Multi-drug resistant tyhoid fever: Review

Abstract

Background: Typhoid fever, caused by Salmonella enterica serovar typhi remains one of the most important infectious diseases globally,  responsible for an estimated 26.9 million infections and 269,000deaths in 2010.Multidrug-resistant typhoid fever (MDRTF) is defined as  typhoid fever caused by Salmonella entericaserovar typhi strains (S. typhi), which are resistant to the first-line recommended drugs for  treatment such as chloramphenicol, ampicillin and trimethoprim sulfamethoxazole. Its have remain a major cause of morbidity and  mortality in developing countries especially in children below five years of age. Although there are no pathognomonic clinical features of  MDRTF at the onset of the illness, high fever (>104°F), toxaemia, abdominal distension, abdominal tenderness, hepatomegaly and  splenomegaly are often reported. The gold standard for the diagnosis of MDRTF is bacterial isolation of the organism in blood cultures. Ciprofloxacin and ceftriaxone are the drugs most commonly used for treatment of MDRTF and produce good clinical results.

Conclusion:  MDRTF remains a major public health problem, particularly in developing countries. Mass immunization in endemic areas with either the  oral live attenuated S.typhi 21a or the injectable unconjugated Vi typhoid vaccine, rational use of antibiotics, improvement in public  sanitation facilities, availability of clean drinking water, promotion of safe food handling practices and public health education are vital in  the prevention of MDRTF.