{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,6,4]],"date-time":"2026-06-04T02:23:38Z","timestamp":1780539818405,"version":"3.54.1"},"reference-count":27,"publisher":"American Society of Tropical Medicine and Hygiene","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,7,6]]},"abstract":"<jats:p>Owing to the increase in <jats:italic>Salmonella<\/jats:italic> strains with decreased fluoroquinolone susceptibility in the endemic areas, we have been treating enteric fever with intravenous ceftriaxone empirically since 2007. In this study, we reevaluated our treatment protocol. This retrospective cohort study was conducted at a single institute in Tokyo, Japan, between January 2006 and December 2013. Enteric fever was defined as isolation of <jats:italic>Salmonella<\/jats:italic> Typhi or <jats:italic>Salmonella<\/jats:italic> Paratyphi A, B, and C from the blood and\/or stool of patients with fever. Of the 35 patients with imported enteric fever, 28 (80%) had returned from south Asia. Ciprofloxacin-susceptible strains were detected in only 12% of the cases. The isolates showed excellent susceptibility to ampicillin (91%), chloramphenicol (94%), ceftriaxone (97%), and azithromycin (97%). One case of <jats:italic>Salmonella<\/jats:italic> Paratyphi B was excluded, and of the remaining 34 patients, 56% were treated with ceftriaxone alone, 26% with ceftriaxone then fluoroquinolone, and 9% with levofloxacin alone. The overall relapse rate was 6.1%; however, among those receiving ceftriaxone monotherapy, the relapse rate was 11% (<jats:italic>N<\/jats:italic> = 2). The relapse group was characterized by longer times to treatment initiation (<jats:italic>P<\/jats:italic> = 0.035) and defervescence (&gt; 7 days) after treatment initiation (<jats:italic>P<\/jats:italic> = 0.022). In such cases, we recommend that ceftriaxone treatment be continued for &gt; 4 days after defervescence or be changed to fluoroquinolone if the strains are found to be susceptible to prevent relapse. Furthermore, ampicillin and chloramphenicol, which are no longer prescribed, may be reconsidered as treatment options in Asia.<\/jats:p>","DOI":"10.4269\/ajtmh.15-0714","type":"journal-article","created":{"date-parts":[[2016,5,10]],"date-time":"2016-05-10T03:05:26Z","timestamp":1462849526000},"page":"19-25","source":"Crossref","is-referenced-by-count":9,"title":["Case Series of Imported Enteric Fever at a Referral Center in Tokyo, Japan: Antibiotic Susceptibility and Risk Factors for Relapse"],"prefix":"10.4269","volume":"95","author":[{"given":"Takashi","family":"Matono","sequence":"first","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasuyuki","family":"Kato","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Masatomo","family":"Morita","sequence":"additional","affiliation":[{"name":"Department of Bacteriology I, National Institute of Infectious Diseases, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hidemasa","family":"Izumiya","sequence":"additional","affiliation":[{"name":"Department of Bacteriology I, National Institute of Infectious Diseases, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kei","family":"Yamamoto","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Satoshi","family":"Kutsuna","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nozomi","family":"Takeshita","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kayoko","family":"Hayakawa","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kazuhisa","family":"Mezaki","sequence":"additional","affiliation":[{"name":"Microbiology Laboratory, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maho","family":"Kawamura","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Hyakunincho, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noriko","family":"Konishi","sequence":"additional","affiliation":[{"name":"Department of Microbiology, Tokyo Metropolitan Institute of Public Health, Hyakunincho, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yasutaka","family":"Mizuno","sequence":"additional","affiliation":[{"name":"Department of Infectious Diseases, Tokyo Medical University, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shuzo","family":"Kanagawa","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, National Center for Global Health and Medicine, Toyama, Shinjuku-ku, Tokyo, Japan."}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Norio","family":"Ohmagari","sequence":"additional","affiliation":[{"name":"Disease Control and Prevention Center, 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Rev","first-page":"CD004530","article-title":"Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever)","volume":"5","author":"Effa","year":"2011"},{"key":"ref5","series-title":"Am J Trop Med Hyg","first-page":"1121","article-title":"Imported enteric fever: case series from the hospital for tropical diseases, London, United Kingdom","volume":"82","author":"Patel","year":"2010"},{"key":"ref6","series-title":"Eur J Clin Microbiol Infect Dis","first-page":"1295","article-title":"Decreased ciprofloxacin susceptibility in Salmonella Typhi and Paratyphi infections in ill-returned travellers: the impact on clinical outcome and future treatment options","volume":"32","author":"Hassing","year":"2013"},{"key":"ref7","series-title":"Crit Care Med","first-page":"580","article-title":"Surviving sepsis campaign: international guidelines for management of severe sepsis and septic shock: 