EMERGING CHALLENGES IN TREATING SCRUB TYPHUS: THE ROLE OF ANTIBIOTIC RESISTANCE AND INNOVATIVE APPROACHES
Main Article Content
Keywords
Scrub typhus, Orientia tsutsugamushi, Antibiotic Resistance, Doxycycline, Vector Control
Abstract
Scrub typhus, caused by the intracellular bacterium Orientia tsutsugamushi, is a significant vector-borne disease transmitted by infected chiggers. It remains endemic in various regions, including parts of Asia and the Pacific Islands. While doxycycline and azithromycin are effective treatments, the emergence of antibiotic-resistant strains of O. tsutsugamushi presents a growing threat to treatment efficacy and patient outcomes. This review explores the mechanisms behind antibiotic resistance, the impact on treatment success, and the challenges faced in managing resistant strains. Furthermore, we discuss strategies such as surveillance and monitoring, the development of new antibiotics, alternative therapeutic approaches, and improved vector control measures to combat this public health threat. Addressing these challenges requires global cooperation, research, and enhanced healthcare systems to ensure effective treatment of scrub typhus in the face of evolving antibiotic resistance.
References
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15. van Schaik EJ, Fratzke AP, Gregory AE, Dumaine JE, Samuel JE. Vaccine development: obligate intracellular bacteria new tools, old pathogens: the current state of vaccines against obligate intracellular bacteria. Frontiers in Cellular and Infection Microbiology. 2024 Mar 19;14:1282183.
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21. Prieto Sánchez P. Does doxycycline post exposure prophylaxis prevent sexually transmitted Infections in women and achieve minimum Inhibitory concentrations in vaginal Mucosa?: a population-based prospective cohort.
22. Chavarría-Bencomo IV, Nevárez-Moorillón GV, Espino-Solís GP, Adame-Gallegos JR. Antibiotic resistance in tick-borne bacteria: a One Health approach perspective. Journal of Infection and Public Health. 2023 Dec 1;16:153-62.
23. Kumar K, Patnaik R, Kumari H, Sharma N. Acute Febrile Illness: A Systematic Review Of Infectious Aetiologies Among Patients. Journal of Pharmaceutical Negative Results. 2022 Dec 21:5079-93.
24. Chen Y, Jiang Y, Xue T, Cheng J. Strategies for the eradication of intracellular bacterial pathogens. Biomaterials Science. 2024.
25. Fisher DJ, Beare PA. Recent advances in genetic systems in obligate intracellular human-pathogenic bacteria. Frontiers in Cellular and Infection Microbiology. 2023 Jun 19;13:1202245.
26. Beaudoin C. Evolution of targets at the host-pathogen interface (Doctoral dissertation).
27. Atwal S, Wongsantichon J, Giengkam S, Saharat K, Pittayasathornthun YJ, Chuenklin S, Wang LC, Chung T, Huh H, Lee SH, Sobota RM. The obligate intracellular bacterium Orientia tsutsugamushi differentiates into a developmentally distinct extracellular state. Nature communications. 2022 Jun 23;13(1):3603.
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29. Tjampakasari CR, Kiranasari A, Abas GM. Rickettsia as an agent of neglected Rickettsia infection. Journal of Clinical Microbiology and Infectious Diseases. 2024 Jun 19;4(1):6-10.
30. Wang Q, Ma T, Ding F, Lim A, Takaya S, Saraswati K, Sartorius B, Day NP, Maude RJ. Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2024 Sep 1;146:107151.
31. Khan MA, Amin A, Farid A, Ullah A, Waris A, Shinwari K, Hussain Y, Alsharif KF, Alzahrani KJ, Khan H. Recent advances in genomics-based approaches for the development of intracellular bacterial pathogen vaccines. Pharmaceutics. 2022 Dec 31;15(1):152.
32. Yanase T, Otsuka Y, Doi K, Tabaru Y, Arserim SK, Sasaki H, Özbel Y, Töz S, Ueda T, Tsuji N, Amoh Y. Other Medically Important Vectors. InMedical Entomology in Asia 2024 Aug 9 (pp. 149-230). Singapore: Springer Nature Singapore.
