Preliminary observation on drug resistant cases of typhoid fever.
We report here a sudden and marked increase in the occurrence, in a captive population, of typhoid fever cases showing multiple drug resistance. Fifty one cases of typhoid fever were seen from January '90 to June '90 of which 49% showed multiple drug resistance. Comparative figures for resistance in the previous three years were 0% (1987), 5% (1988), 14% (1989). Shared resistance to chloramphenicol, ampicillin, amoxycillin and sensitivity to gentamicin, kanamycin, sisomycin, cephazolin, norfloxacin and ciprofloxacin in most of our cases suggest infection by a common strain with R-factor, mediated resistance. The illness was prolonged and associated with serious complications. Therapy with combination of quinolone derivatives and aminoglycoside antibiotics seemed justified on the basis of the in-vitro tests and clinical response. Efforts to identify the strain and stern public health measures to prevent further development of drug resistant S typhi are urgently indicated.
Madan
A
A
Department of Pathology, Jagjivanram Hospital (Western Railway) Maratha Mandir Marg, Bombay Central.
Dhar
A
A
Kulshrestha
P P
PP
Laghate
V D
VD
Dhar
P
P
D002702:Chloramphenicol Resistance; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D005260:Female; D006801:Humans; D015994:Incidence; D007194:India / Q000453:epidemiology; D008297:Male; D008826:Microbial Sensitivity Tests; D012485:Salmonella typhi / Q000187:drug effects*; D014435:Typhoid Fever / Q000188:drug therapy* / Q000453:epidemiology