Oh H M, Chew S K, Monteiro E H
Communicable Disease Centre, Singapore.
Singapore Med J. 1994 Dec;35(6):599-601.
A study was conducted to determine the clinical and epidemiological characteristics of multidrug-resistant (MDR) typhoid fever in Singapore. Twenty-one of 121 patients with typhoid fever had MDR typhoid fever after recent travel to the Indian subcontinent. Fifty patients with drug susceptible typhoid fever were also analysed for comparison. Nineteen of the MDR S. typhi isolates had resistance to ampicillin, chloramphenicol and trimethoprim-sulphamethoxazole (TMP-SMX) while the remainder had resistance to ampicillin and TMP-SMX. The predominant presenting symptoms were fever and diarrhoea. Eleven patients with MDR typhoid fever were treated with oral ciprofloxacin and nine with intravenous ceftriaxone. The patients with MDR typhoid fever had a longer duration of fever defervescence (8 +/- 5 days) compared to those with drug-susceptible typhoid fever (5.7 +/- 4.16 days) (p < 0.01). Eighteen patients were cured and one patient defaulted treatment. Two patients relapsed within two months of treatment. The study showed that 17.4% of patients with typhoid fever had imported MDR S. typhi after recent travel to the Indian subcontinent where MDR typhoid fever is prevalent.
一项研究旨在确定新加坡耐多药伤寒热的临床和流行病学特征。121例伤寒热患者中有21例在近期前往印度次大陆后感染了耐多药伤寒热。还分析了50例药物敏感型伤寒热患者以作比较。19株耐多药伤寒杆菌分离株对氨苄西林、氯霉素和复方新诺明耐药，其余菌株对氨苄西林和复方新诺明耐药。主要症状为发热和腹泻。11例耐多药伤寒热患者接受口服环丙沙星治疗，9例接受静脉注射头孢曲松治疗。耐多药伤寒热患者发热消退时间（8±5天）比药物敏感型伤寒热患者（5.7±4.16天）更长（p<0.01）。18例患者治愈，1例患者未接受治疗。2例患者在治疗后两个月内复发。该研究表明，17.4%的伤寒热患者在近期前往耐多药伤寒热流行的印度次大陆后感染了输入性耐多药伤寒杆菌。
