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著者: Surendra Karki, Prabin Shakya, Allen C Cheng, Shyam Prakash Dumre, Karin Leder
雑誌名: Clin Infect Dis. 2013 Nov;57(10):e167-76. doi: 10.1093/cid/cit563. Epub 2013 Aug 28.
Abstract/Text
Prospective time-trend analyses on shifting etiology and trends of drug resistance in enteric fever are scarce. Using published and unpublished datasets from Nepal, we performed a systematic review and meta-analysis to understand the trends in etiology and resistance to antimicrobials that have occurred since 1993. Thirty-two studies involving 21 067 Salmonella enterica serotype Typhi (ST) and S. enterica serotype Paratyphi A (SPA) isolates were included. There was an increasing trend in enteric fever caused by SPA during the last 2 decades (P < .01). We observed sharply increasing trends in resistance to nalidixic acid and ciprofloxacin for both ST and SPA. In contrast, multi-drug resistance (MDR), resistance to traditional first-line antibiotics such as chloramphenicol and co-trimoxazole have significantly decreased for both organisms. The resistance to ceftriaxone has remained low, suggesting it is likely to remain useful as a reserve antibiotic for treatment. Trends in decreasing resistance to traditional first-line antibiotics and decreasing MDR provide an opportunity to reconsider these first-line antimicrobials as therapeutic options.
PMID 23985342 Clin Infect Dis. 2013 Nov;57(10):e167-76. doi: 10.1093/cid/cit563. Epub 2013 Aug 28.
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