Hamdulay Khadija, Rawekar Rajendra, Tayade Ashwini, Kumar Sunil, Acharya Sourya
Medicine, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Infectious Disease, Jawaharlal Nehru Medical College, Datta Meghe Institute of Higher Education and Research, Wardha, IND.
Cureus. 2024 Jun 24;16(6):e63070. doi: 10.7759/cureus.63070. eCollection 2024 Jun.
Enteric fever, predominantly caused by serovar Typhi and serovar Paratyphi, remains a significant global health challenge. This comprehensive review examines the evolving epidemiology and antibiotic resistance associated with enteric fever. We provide an overview of the disease's definition and historical context, highlighting the substantial impact of antibiotic resistance on treatment efficacy. The review details the global burden, incidence trends, and risk factors of enteric fever while elucidating the pathogenesis and clinical manifestations of the disease. A critical analysis of antibiotic resistance mechanisms reveals the alarming rise of multi-drug resistant (MDR) and extensively drug-resistant (XDR) strains, complicating treatment regimens and underscoring the need for novel therapeutic strategies. Current treatment protocols, the role of empirical therapy, and the rational use of antibiotics are discussed in depth. Additionally, we explore prevention and control strategies, emphasizing the importance of vaccination programs, sanitation improvements, and effective public health interventions. The review concludes with recommendations for future actions, including enhanced surveillance, research and development of new antibiotics, expansion of vaccination efforts, and improved public health infrastructure. The findings highlight the necessity for updated clinical guidelines and sustained global efforts to address the challenges of enteric fever and its evolving antibiotic resistance patterns. Through coordinated action and continued innovation, it is possible to mitigate the impact of this enduring public health threat.
伤寒主要由伤寒血清型和副伤寒血清型引起，仍然是一项重大的全球卫生挑战。这篇全面综述探讨了与伤寒相关的不断演变的流行病学和抗生素耐药性。我们概述了该疾病的定义和历史背景，强调了抗生素耐药性对治疗效果的重大影响。综述详细阐述了伤寒的全球负担、发病率趋势和风险因素，同时阐明了该疾病的发病机制和临床表现。对抗生素耐药机制的批判性分析揭示了多重耐药（MDR）和广泛耐药（XDR）菌株惊人的增长，使治疗方案复杂化，并凸显了对新型治疗策略的需求。深入讨论了当前的治疗方案、经验性治疗的作用以及抗生素的合理使用。此外，我们探讨了预防和控制策略，强调了疫苗接种计划、改善卫生条件和有效的公共卫生干预措施的重要性。综述最后提出了未来行动的建议，包括加强监测、研发新抗生素、扩大疫苗接种工作以及改善公共卫生基础设施。研究结果强调了更新临床指南以及全球持续努力应对伤寒挑战及其不断演变的抗生素耐药模式的必要性。通过协调行动和持续创新，有可能减轻这一持久的公共卫生威胁的影响。
