Résumé :
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[BDSP. Notice produite par INIST bwR0xNg6. Diffusion soumise à autorisation]. Context Multidrug-resistant Salmonella serotype Typhi infections have been reported worldwide, but data on the incidence of resistant strains in the United States are lacking. Objectives To determine the incidence of antimicrobial-resistant Salmonella Typhi infections and to identify risk factors for infection. Design Cross-sectional laboratory-based surveillance study. Setting and Participants A total of 293 persons with symptomatic typhoid fever who had Salmonella Typhi isolates and epidemiological information submitted to US public health departments and laboratories from June 1,1996, to May 31,1997. Main Outcome Measures Proportion of Salmonella Typhi isolates demonstrating resistance to 12 antimicrobial agents ; patient epidemiological factors associated with drug-resistant infections. Results Median age was 21 years (range, 3 months to 84 years) ; 56% were male. Two hundred twenty-eight (80%) were hospitalized ; 2 died. In the 6 weeks before illness onset, 81% of patients had traveled abroad. Seventy-four Salmonella Typhi isolates (25%) were resistant to 1 or more antimicrobial agent, and 51 (17%) were resistant to 5 or more agents, including ampicillin, chloramphenicol, and trimethoprimsulfamethoxazole (multidrug-resistant Salmonella Typhi [MDRST]). Although no resistance to ciprofloxacin or ceftriaxone was observed, 20 isolates (7%) were nalidixic acid-resistant (NARST). (...)
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