title: [Typhoid fever: facing the challenge of resistant strains].
abstract: The introduction of chloramphenicol in 1948 revolutionised the outcome of typhoid fever but chloramphenicol-resistant strains of Salmonella enterica serotype Typhi were reported just two years later. Resistance followed also the introduction of ampicillin and co-trimoxazole. During the second half of the 1980s, strains resistant to the three first-line antimicrobial agents, chloramphenicol, ampicillin and co-trimoxazole emerged and spread rapidly throughout the Indian subcontinent and South East Asia. During the 1990s when fluoroquinolones had become a first-line treatment for typhoid fever, these multi drug resistant (MDR) strains acquired an additional resistance to nalidixic acid with decreased susceptibilities to ciprofloxacin (CIPDS) (MIC range, 0.125-1 mg/l). Considerable data have now accumulated to suggest that infections due to CIPDS strains may not respond satisfactorily to therapy with ciprofloxacin or ofloxacin. Furthermore, identification of such CIPDS strains in clinical laboratories is not easy without determination of MIC of ciprofloxacin. Recently, several isolates highly resistant to ciprofloxacin or to extended-spectrum cephalosporins of Asian origin have been reported.
authors.affiliation: Institut Pasteur, Centre national de référence des Salmonella, unité des bactéries pathogènes entériques, 28 rue du docteur Roux, Paris cedex 15, France. fxweill@pasteur.fr
authors.forename: François-Xavier
authors.initials: FX
authors.lastname: Weill
mesh_terms: D000667:Ampicillin / Q000627:therapeutic use; D000900:Anti-Bacterial Agents / Q000627:therapeutic use*; D002701:Chloramphenicol / Q000627:therapeutic use*; D002939:Ciprofloxacin / Q000494:pharmacology / Q000627:therapeutic use; D004351:Drug Resistance; D018432:Drug Resistance, Multiple / Q000187:drug effects / Q000502:physiology; D006801:Humans; D012485:Salmonella typhi / Q000187:drug effects / Q000302:isolation & purification; D015662:Trimethoprim, Sulfamethoxazole Drug Combination / Q000627:therapeutic use; D014435:Typhoid Fever / Q000188:drug therapy*
chemical_list: D000900:Anti-Bacterial Agents; D002939:Ciprofloxacin; D002701:Chloramphenicol; D000667:Ampicillin; D015662:Trimethoprim, Sulfamethoxazole Drug Combination