title: An outbreak of peritonitis caused by multidrug-resistant Salmonella Typhi in Kinshasa, Democratic Republic of Congo.
abstract: Between October 2004 and January 2005, 144 patients with peritonitis were admitted to the surgical wards of Kinshasa General Hospital and a few private city clinics. 63 patients (44%) underwent surgical intervention because of intestinal perforation consistent with typhoid fever; the case fatality rate was 53%. The majority of patients had received a course of first-line antibiotics such as chloramphenicol, ampicillin or co-trimoxazole before admission. On bacteriological investigation, Salmonella Typhi was isolated from the blood of 11 patients with peritonitis. The isolates were all resistant to ampicillin, chloramphenicol, tetracycline and co-trimoxazole, but sensitive to third-generation cephalosporins, quinolone (nalidixic acid, ciprofloxacine) and amoxicillin-clavulanic acid. Several factors contributed to the poor outcome of this disease including a) the use of inappropriate antibiotics, b) long delay in diagnosis, c) difficult access to health facilities. This is the first documented outbreak of typhoid fever caused by a multidrug-resistant S. Typhi in Kinshasa.
authors.affiliation: National Institute for Biomedical Research, Kinshasa, The Democratic Republic of Congo.
authors.forename: J J
authors.initials: JJ
authors.lastname: Muyembe-Tamfum
authors.forename: J
authors.initials: J
authors.lastname: Veyi
authors.forename: M
authors.initials: M
authors.lastname: Kaswa
authors.forename: O
authors.initials: O
authors.lastname: Lunguya
authors.forename: J
authors.initials: J
authors.lastname: Verhaegen
authors.forename: M
authors.initials: M
authors.lastname: Boelaert
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002648:Child; D015169:Colony Count, Microbial; D015023:Democratic Republic of the Congo / Q000453:epidemiology; D004196:Disease Outbreaks; D004305:Dose-Response Relationship, Drug; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D010538:Peritonitis / Q000188:drug therapy / Q000453:epidemiology* / Q000382:microbiology; D012485:Salmonella typhi / Q000187:drug effects* / Q000254:growth & development / Q000472:pathogenicity; D016896:Treatment Outcome; D014435:Typhoid Fever / Q000188:drug therapy / Q000453:epidemiology* / Q000401:mortality / Q000601:surgery; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents