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Enteric fever imported to the Czech Republic: epidemiology, clinical characteristics and antimicrobial susceptibility.
[typhoid]
The
aim
of
this
study
was
to
describe
epidemiological
and
clinical
characteristics
of
imported
enteric
fever
in
Czech
travellers
and
to
determine
the
antimicrobial
susceptibility
of
isolated
strains
.
Retrospective
descriptive
study
included
adult
patients
treated
with
enteric
fever
at
Hospital
Na
Bulovce
during
January
2004
-
December
2012
.
A
case
of
typhoid
or
paratyphoid
fever
was
defined
as
isolation
of
Salmonella
Typhi
or
Paratyphi
from
blood
or
stool
.
During
the
study
period
,
there
have
been
diagnosed
19
cases
of
enteric
fever
(
12
males
and
7
females
)
with
age
median
of
30
years
;
14
cases
were
caused
by
Salmonella
Typhi
and
5
cases
by
S
.
Paratyphi
A
.
The
infection
has
been
acquired
in
South
Asia
(
16
patients
;
84
.
2
%
)
,
in
Africa
(
Egypt
,
Angola
)
in
two
cases
(
10
.
5
%
)
,
and
in
Mexico
(
1
;
5
.
3
%
)
.
Symptoms
included
fever
(
all
patients
)
,
diarrhoea
(
16
cases
;
84
.
2
%
)
,
headache
(
9
;
47
.
4
%
)
,
and
abdominal
pain
(
7
;
36
.
8
%
)
.
Seventeen
patients
(
89
.
5
%
)
were
treated
with
fluoroquinolones
;
however
,
the
treatment
failure
was
observed
in
seven
of
them
(
41
.
2
%
)
.
Decreased
ciprofloxacin
susceptibility
was
detected
in
eight
strains
(
66
.
7
%
)
,
and
one
strain
(
8
.
3
%
)
was
multidrug
resistant
.
Sequence
analysis
of
quinolone
resistance-determining
regions
(
QRDR
)
of
the
gyrA
gene
revealed
the
presence
of
amino
acid
substitutions
in
all
tested
isolates
with
decreased
ciprofloxacin
susceptibility
.
Typhoid
and
paratyphoid
fevers
represent
epidemiologically
important
diseases
that
may
lead
to
potentially
life-threatening
complications
.
Major
issue
in
the
management
of
enteric
fever
represents
the
non-
susceptibility
of
Salmonella
strains
to
fluoroquinolones
and
other
antimicrobials
.
