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首页> 外文期刊>JMIR public health and surveillance. >Morbidity and Mortality Associated with Typhoid Fever among Hospitalized Patients, District Hyderabad, Pakistan, 2017-2018
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Morbidity and Mortality Associated with Typhoid Fever among Hospitalized Patients, District Hyderabad, Pakistan, 2017-2018

机译：与住院病患者，地区海德拉巴，巴基斯坦，2017-2018相关的发病率和死亡率

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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.
机译：背景，巴基斯坦海德拉巴是第一个见证广泛毒性（XDR）伤寒疫情的城市。爆发菌株对氨苄青霉素，氯霉素，三甲双胍 - 磺胺甲氧唑，氟喹诺酮和第三代头孢菌素具有抗性，因此极大地限制了治疗方案。然而，尽管有超过5000个记录的案件，有关死亡率和发病率的信息已经有限。目的解决现有的知识差距，本研究旨在评估巴基斯坦XDR和非XDR沙门氏菌塞洛伐克毒素剧死相关的发病率和死亡率。方法介绍2016年10月1日至2018年9月30日从海德拉巴5家医院审查了文化证实伤民案件的医疗记录。我们记录了年龄，性别，发烧，身体检查，血清学和微生物测试结果的数据，住院治疗前后，住院期，并发症和死亡时间。结果总共1452例培养证实的伤寒病例，包括947例（66％）XDR伤寒病例和505例（34％）非XDR伤寒病例。总体而言，360（38％）XDR伤寒患者和89例（18％）患有非XDL伤寒患者（P <5.001）的患者报告了≥1个并发症。髂骨穿孔是XDR伤寒（n = 210,33％）和非XDR伤寒患者（N = 71,14％）（P <.001）的患者中最常见的复杂性。总体而言，死亡率在17例（1.8％）患有XDR S Typhi感染和3（0.6％）患者的非XDR S Typhi感染患者中有患者记录（1.8％）患者（P = .06）。结论作为这一首要XDR伤寒爆发继续传播，住院前的疾病持续时间增加，并发症率增加对临床护理和医疗费用具有重要意义，并提高了预防和控制措施的重要性。

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