33. Mojahed N, Mohammadkhani MA, Mohamadkhani A. Climate crises and developing vector-borne diseases: a narrative review. Iranian journal of public health. 2022 Dec;51(12):2664.
34. Wang T, Meng F, Che T, Chen J, Zhang H, Ji Y, Fan Z, Zhao G, Zhang W, Jiang B, Xu Q. Mapping the distributions of blood-sucking mites and mite-borne agents in China: a modeling study. Infectious Diseases of Poverty. 2022 Apr 9;11(1):41.
35. Diaz JH. Mite-Human Interactions: Nuisances, Vectors, Parasites, Allergens, and Commensals. Elsevier; 2023 Dec 1.
36. Appugol KA, Mangang IB, Loganathan M. Rising Concerns in Entomophagy. AGRICULTURE & FOOD E-NEWSLETTER. 2022 Apr:10.
37. Blache N, Chalvet-Monfray K, Déprés C, Morand S. A scoping review of the impacts of forest dynamics on acari-borne diseases: beyond forest fragmentation.
38. Endale H, Mathewos M, Abdeta D. Potential causes of spread of antimicrobial resistance and preventive measures in one health perspective-a review. Infection and Drug Resistance. 2023 Dec 31:7515-45.
39. Narendar R, Krishnan J. Unraveling the Impact of Rickettsial Infections. Vector Borne Diseases: Current Trends and Public Health Perspectives. 2024:9.
40. Riffaud CM, Rucks EA, Ouellette SP. Persistence of obligate intracellular pathogens: alternative strategies to overcome host-specific stresses. Frontiers in Cellular and Infection Microbiology. 2023 May 22;13:1185571.
41. Vashisht V, Vashisht A, Mondal AK, Farmaha J, Alptekin A, Singh H, Ahluwalia P, Srinivas A, Kolhe R. Genomics for emerging pathogen identification and monitoring: Prospects and obstacles. BioMedInformatics. 2023 Dec 7;3(4):1145-77.
42. Sharma D, Sharma A, Singh B, Kumar S, Verma SK. Neglected scrub typhus: an updated review with a focus on omics technologies. Asian Pacific Journal of Tropical Medicine. 2022 Dec 1;15(12):531-41.
43. Janssen RM, Oerlemans AJ, Van Der Hoeven JG, Ten Oever J, Schouten JA, Hulscher ME. Why we prescribe antibiotics for too long in the hospital setting: a systematic scoping review. Journal of Antimicrobial Chemotherapy. 2022 Aug 1;77(8):2105-19.
44. Singhal M, Agrawal M, Bhavna K, Sethiya NK, Bhargava S, Gondkar KS, Joshi K, Rana VS, Sahoo J, Arora MK. Chloramphenicol and tetracycline (broad spectrum antibiotics). InAntibiotics-Therapeutic Spectrum and Limitations 2023 Jan 1 (pp. 155-165). Academic Press.
45. Dahiphle AV, Achliya A, Chhajed N, Rode V, Bhise K. Study of Clinical and Demographic Profile of Scrub Typhus Patients Admitted to a Tertiary Care Hospital in Central India. International Journal of Integrated Health Sciences. 2024 Mar 30;12(1):24-30.
46. Choudhuri AH, Das B, editors. Interpreting Laboratory Tests in Intensive Care. CRC Press; 2024 Dec 30.
47. Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals. 2023 Nov 15;16(11):1615.
48. Jain HK, Das A, Dixit S, Kaur H, Pati S, Ranjit M, Dutta A, Bal M. Development and implementation of a strategy for early diagnosis and management of scrub typhus: an emerging public health threat. Frontiers in Public Health. 2024 Apr 10;12:1347183.
49. Ahmed S. Agriculture and Zoonotic Diseases in Farmers in India. Int. J. Agric. Env. Sustain. 2024;6(1):1.
50. Varghese GM, Dayanand D, Gunasekaran K, Kundu D, Wyawahare M, Sharma N, Chaudhry D, Mahajan SK, Saravu K, Aruldhas BW, Mathew BS. Intravenous doxycycline, azithromycin, or both for severe scrub typhus. New England Journal of Medicine. 2023 Mar 2;388(9):792-803.
