title: Treatment failure in a typhoid patient infected with nalidixic acid resistant S. enterica serovar Typhi with reduced susceptibility to ciprofloxacin: a case report from Cameroon.
abstract: BACKGROUND
  Fluoroquinolones or third generation cephalosporins are the drugs of choice for the treatment of typhoid fever. Treatment failure with fluoroquinolones has been reported in Asia and Europe. We report a case of ciprofloxacin treatment failure in typhoid fever in Cameroon.
  
  
  METHODS
  A 29-year-old female patient with suspected typhoid fever from Kumba, Cameroon, yielded growth of Salmonella enterica serovar Typhi in blood culture. The isolate was resistant to nalidixic acid but sensitive to ciprofloxacin by disc diffusion test. However, the patient did not respond to treatment with ciprofloxacin, although the isolate was apparently susceptible to ciprofloxacin.
  
  
  CONCLUSIONS
  Treatment failure with ciprofloxacin in our case indicates the presence of nalidixic acid resistant S. enterica serovar Typhi (NARST) with reduced susceptibility to ciprofloxacin in Cameroon (Central Africa).
authors.affiliation: St. John's Maternity and Hospital, Fiango, Kumba, Cameroon. jnkemngu@yahoo.com
authors.forename: Njinkeng J
authors.initials: NJ
authors.lastname: Nkemngu
authors.forename: Etienne D N
authors.initials: ED
authors.lastname: Asonganyi
authors.forename: Anna L
authors.initials: AL
authors.lastname: Njunda
mesh_terms: D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use; D002163:Cameroon; D002443:Ceftriaxone / Q000627:therapeutic use; D002939:Ciprofloxacin / Q000494:pharmacology* / Q000627:therapeutic use*; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008826:Microbial Sensitivity Tests; D009268:Nalidixic Acid / Q000494:pharmacology*; D012485:Salmonella typhi / Q000187:drug effects*; D017211:Treatment Failure; D014435:Typhoid Fever / Q000188:drug therapy* / Q000382:microbiology*
chemical_list: D000900:Anti-Bacterial Agents; D009268:Nalidixic Acid; D002939:Ciprofloxacin; D002443:Ceftriaxone