ArticlePLoS neglected tropical diseases2017
The clinical and microbiological characteristics of enteric fever in Cambodia, 2008-2015.
Article in PLoS neglected tropical diseases, 2017. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 30 papers, 1 of them a synthesis that pooled it.
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Who cites it
30 citing papers in PubMed, 1 synthesis or guideline pooled it, 48 citations in OpenAlex.
- Pooled it
- Homologous and heterologous re-challenge with Salmonella Typhi and Salmonella Paratyphi A in a randomised controlled human infection model.PLoS neglected tropical diseases · 2020Trial
- Global trends and molecular epidemiology of Azithromycin-resistantOne health (Amsterdam, Netherlands) · 2026Article
- Estimating enteric fever seroincidence in rural western Cambodia: Findings from a population-based cross-sectional serosurvey.PLoS neglected tropical diseases · 2026Article
- Estimating enteric fever seroincidence in rural western Cambodia: findings from a population-based cross-sectional serosurvey.medRxiv : the preprint server for health sciences · 2026Article
- Combating antimicrobial resistance in Asia: A comprehensive review of strategic action plans, policies, and the role of the WHO.Saudi medical journal · 2025Review
- Prevalence and characterization of third-generation cephalosporin, carbapenem and colistin-resistant Enterobacterales isolated from clinical samples in Cambodia.New microbes and new infections · 2025Article
- Clinical presentation and outcome of enteric fever in adult patients with cancer: a perspective from Pakistan.Access microbiology · 2024Article
- FromACS omega · 2023Review
- Phylogenomic investigation of an outbreak of fluoroquinolone-resistantMicrobial genomics · 2023Article
- The Emergence of Travel-related Infections in Critical Care Units.Journal of translational internal medicine · 2022Article
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- Paratyphoid Fever A: Infection and Prevention.Frontiers in microbiology · 2022Review
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- Antimicrobial resistance detection in Southeast Asian hospitals is critically important from both patient and societal perspectives, but what is its cost?PLOS global public health · 2021Article
- Phylogenetic Analysis Indicates a Longer Term Presence of the Globally Distributed H58 Haplotype of Salmonella Typhi in Southern India.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2020Article
- Antimicrobial Resistance Surveillance in Low- and Middle-Income Countries: Progress and Challenges in Eight South Asian and Southeast Asian Countries.Clinical microbiology reviews · 2020Review
- An Observational Study of Sepsis in Takeo Province Cambodia: An in-depth examination of pathogens causing severe infections.PLoS neglected tropical diseases · 2020Observational
- Antimicrobial Resistance in Salmonella enterica Serovar Paratyphi B Variant Java in Poultry from Europe and Latin America.Emerging infectious diseases · 2020Article
Corrections and comments
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Authors and funding
13 authors at 5 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundEnteric fever remains a major public health problem in low resource settings and antibiotic resistance is increasing. In Asia, an increasing proportion of infections is caused by Salmonella enterica serovar Paratyphi A, which for a long time was assumed to cause a milder clinical syndrome compared to Salmonella enterica serovar Typhi. METHODOLOGY: A retrospective chart review study was conducted of 254 unique cases of blood culture confirmed enteric fever who presented at a referral adult hospital in Phnom Penh, Cambodia between 2008 and 2015. Demographic, clinical and laboratory data were collected from clinical charts and antibiotic susceptibility testing was performed. Whole genome sequence analysis was performed on a subset of 121 isolates.
resultsOne-hundred-and-ninety unique patients were diagnosed with Salmonella Paratyphi A and 64 with Salmonella Typhi. In the period 2008-2012, Salmonella Paratyphi A comprised 25.5% of 47 enteric fever cases compared to 86.0% of 207 cases during 2013-2015. Presenting symptoms were identical for both serovars but higher median leukocyte counts (6.8 x 109/L vs. 6.3 x 109/L; p = 0.035) and C-reactive protein (CRP) values (47.0 mg/L vs. 36 mg/L; p = 0.034) were observed for Salmonella Typhi infections. All but one of the Salmonella Typhi isolates belonged to haplotype H58 associated with multidrug resistance (MDR) (i.e. resistance to ampicillin, chloramphenicol and co-trimoxazole).;42.9% actually displayed MDR compared to none of the Salmonella Paratyphi A isolates. Decreased ciprofloxacin susceptibility (DCS) was observed in 96.9% (62/64) of Salmonella Typhi isolates versus 11.5% (21/183) of Salmonella Paratyphi A isolates (all but one from 2015). All isolates were susceptible to azithromycin and ceftriaxone.
conclusionsIn Phnom Penh, Cambodia, Salmonella Paratyphi A now causes the majority of enteric fever cases and decreased susceptibility against ciprofloxacin is increasing. Overall, Salmonella Typhi was significantly more associated with MDR and DCS compared to Salmonella Paratyphi A.
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