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[Epidemiological characteristics of typhoid fever and antibiotic susceptibility testing of Salmonella Typhi isolates in Guangxi, 1994-2013].
[typhoid]
Through
analyzing
the
typhoid
epidemics
and
to
determine
and
monitor
regional
resistance
characteristics
of
the
shift
of
drug
resistant
profile
on
Salmonella
(
S
.
)
Typhi
,
to
understand
the
related
epidemiological
characteristics
of
typhoid
fever
and
to
provide
evidence
for
the
development
of
strategies
,
in
Guangxi
.
D
ata
of
typhoid
fever
from
surveillance
and
reporting
system
between
1994
to
2013
was
collected
and
statistically
analyzed
epidemiologically
.
The
susceptibility
of
475
S
.
Typhi
isolates
from
patients
on
ten
antibiotics
was
tested
by
broth
micro-dilution
method
and
minimum
inhibition
concentration
was
obtained
and
interpreted
based
on
the
CLSI
standard
.
From
1994
to
2013
,
a
total
of
57
928
cases
of
typhoid
fever
were
reported
in
Guangxi
province
with
an
annual
incidence
of
6
.
29
/
100
000
and
mortality
as
0
.
03
%
.
The
higher
incidence
was
observed
in
the
population
under
20
years
of
age
.
There
was
no
significant
difference
on
incidence
between
male
and
female
,
but
farmers
and
students
were
among
the
hardest
hit
groups
.
More
cases
were
seen
from
the
northern
part
of
the
province
.
Cases
appeared
all
year
round
with
the
peak
from
May
to
October
.
A
total
of
13
major
outbreaks
during
2001
to
2013
were
reported
and
the
main
transmission
route
was
water-borne
.
All
the
strains
were
sensitive
to
third
generation
cephalosporins
cefotaxime
and
fluoroquinolones
norfloxacin
.
The
susceptibility
rates
to
tetracycline
,
chloramphenicol
,
ampicillin
and
gentamicin
was
around
98
%
but
relative
lower
susceptible
rate
to
ciprofloxacin
was
seen
as
89
.
89
%
.
The
lowest
susceptibility
was
found
for
streptomycin
and
sulfamethoxazole
agents
,
with
the
rates
as
67
.
73
%
and
65
.
89
%
,
respectively
.
One
strain
was
found
to
have
been
resistant
to
ciprofloxacin
and
another
47
isolates
with
reduced
susceptibility
to
ciprofloxacin
.
Twenty
eight
isolates
were
found
to
be
resistant
to
multiple
antibiotics
and
one
displayed
ampicillin
,
chloramphenicol
,
streptomycin
,
sulfamethoxazole
tetracycline
and
nalidixic
acid
(
ACSSxT-NAL
)
resistance
profile
.
This
was
the
first
report
in
China
.
Multi-drug
resistant
strains
were
frequently
isolated
from
small
scale
outbreaks
of
typhoid
fever
.
The
incidence
of
typhoid
fever
in
Guangxi
was
still
high
and
some
strains
showed
multi-drug
resistance
and
reduced
susceptibility
to
ciprofloxacin
,
indicating
that
the
surveillance
and
monitor
programs
on
drug
resistance
of
S
.
Typhi
should
be
strengthened
,
to
prevent
large
scale
outbreaks
of
typhoid
fever
in
this
province
.
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