2012","volume":"41","author":"Dellinger","year":"2013"},{"key":"ref8","series-title":"Clin Microbiol Infect","first-page":"633","article-title":"The diagnostic significance of relative bradycardia in infectious disease","volume":"6","author":"Cunha","year":"2000"},{"key":"ref9","series-title":"Emerg Infect Dis","first-page":"705","article-title":"Salmonella subtypes with increased MICs for azithromycin in travelers returned to The Netherlands","volume":"20","author":"Hassing","year":"2014"},{"key":"ref10","series-title":"Euro Surveill","first-page":"20632","article-title":"Salmonella enterica serotype Paratyphi A carrying CTX-M-15 type extended-spectrum beta-lactamase isolated from a Japanese traveller returning from India, Japan, July 2013","volume":"18","author":"Mawatari","year":"2013"},{"key":"ref11","series-title":"Euro Surveill","first-page":"20594","article-title":"Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia, January to September 2013","volume":"18","author":"Tourdjman","year":"2013"},{"key":"ref12","series-title":"Epidemiol Infect","first-page":"602","article-title":"Increase in paratyphoid fever cases in Japanese travellers returning from Cambodia in 2013","volume":"144","author":"Saitoh","year":"2015"},{"key":"ref13","series-title":"JAMA","first-page":"2668","article-title":"Laboratory-based surveillance of Salmonella serotype Typhi infections in the United States: antimicrobial resistance on the rise","volume":"283","author":"Ackers","year":"2000"},{"key":"ref14","series-title":"Ann Intern Med","first-page":"67","article-title":"Health disparities among travelers visiting friends and relatives abroad","volume":"142","author":"Angell","year":"2005"},{"key":"ref15","series-title":"New Microbiol","first-page":"25","article-title":"Predictive value of clinical and laboratory findings in the diagnosis of the enteric fever","volume":"32","author":"Kuvandik","year":"2009"},{"key":"ref16","series-title":"Clin Infect Dis","first-page":"1100","article-title":"Multidrug-resistant typhoid fever with neurologic findings on the Malawi-Mozambique border","volume":"54","author":"Lutterloh","year":"2012"},{"key":"ref17","series-title":"BMC Infect Dis","first-page":"73","article-title":"Risk factors for the development of severe typhoid fever in Vietnam","volume":"14","author":"Parry","year":"2014"},{"key":"ref18","series-title":"Arch Intern Med","first-page":"533","article-title":"Typhoid fever. An epidemic with remarkably few clinical signs and symptoms","volume":"144","author":"Klotz","year":"1984"},{"key":"ref19","series-title":"Lancet Infect Dis","first-page":"623","article-title":"Typhoid and paratyphoid fever in travellers","volume":"5","author":"Connor","year":"2005"},{"key":"ref20","series-title":"JAMA","first-page":"2607","article-title":"Risk factors for typhoid and paratyphoid fever in Jakarta, Indonesia","volume":"291","author":"Vollaard","year":"2004"},{"key":"ref21","series-title":"Clin Infect Dis","first-page":"1467","article-title":"Enteric (typhoid) fever in travelers","volume":"41","author":"Basnyat","year":"2005"},{"key":"ref22","series-title":"Lancet","first-page":"1136","article-title":"Typhoid fever","volume":"385","author":"Wain","year":"2015"},{"key":"ref23","series-title":"Clin Infect Dis","first-page":"1134","article-title":"Azithromycin versus ceftriaxone for the treatment of uncomplicated typhoid fever in children","volume":"31","author":"Frenck","year":"2000"},{"key":"ref24","series-title":"BMJ","first-page":"b1865","article-title":"A comparison of fluoroquinolones versus other antibiotics for treating enteric fever: meta-analysis","volume":"338","author":"Thaver","year":"2009"},{"key":"ref25","series-title":"Clin Microbiol Infect","first-page":"959","article-title":"Treatment of typhoid fever in the 21st century: promises and shortcomings","volume":"17","author":"Butler","year":"2011"},{"key":"ref26","series-title":"Antimicrob Agents Chemother","first-page":"1855","article-title":"A randomized controlled comparison of azithromycin and ofloxacin for treatment of multidrug-resistant or nalidixic acid-resistant enteric fever","volume":"44","author":"Chinh","year":"2000"},{"key":"ref27","series-title":"Int J Antimicrob Agents","first-page":"350","article-title":"Treatment of typhoid fever in children with a flexible-duration of ceftriaxone, compared with 14-day treatment with chloramphenicol","volume":"21","author":"Tatli","year":"2003"}],"container-title":["The American Society of Tropical Medicine and Hygiene"],"original-title":[],"link":[{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/95\/1\/article-p19.xml","content-type":"text\/html","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/95\/1\/article-p19.xml","content-type":"text\/html","content-version":"vor","intended-application":"syndication"},{"URL":"https:\/\/www.ajtmh.org\/downloadpdf\/journals\/tpmd\/95\/1\/article-p19.xml","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2024,8,7]],"date-time":"2024-08-07T22:03:13Z","timestamp":1723068193000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.ajtmh.org\/view\/journals\/tpmd\/95\/1\/article-p19.xml"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,7,6]]},"references-count":27,"journal-issue":{"issue":"1"},"URL":"https:\/\/doi.org\/10.4269\/ajtmh.15-0714","relation":{},"ISSN":["0002-9637","1476-1645"],"issn-type":[{"value":"0002-9637","type":"print"},{"value":"1476-1645","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,7,6]]}}}