한국에서 광역내성 Salmonella Typhi 첫 증례
The First Case of Extensively Drug-resistant Salmonella Typhi in South Korea
2경북대학교 의과대학 임상병리학교실
3경북대학교 의과대학 미생물학교실
1Department of Laboratory Medicine, Kyungpook National University Chilgok Hospital, Daegu, Korea
2Department of Clinical Pathology, School of Medicine, Kyungpook National University, Daegu, Korea
3Department of Microbiology, School of Medicine, Kyungpook National University, Daegu, Korea
This is an Open Access article distributed under the terms of the Creative Commons Attribution Non-Commercial License (http://creativecommons.org/licenses/by-nc/4.0/) which permits unrestricted non-commercial use, distribution, and reproduction in any medium, provided the original work is properly cited.
Lab Med Online 2020; 10(4): 340-342
Published October 1, 2020
Copyright © The Korean Society for Laboratory Medicine.
Typhoid fever, caused by
A 28-year-old male patient having fever and cough for a day visited the emergency department on the next day. He was found negative for the influenza antigen test and was discharged with a three-day prescription of cefdinir. After three days, he visited the emergency department again with the same symptoms and worsening diarrhea. Therefore, the treatment was switched to amoxicillin and a β-lactamase inhibitor. However, due to uncontrolled fever and significantly worsened diarrhea, he was hospitalized. Chest X-ray and abdomen CT scan were unremarkable except an evidence of probable mesenteric lymphadenitis. Therefore, he was treated with ceftriaxone for five days; however, his symptoms did not improve. Although his history was unremarkable, the symptoms began in 26 days after his arrival in Korea from a visit to Pakistan. AST, ALT, and ALP were moderately increased, but all the viral hepatitis markers were negative. Stool culture for
The emergence of S. Typhi strains resistant to antimicrobial agents leads to treatment failure and treatment change in antimicrobial policy. Ciprofloxacin was the drug of choice for typhoid fever in 1997 as
In conclusion, we should pay attention to the emergence of XDR strains of
The authors thank medical doctors, Sang Su Lee, Woo Kyung Sung, and Kyung Min Lee and medical laboratory technologist Eun Jeong Lee at Sangju Red Cross Hospital for cooperating with this study.
The pathogenic strain for this study was provided by the Kyungpook National University Hospital Culture Collection for Pathogens, a member of the National Biobank of Korea, which is supported by the Ministry of Health and Welfare.
- Buchan BW, Faron ML, Humphries RM, Dekker J, Ledeboer NA.
Escherichia, Shigella, and Salmonella. 12th ed. Washington DC: ASM Press, 2019:688-723.
- Freedman J, Lighton L, Jones J. Defining travel-associated cases of enteric fever. J Infect Public Health 2014;7:377-85.
- Wong MH, Yan M, Chan EW, Biao K, Chen S. Emergence of clinical
Salmonella entericaserovar Typhimurium isolates with concurrent resistance to ciprofloxacin, ceftriaxone, and azithromycin. Antimicrob Agents Chemother 2014;58:3752-6.
- Britto CD, Wong VK, Dougan G, Pollard AJ. A systematic review of antimicrobial resistance in
Salmonella entericaserovar Typhi, the etiological agent of typhoid. PLoS Negl Trop Dis 2018;12:e0006779.
- Clinical and Laboratory Standards Institute. Performance standards for antimicrobial susceptibility testing. 29th ed. CLSI supplement M100. Wayne, PA: Clinical and Laboratory Standards Institute, 2019.
- Chatham-Stephens K, Medalla F, Hughes M, Appiah GD, Aubert RD, Caidi H, et al. Emergence of extensively drug-resistant
SalmonellaTyphi infections among travelers to or from Pakistan - United States, 2016-2018. MMWR Morb Mortal Wkly Rep 2019;68:11-3.
- Rowe B, Ward LR, Threlfall EJ. Multidrug-resistant
Salmonella typhi: a worldwide epidemic. Clin Infect Dis 1997;24:S106-9.
- Klemm EJ, Shakoor S, Page AJ, Qamar FN, Judge K, Saeed DK, et al. Emergence of an extensively drug-resistant
Salmonella entericaserovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third-generation cephalosporins. mBio 2018;9:e00105-18.
- Wong W, Rawahi HA, Patel S, Yau Y, Eshaghi A, Zittermann S, et al. The first Canadian pediatric case of extensively drug-resistant
Salmonella Typhioriginating from an outbreak in Pakistan and its implication for empiric antimicrobial choices. IDCases 2019;15:e00492.
- Yousafzai MT, Qamar FN, Shakoor S, Saleem K, Lohana H, Karim S, et al. Ceftriaxone-resistant
Salmonella TyphiOutbreak in Hyderabad City of Sindh, Pakistan: High Time for the Introduction of Typhoid Conjugate Vaccine. Clin Infect Dis 2019;68:S16-21.