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Typhoid outbreak in songkhla, Thailand 2009-2011: clinical outcomes, susceptibility patterns, and reliability of serology tests.
[typhoid]
To
determine
the
clinical
manifestations
and
outcomes
,
the
reliability
of
Salmonella
enterica
serotype
Typhi
(
S
ser
.
Typhi
)
IgM
and
IgG
rapid
tests
,
and
the
susceptibility
patterns
and
the
response
to
treatment
during
the
2009
-
2011
typhoid
outbreak
in
Songkhla
province
in
Thailand
.
T
he
medical
records
of
children
aged
<
15
years
with
S
ser
.
Typhi
bacteremia
were
analysed
.
The
efficacy
of
the
typhoid
IgM
and
IgG
rapid
tests
and
susceptibility
of
the
S
ser
.
Typhi
to
the
current
main
antibiotics
used
for
typhoid
(
amoxicillin
,
ampicillin
,
cefotaxime
,
ceftriaxone
,
co
-trimoxazole
,
and
ciprofloxacin
)
,
were
evaluated
.
S
ser
.
Typhi
bacteremia
was
found
in
368
patients
,
and
all
isolated
strains
were
susceptible
to
all
6
antimicrobials
tested
.
Most
of
the
patients
were
treated
with
ciprofloxacin
for
7
-
14
days
.
The
median
time
(
IQR
)
of
fever
before
treatment
and
duration
of
fever
after
treatment
were
5
(
4
,
7
)
days
and
4
(
3
,
5
)
days
,
respectively
.
Complications
of
ascites
,
lower
respiratory
symptoms
,
anemia
(
Hct
<
30
%
)
,
and
ileal
perforation
were
found
in
7
,
7
,
22
,
and
1
patients
,
respectively
.
None
of
the
patients
had
recurrent
infection
or
died
.
The
sensitivities
of
the
typhoid
IgM
and
IgG
tests
were
58
.
3
%
and
25
.
6
%
respectively
,
and
specificities
were
74
.
1
%
and
50
.
5
%
,
respectively
.
Most
of
the
patients
were
diagnosed
at
an
early
stage
and
treated
with
a
good
outcome
.
All
S
ser
.
Typhi
strains
were
susceptible
to
standard
first
line
antibiotic
typhoid
treatment
.
The
typhoid
IgM
and
IgG
rapid
tests
had
low
sensitivity
and
moderate
specificity
.
Diseases
Validation
Diseases presenting
"current main antibiotics"
symptom
typhoid
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