Abstract
In developed countries as well as in Russia enteric fever occurs rarely, whereas several areas in the world are still endemic. At present, prevalence of resistance to most of conventional antimicrobials in Salmonella enterica serotype Typhi is increasing worldwide, including the resistance to quinolones, with a number of documented cases of clinical failure of newer antimicrobial agents. The article reviews the information on etiology, epidemiology, and pathogenesis of enteric fever. Temporal changes in antimicrobial resistance of S. Typhi and associated problems are given in detail. Clinical features of enteric fever and its complications, as well as approaches to laboratory diagnosis are described. The focus on the choice of antimicrobial agents for the treatment of enteric fever, taking into consideration changes in resistance patterns of the pathogen and up-to-date data on efficacy and safety of antibiotics, especially in children and pregnant women, is made. Treatment of severe typhoid and its complications is also presented. Data on currently available typhoid vaccines and future of specific prophylaxis are considered.
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