%. Despite the large relapse burden, the factors associated with relapse are largely unknown.Methodology: We have followed a protocol for the diagnosis and management of pediatric typhoid since 1988. We report factors associated with relapse of culture-proven enteric fever in 1,650 children presenting to the Aga Khan University Medical Center, Karachi, Pakistan, over a 15-year period.Results: In those infected with multiple drug resistant (MDR) strains, factors associated with subsequent relapse include constipation at presentation and presentation within 14 days of fever onset. Diarrhoea in those children infected with drug sensitive strains had an association with decreased subsequent relapse, as was quinolone therapy.Conclusions: Multiple clinical factors at presentation are associated with subsequent typhoid fever relapse. These factors may be postulated to be associated with subsequent relapse due to alterations in the reticuloendothelial system organism load. These data will be valuable in developing algorithms for clinical follow-up in children infected with MDR enteric fever.