Cargando…
Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review
BACKGROUND: Hyderabad, Pakistan, was the first city to witness an outbreak of extensively drug resistant (XDR) typhoid fever. The outbreak strain is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporin, thus greatly limiting tr...
Autores principales: | , , , , , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
JMIR Publications
2021
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167610/ https://www.ncbi.nlm.nih.gov/pubmed/33999000 http://dx.doi.org/10.2196/27268 |
_version_ | 1783701728594493440 |
---|---|
author | Fatima, Munaza Kumar, Santosh Hussain, Mudassar Memon, Naveed Masood Vighio, Anum Syed, Muhammad Asif Chaudhry, Ambreen Hussain, Zakir Baig, Zeeshan Iqbal Baig, Mirza Amir Asghar, Rana Jawad Ikram, Aamer Khader, Yousef |
author_facet | Fatima, Munaza Kumar, Santosh Hussain, Mudassar Memon, Naveed Masood Vighio, Anum Syed, Muhammad Asif Chaudhry, Ambreen Hussain, Zakir Baig, Zeeshan Iqbal Baig, Mirza Amir Asghar, Rana Jawad Ikram, Aamer Khader, Yousef |
author_sort | Fatima, Munaza |
collection | PubMed |
description | BACKGROUND: Hyderabad, Pakistan, was the first city to witness an outbreak of extensively drug resistant (XDR) typhoid fever. The outbreak strain is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporin, thus greatly limiting treatment options. However, despite over 5000 documented cases, information on mortality and morbidity has been limited. OBJECTIVE: To address the existing knowledge gap, this study aimed to assess the morbidity and mortality associated with XDR and non-XDR Salmonella serovar Typhi infections in Pakistan. METHODS: We reviewed the medical records of culture-confirmed typhoid cases in 5 hospitals in Hyderabad from October 1, 2016, to September 30, 2018. We recorded data on age, gender, onset of fever, physical examination, serological and microbiological test results, treatment before and during hospitalization, duration of hospitalization, complications, and deaths. RESULTS: A total of 1452 culture-confirmed typhoid cases, including 947 (66%) XDR typhoid cases and 505 (34%) non-XDR typhoid cases, were identified. Overall, ≥1 complications were reported in 360 (38%) patients with XDR typhoid and 89 (18%) patients with non-XDR typhoid (P<.001). Ileal perforation was the most commonly reported complication in both patients with XDR typhoid (n=210, 23%) and patients with non-XDR typhoid (n=71, 14%) (P<.001). Overall, mortality was documented among 17 (1.8%) patients with XDR S Typhi infections and 3 (0.6%) patients with non-XDR S Typhi infections (P=.06). CONCLUSIONS: As this first XDR typhoid outbreak continues to spread, the increased duration of illness before hospitalization and increased rate of complications have important implications for clinical care and medical costs and heighten the importance of prevention and control measures. |
format | Online Article Text |
id | pubmed-8167610 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | JMIR Publications |
record_format | MEDLINE/PubMed |
spelling | pubmed-81676102021-06-11 Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review Fatima, Munaza Kumar, Santosh Hussain, Mudassar Memon, Naveed Masood Vighio, Anum Syed, Muhammad Asif Chaudhry, Ambreen Hussain, Zakir Baig, Zeeshan Iqbal Baig, Mirza Amir Asghar, Rana Jawad Ikram, Aamer Khader, Yousef JMIR Public Health Surveill Short Paper BACKGROUND: Hyderabad, Pakistan, was the first city to witness an outbreak of extensively drug resistant (XDR) typhoid fever. The outbreak strain is resistant to ampicillin, chloramphenicol, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporin, thus greatly limiting treatment options. However, despite over 5000 documented cases, information on mortality and morbidity has been limited. OBJECTIVE: To address the existing knowledge gap, this study aimed to assess the morbidity and mortality associated with XDR and non-XDR Salmonella serovar Typhi infections in Pakistan. METHODS: We reviewed the medical records of culture-confirmed typhoid cases in 5 hospitals in Hyderabad from October 1, 2016, to September 30, 2018. We recorded data on age, gender, onset of fever, physical examination, serological and microbiological test results, treatment before and during hospitalization, duration of hospitalization, complications, and deaths. RESULTS: A total of 1452 culture-confirmed typhoid cases, including 947 (66%) XDR typhoid cases and 505 (34%) non-XDR typhoid cases, were identified. Overall, ≥1 complications were reported in 360 (38%) patients with XDR typhoid and 89 (18%) patients with non-XDR typhoid (P<.001). Ileal perforation was the most commonly reported complication in both patients with XDR typhoid (n=210, 23%) and patients with non-XDR typhoid (n=71, 14%) (P<.001). Overall, mortality was documented among 17 (1.8%) patients with XDR S Typhi infections and 3 (0.6%) patients with non-XDR S Typhi infections (P=.06). CONCLUSIONS: As this first XDR typhoid outbreak continues to spread, the increased duration of illness before hospitalization and increased rate of complications have important implications for clinical care and medical costs and heighten the importance of prevention and control measures. JMIR Publications 2021-05-17 /pmc/articles/PMC8167610/ /pubmed/33999000 http://dx.doi.org/10.2196/27268 Text en ©Munaza Fatima, Santosh Kumar, Mudassar Hussain, Naveed Masood Memon, Anum Vighio, Muhammad Asif Syed, Ambreen Chaudhry, Zakir Hussain, Zeeshan Iqbal Baig, Mirza Amir Baig, Rana Jawad Asghar, Aamer Ikram, Yousef Khader. Originally published in JMIR Public Health and Surveillance (https://publichealth.jmir.org), 17.05.2021. https://creativecommons.org/licenses/by/4.0/This is an open-access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work, first published in JMIR Public Health and Surveillance, is properly cited. The complete bibliographic information, a link to the original publication on https://publichealth.jmir.org, as well as this copyright and license information must be included. |
spellingShingle | Short Paper Fatima, Munaza Kumar, Santosh Hussain, Mudassar Memon, Naveed Masood Vighio, Anum Syed, Muhammad Asif Chaudhry, Ambreen Hussain, Zakir Baig, Zeeshan Iqbal Baig, Mirza Amir Asghar, Rana Jawad Ikram, Aamer Khader, Yousef Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title | Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title_full | Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title_fullStr | Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title_full_unstemmed | Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title_short | Morbidity and Mortality Associated with Typhoid Fever Among Hospitalized Patients in Hyderabad District, Pakistan, 2017-2018: Retrospective Record Review |
title_sort | morbidity and mortality associated with typhoid fever among hospitalized patients in hyderabad district, pakistan, 2017-2018: retrospective record review |
topic | Short Paper |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8167610/ https://www.ncbi.nlm.nih.gov/pubmed/33999000 http://dx.doi.org/10.2196/27268 |
work_keys_str_mv | AT fatimamunaza morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT kumarsantosh morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT hussainmudassar morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT memonnaveedmasood morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT vighioanum morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT syedmuhammadasif morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT chaudhryambreen morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT hussainzakir morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT baigzeeshaniqbal morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT baigmirzaamir morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT asgharranajawad morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT ikramaamer morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview AT khaderyousef morbidityandmortalityassociatedwithtyphoidfeveramonghospitalizedpatientsinhyderabaddistrictpakistan20172018retrospectiverecordreview |