Report of Relapse Typhoid Fever Cases from Kolkata, India: Recrudescence or Reinfection?

Japanese journal of infectious diseases

Surojit Das¹  Sriparna Samajpati² 

[1] Microbiology Division, Apollo Gleneagles Hospitals;Microbiology Division, National Institute of Cholera and Enteric Diseases

关键词: Salmonella Typhi;    recrudescence;    reinfection;    antimicrobial resistance;    molecular subtyping;   

DOI  :  10.7883/yoken.JJID.2017.321

学科分类：传染病学

来源: National Institute of Infectious Diseases

【 摘 要 】

Three relapse cases were reported out of 107 hospital-attending typhoid cases within a period of 2 years (2014–2016) from Apollo Gleneagles Hospital, Kolkata, India. During the first episode of typhoid fever, 2 of the 3 cases were treated with ceftriaxone (CRO) for 7 days, and 1 was treated for 14 days. Six Salmonella Typhi (S. Typhi) isolates, obtained from the 3 patients during both typhoid episodes, were subjected to antimicrobial susceptibility testing, detection of quinolone resistance-determining region (QRDR) mutation and molecular subtyping by pulsed-field gel electrophoresis (PFGE), multiple-locus variable number tandem repeat analysis (MLVA), multilocus sequence typing (MLST), clustered regularly interspaced short palindromic repeats (CRISPR), and H58 haplotyping. Pairs of the S. Typhi strains isolated from two of the patients during the 1st and 2nd episodes were similar with respect to the antimicrobial resistance (AMR) profiles, QRDR mutations, and molecular subtypes; whereas, the S. Typhi strain pair isolated from the 3rd patient were different in their AMR profiles, QRDR mutations, and MLVA profiles. From these observations, it may be concluded that in spite of treating typhoid cases with CRO for 7–14 days, relapse of typhoid fever might occur. The article also showed the advantage of MLVA typing over PFGE, MLST, and CRISPR typing for the discrimination of strains isolated from the same patient in case of relapse of typhoid fever.

【 授权许可】

Unknown