51. Vanramliana, Pautu L, Lalmalsawma P, Rosangkima G, Sarma DK, Chinzah H, Malvi Y, Kodali NK, Amarthaluri C, Balasubramani K, Balabaskaran Nina P. Epidemiology of scrub typhus and other rickettsial infections (2018–22) in the hyper-endemic setting of Mizoram, North-East India. PLoS Neglected Tropical Diseases. 2023 Nov 1;17(11):e0011688.
52. Londoño AF, Farner JM, Dillon M, Grab DJ, Kim Y, Scorpio DG, Dumler JS. Benidipine impairs innate immunity converting sublethal to lethal infections in a murine model of spotted fever rickettsiosis. PLOS Neglected Tropical Diseases. 2024 Feb 26;18(2):e0011993.
53. Sathya Jeevitha B, Krishnan J. Scrub typhus-An Integrated Omics Approach. Vector Borne Diseases: Current Trends and Public Health Perspectives. 2024 Dec 17:61.
54. Durr HA, Leipzig ND. Advancements in bacteriophage therapies and delivery for bacterial infection. Materials Advances. 2023;4(5):1249-57.
55. Zhou S, Liu Z, Song J, Chen Y. Disarm the bacteria: what temperate phages can do. Current Issues in Molecular Biology. 2023 Feb 1;45(2):1149-67.
56. Singh B, Kumar D, Kumar G, Saroha P, Vikram K, Gupta SK, Singh H. Insecticidal Paint: An Alternate Integrated Vector Management Strategy for Mosquito Control. Process Safety and Environmental Protection. 2024 Mar 30.
57. Pandey RP, Konyak MB, Soni M, Saikia S, Chang T, Gogoi I, Khongstid I, Sharma M. Scrub typhus: epidemiology, clinical presentations, and diagnostic approaches.
58. Khairkar M, Vagha S, Deotale V. Review on Scrub Typhus: An Important Etiology of Acute Undifferentiated Fever Illness. Cureus. 2023 Oct;15(10).
59. Shaw JA. Vector-Borne/Zoonotic Diseases. InHistorical Diseases from a Modern Perspective: The American Experience 2024 Jun 30 (pp. 65-100). Cham: Springer Nature Switzerland.
60. Sumit, Gupta S, Kaushal A. Advanced Diagnostic Techniques for Scrub Typhus: From Conventional Methods to Nanotechnology Solutions. ChemistrySelect. 2024 Sep 11;9(34):e202402240.
61. Sulis G, Sayood S, Gandra S. How can we tackle the overuse of antibiotics in low-and middle-income countries?. Expert Review of Anti-infective Therapy. 2023 Nov 2;21(11):1189-201.
62. Srivastav AK, Das P, Srivastava AK. Future Trends, Innovations, and Global Collaboration. InBiotech and IoT: An Introduction Using Cloud-Driven Labs 2024 Sep 25 (pp. 309-398). Berkeley, CA: Apress.
63. Kumar R. Epidemiological Challenges in India. InHandbook of Epidemiology 2024 Apr 5 (pp. 1-27). New York, NY: Springer New York.
2. Chakraborty S, Sarma N. Scrub typhus: an emerging threat. Indian Journal of Dermatology. 2017 Sep 1;62(5):478-85.
3. Chang WH, Hung CH. Ocular inflammation in tsutsugamushi disease–a case report. European Journal of Ophthalmology. 2024 Jun 17:11206721241262840.
4. Kumar D, Jakhar SD. Emerging trends of scrub typhus disease in southern Rajasthan, India: A neglected public health problem. Journal of Vector Borne Diseases. 2022 Oct 1;59(4):303-11.
5. Paris DH, Day NP. SECTION VI Bacterial Infections. Manson's Tropical Infectious Diseases. 2023 Jul 14:326.
6. Srivastava P, Shukla A, Singh R, Kant R, Mishra N, Behera SP, Dwivedi GR, Yadav DK. Orientia tsutsugamushi: An Unusual Intracellular Bacteria—Adaptation Strategies, Available Antibiotics, and Alternatives for Treatment. Current Microbiology. 2024 Aug;81(8):236.
