For typhoid, paratyphoid, and shigellosis, definitive diagnosis is undertaken based on bacterial isolation. Given there is no routine antimicrobial resistance monitoring regarding Salmonella Typhi, Salmonella Paratyphi A, and Shigella spp, susceptibility tests are performed at the National Institute of Infectious Diseases, using strains submitted based on the Notification for Epidemiological Surveillance. Antimicrobial resistance information concerning Shigella spp. is also used as data reported to GLASS.
Antimicrobial susceptibility tests are performed using strains that are submitted based on the Notification for Epidemiological Surveillance (HSB/TIDCD Notification No. 100901, PFSB/ISD Notification No. 100902). In antimicrobial susceptibility tests, assessment was performed in accordance with CLSI standards, using a broth microdilution method for Salmonella Typhi and Salmonella Paratyphi A, and using a disk diffusion method for Shigella spp.
Treatment with antimicrobials is essential for typhoid and paratyphoid. To enable the proper selection of effective therapeutic agents, it is necessary to conduct continuous monitoring. The proportion of strains that are resistant to quinolones and other commonly used antibacterials are high in Shigella spp, and therefore recurrence is also possible even after administering antimicrobials. Careful monitoring is required to prevent possible spread of infection in Japan.