Hospital for Tropical Diseases, London, United Kingdom.
Am J Trop Med Hyg. 2010 Jun;82(6):1121-6. doi: 10.4269/ajtmh.2010.10-0007.
Our current knowledge of the clinical characteristics of enteric fever is drawn mainly from population-based studies in disease-endemic countries, and there are limited data published on cases in returning travelers. We report the clinical characteristics of enteric fever in 92 travelers returning to London, United Kingdom. Salmonella typhi and S. paratyphi resulted in an almost indistinguishable clinical picture. Rose spots and relative bradycardia were found only in a few patients. A total of 91% of the patients had a normal leukocyte count, which was associated with a markedly increased level of alanine aminotransferase in 82%. A total of 57% of the S. typhi isolates had decreased susceptibility to ciprofloxacin and resistance to nalidixic acid; these isolates were from southern Asia. Thirty percent were multidrug resistant; all were from southern Asia and Nigeria. None of the paratyphoid isolates were multidrug resistant but rates of decreased susceptibility to fluoroquinolones were higher than in S. typhi (74%).
我们目前对肠热病临床特征的了解主要来自疾病流行国家的基于人群的研究，有关返回旅行者中肠热病病例的资料有限。我们报告了 92 例返回英国伦敦的旅行者患肠热病的临床特征。伤寒沙门氏菌和副伤寒沙门氏菌导致的临床症状几乎无法区分。玫瑰疹和相对心动过缓仅在少数患者中发现。91%的患者白细胞计数正常，这与 82%的丙氨酸氨基转移酶水平显著升高有关。共有 57%的伤寒沙门氏菌分离株对环丙沙星的敏感性降低，对萘啶酸耐药；这些分离株来自南亚。30%为多重耐药；均来自南亚和尼日利亚。副伤寒沙门氏菌分离株均无多重耐药，但对氟喹诺酮类药物的敏感性降低率高于伤寒沙门氏菌（74%）。