7. Roat G, Singh R, Kumar S, Tank L, Mosalpuri A, Dadhich A, Jain S. AN OBSERVATIONAL STUDY ON CLINICAL SPECTRUM, DIAGNOSIS, COMPLICATIONS AND THERAPEUTIC OUTCOME OF SCRUB TYPHUS: AN EMERGING RICKETTSIAL INFECTION. Int J Acad Med Pharm. 2023;5(3):1796-801.
8. Mehl J. The Role of Bacterial RNA as a Pathogen-Associated Molecular Pattern in Orientia tsutsugamushi Infection.
9. Ademulegun FG, Uyigue PO, Onemu SO, Ojo B, Oduwole OA. Emerging and Re-Emerging Bacterial Infections: An Overview. Sokoto Journal of Medical Laboratory Science. 2024;9(4):151-68.
10. Rao RS, Ghate SD, Shastry RP, Kurthkoti K, Suravajhala P, Patil P, Shetty P. Prevalence and heterogeneity of antibiotic resistance genes in Orientia tsutsugamushi and other rickettsial genomes. Microbial Pathogenesis. 2023 Jan 1;174:105953.
11. Rajaiah P. Scrub typhus, a mite-borne rickettsiosis: innovative approaches for intervention strategies. Discover Medicine. 2024 Sep 30;1(1):58.
12. Sivasubramanian BP, Abdul Khader AH, Ravikumar DB, Dominic Savio FV, Thirupathy U, Thiruvadi V, Prasad R, Thokala H, Qadeer H, Venkataperumal DP, Gupta A. Comprehensive review on cardiac manifestation of scrub typhus. Frontiers in Tropical Diseases. 2024 Sep 20;5:1375087.
13. Gitau MS, Asiago OH, Rogers OO, Reddy KS, PradeepKumar B, Sudheer A, Pasala PK, Swarna P. A Comprehensive Review on Scrub Typhus: Epidemiology, Transmission, Diagnosis and Management. UTTAR PRADESH JOURNAL OF ZOOLOGY. 2024 Apr 4;45(8):93-105.
14. Lu D, Wang T, Luo Z, Ye F, Qian J, Zhang J, Wang C. Evaluation of the therapeutic effect of antibiotics on scrub typhus: a systematic review and network meta-analysis. Frontiers in Public Health. 2022 Apr 27;10:883945.
15. van Schaik EJ, Fratzke AP, Gregory AE, Dumaine JE, Samuel JE. Vaccine development: obligate intracellular bacteria new tools, old pathogens: the current state of vaccines against obligate intracellular bacteria. Frontiers in Cellular and Infection Microbiology. 2024 Mar 19;14:1282183.
16. Kanan M, Ramadan M, Haif H, Abdullah B, Mubarak J, Ahmad W, Mari S, Hassan S, Eid R, Hasan M, Qahl M. RETRACTED: Empowering Low-and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward. Antibiotics. 2023 Oct 2;12(10):1504.
17. Chunduru K, A. R M, Poornima S, Hande H M, Devaki R, Varghese GM, Saravu K. Clinical, laboratory profile and molecular characterization of Orientia tsutsugamushi among fatal scrub typhus patients from Karnataka, India. Infectious Diseases. 2024 Mar 3;56(3):220-9.
18. Gupta N, Boodman C, Jouego CG, Van Den Broucke S. Doxycycline vs azithromycin in patients with scrub typhus: a systematic review of literature and meta-analysis. BMC Infectious Diseases. 2023 Dec 18;23(1):884.
19. Mehta KK, Jayalal JA, Lele J, Joshi P, Rekha S, Vora A, John B. A Stepwise Guide for Differential Diagnosis and Management of Acute Fever in Primary Care: An Indian Perspective. Evaluation. 2022 Apr;120(4).
20. Sharma A, Mahajan V, Guglani V, Singla N, Saini SS. Open-labeled Randomized Controlled Trial on Efficacy of Azithromycin Versus Doxycycline in Pediatric Scrub Typhus. The Pediatric Infectious Disease Journal. 2023 Dec 1;42(12):1067-72.
