Multidrug-resistant typhoid fever in Singapore

Area of Science:

• Infectious Diseases
• Epidemiology
• Microbiology

Background:

• Multidrug-resistant (MDR) typhoid fever is a growing global health concern.
• Travel to endemic regions, such as the Indian subcontinent, is a significant risk factor for acquiring MDR typhoid fever.
• Understanding the clinical and epidemiological profile of MDR typhoid fever is crucial for effective management and public health strategies.

Purpose of the Study:

• To characterize the clinical and epidemiological features of multidrug-resistant (MDR) typhoid fever in Singapore.
• To compare the outcomes of MDR typhoid fever with drug-susceptible typhoid fever.
• To identify the prevalence of specific drug resistance patterns in MDR Salmonella Typhi isolates.

Main Methods:

• Retrospective analysis of typhoid fever cases in Singapore.
• Comparison of clinical data between MDR and drug-susceptible typhoid fever patients.
• Antimicrobial susceptibility testing of Salmonella Typhi isolates.

Main Results:

• 17.4% of typhoid fever cases were identified as MDR, primarily linked to travel to the Indian subcontinent.
• MDR Salmonella Typhi isolates commonly exhibited resistance to ampicillin, chloramphenicol, and trimethoprim-sulphamethoxazole (TMP-SMX).
• Patients with MDR typhoid fever had a significantly longer duration of fever defervescence (8 days) compared to those with drug-susceptible typhoid fever (5.7 days).

Conclusions:

• Imported MDR typhoid fever is a notable issue in Singapore, associated with travel to the Indian subcontinent.
• MDR typhoid fever is associated with prolonged illness, posing clinical challenges.
• Effective treatment strategies and surveillance are essential to combat the spread of MDR typhoid fever.