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Factors associated with typhoid relapse in the era of multiple drug resistant strains

Kaashif Aqeeb Ahmad1, Liaqat Hayat Khan, Bakht Roshan

  • 1Pediatrix Medical Group, San Antonio, Texas, USA. kaashif_ahmad@pediatrix.com

Journal of Infection in Developing Countries
|October 15, 2011
PubMed

Insights

Typhoid fever relapse is common, especially with multidrug-resistant strains. Constipation and early fever onset are key risk factors in children with MDR typhoid. Understanding these factors aids in better clinical management.

Area of Science:

  • Pediatric Infectious Diseases
  • Bacteriology
  • Clinical Epidemiology

Background:

  • Typhoid fever affects over 27 million people globally each year.
  • A significant clinical relapse rate of 5% to 20% is observed in typhoid cases.
  • Factors contributing to typhoid fever relapse remain largely unidentified.

Purpose of the Study:

  • To identify clinical factors associated with typhoid fever relapse in children.
  • To investigate the impact of antimicrobial resistance on relapse rates.
  • To inform clinical follow-up strategies for pediatric typhoid.

Main Methods:

  • A 15-year retrospective study of 1,650 children with culture-proven enteric fever.
  • Data collected from the Aga Khan University Medical Center, Karachi, Pakistan.
  • Analysis of clinical presentation and treatment in relation to relapse.

Main Results:

  • Constipation and presentation within 14 days of fever onset were linked to relapse in multidrug-resistant (MDR) typhoid.
  • Diarrhea was associated with decreased relapse in drug-sensitive typhoid cases.
  • Quinolone therapy also showed a protective effect against relapse in drug-sensitive strains.

Conclusions:

  • Clinical factors at presentation significantly influence typhoid fever relapse.
  • These factors may relate to changes in the reticuloendothelial system's organism load.
  • Findings are crucial for developing targeted clinical follow-up algorithms for MDR typhoid in children.
Abstract

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