21. Prieto Sánchez P. Does doxycycline post exposure prophylaxis prevent sexually transmitted Infections in women and achieve minimum Inhibitory concentrations in vaginal Mucosa?: a population-based prospective cohort.
22. Chavarría-Bencomo IV, Nevárez-Moorillón GV, Espino-Solís GP, Adame-Gallegos JR. Antibiotic resistance in tick-borne bacteria: a One Health approach perspective. Journal of Infection and Public Health. 2023 Dec 1;16:153-62.
23. Kumar K, Patnaik R, Kumari H, Sharma N. Acute Febrile Illness: A Systematic Review Of Infectious Aetiologies Among Patients. Journal of Pharmaceutical Negative Results. 2022 Dec 21:5079-93.
24. Chen Y, Jiang Y, Xue T, Cheng J. Strategies for the eradication of intracellular bacterial pathogens. Biomaterials Science. 2024.
25. Fisher DJ, Beare PA. Recent advances in genetic systems in obligate intracellular human-pathogenic bacteria. Frontiers in Cellular and Infection Microbiology. 2023 Jun 19;13:1202245.
26. Beaudoin C. Evolution of targets at the host-pathogen interface (Doctoral dissertation).
27. Atwal S, Wongsantichon J, Giengkam S, Saharat K, Pittayasathornthun YJ, Chuenklin S, Wang LC, Chung T, Huh H, Lee SH, Sobota RM. The obligate intracellular bacterium Orientia tsutsugamushi differentiates into a developmentally distinct extracellular state. Nature communications. 2022 Jun 23;13(1):3603.
28. Badro DA. Chronic Kidney Disease Management in Developing Countries. InHandbook of Medical and Health Sciences in Developing Countries: Education, Practice, and Research 2023 Apr 20 (pp. 1-146). Cham: Springer International Publishing.
29. Tjampakasari CR, Kiranasari A, Abas GM. Rickettsia as an agent of neglected Rickettsia infection. Journal of Clinical Microbiology and Infectious Diseases. 2024 Jun 19;4(1):6-10.
30. Wang Q, Ma T, Ding F, Lim A, Takaya S, Saraswati K, Sartorius B, Day NP, Maude RJ. Global and regional seroprevalence, incidence, mortality of, and risk factors for scrub typhus: A systematic review and meta-analysis. International Journal of Infectious Diseases. 2024 Sep 1;146:107151.
31. Khan MA, Amin A, Farid A, Ullah A, Waris A, Shinwari K, Hussain Y, Alsharif KF, Alzahrani KJ, Khan H. Recent advances in genomics-based approaches for the development of intracellular bacterial pathogen vaccines. Pharmaceutics. 2022 Dec 31;15(1):152.
32. Yanase T, Otsuka Y, Doi K, Tabaru Y, Arserim SK, Sasaki H, Özbel Y, Töz S, Ueda T, Tsuji N, Amoh Y. Other Medically Important Vectors. InMedical Entomology in Asia 2024 Aug 9 (pp. 149-230). Singapore: Springer Nature Singapore.
33. Mojahed N, Mohammadkhani MA, Mohamadkhani A. Climate crises and developing vector-borne diseases: a narrative review. Iranian journal of public health. 2022 Dec;51(12):2664.
34. Wang T, Meng F, Che T, Chen J, Zhang H, Ji Y, Fan Z, Zhao G, Zhang W, Jiang B, Xu Q. Mapping the distributions of blood-sucking mites and mite-borne agents in China: a modeling study. Infectious Diseases of Poverty. 2022 Apr 9;11(1):41.
35. Diaz JH. Mite-Human Interactions: Nuisances, Vectors, Parasites, Allergens, and Commensals. Elsevier; 2023 Dec 1.
36. Appugol KA, Mangang IB, Loganathan M. Rising Concerns in Entomophagy. AGRICULTURE & FOOD E-NEWSLETTER. 2022 Apr:10.
37. Blache N, Chalvet-Monfray K, Déprés C, Morand S. A scoping review of the impacts of forest dynamics on acari-borne diseases: beyond forest fragmentation.
38. Endale H, Mathewos M, Abdeta D. Potential causes of spread of antimicrobial resistance and preventive measures in one health perspective-a review. Infection and Drug Resistance. 2023 Dec 31:7515-45.
39. Narendar R, Krishnan J. Unraveling the Impact of Rickettsial Infections. Vector Borne Diseases: Current Trends and Public Health Perspectives. 2024:9.
40. Riffaud CM, Rucks EA, Ouellette SP. Persistence of obligate intracellular pathogens: alternative strategies to overcome host-specific stresses. Frontiers in Cellular and Infection Microbiology. 2023 May 22;13:1185571.
41. Vashisht V, Vashisht A, Mondal AK, Farmaha J, Alptekin A, Singh H, Ahluwalia P, Srinivas A, Kolhe R. Genomics for emerging pathogen identification and monitoring: Prospects and obstacles. BioMedInformatics. 2023 Dec 7;3(4):1145-77.
42. Sharma D, Sharma A, Singh B, Kumar S, Verma SK. Neglected scrub typhus: an updated review with a focus on omics technologies. Asian Pacific Journal of Tropical Medicine. 2022 Dec 1;15(12):531-41.
43. Janssen RM, Oerlemans AJ, Van Der Hoeven JG, Ten Oever J, Schouten JA, Hulscher ME. Why we prescribe antibiotics for too long in the hospital setting: a systematic scoping review. Journal of Antimicrobial Chemotherapy. 2022 Aug 1;77(8):2105-19.
44. Singhal M, Agrawal M, Bhavna K, Sethiya NK, Bhargava S, Gondkar KS, Joshi K, Rana VS, Sahoo J, Arora MK. Chloramphenicol and tetracycline (broad spectrum antibiotics). InAntibiotics-Therapeutic Spectrum and Limitations 2023 Jan 1 (pp. 155-165). Academic Press.
45. Dahiphle AV, Achliya A, Chhajed N, Rode V, Bhise K. Study of Clinical and Demographic Profile of Scrub Typhus Patients Admitted to a Tertiary Care Hospital in Central India. International Journal of Integrated Health Sciences. 2024 Mar 30;12(1):24-30.
46. Choudhuri AH, Das B, editors. Interpreting Laboratory Tests in Intensive Care. CRC Press; 2024 Dec 30.
47. Muteeb G, Rehman MT, Shahwan M, Aatif M. Origin of antibiotics and antibiotic resistance, and their impacts on drug development: A narrative review. Pharmaceuticals. 2023 Nov 15;16(11):1615.
48. Jain HK, Das A, Dixit S, Kaur H, Pati S, Ranjit M, Dutta A, Bal M. Development and implementation of a strategy for early diagnosis and management of scrub typhus: an emerging public health threat. Frontiers in Public Health. 2024 Apr 10;12:1347183.
49. Ahmed S. Agriculture and Zoonotic Diseases in Farmers in India. Int. J. Agric. Env. Sustain. 2024;6(1):1.
50. Varghese GM, Dayanand D, Gunasekaran K, Kundu D, Wyawahare M, Sharma N, Chaudhry D, Mahajan SK, Saravu K, Aruldhas BW, Mathew BS. Intravenous doxycycline, azithromycin, or both for severe scrub typhus. New England Journal of Medicine. 2023 Mar 2;388(9):792-803.
51. Vanramliana, Pautu L, Lalmalsawma P, Rosangkima G, Sarma DK, Chinzah H, Malvi Y, Kodali NK, Amarthaluri C, Balasubramani K, Balabaskaran Nina P. Epidemiology of scrub typhus and other rickettsial infections (2018–22) in the hyper-endemic setting of Mizoram, North-East India. PLoS Neglected Tropical Diseases. 2023 Nov 1;17(11):e0011688.
52. Londoño AF, Farner JM, Dillon M, Grab DJ, Kim Y, Scorpio DG, Dumler JS. Benidipine impairs innate immunity converting sublethal to lethal infections in a murine model of spotted fever rickettsiosis. PLOS Neglected Tropical Diseases. 2024 Feb 26;18(2):e0011993.
53. Sathya Jeevitha B, Krishnan J. Scrub typhus-An Integrated Omics Approach. Vector Borne Diseases: Current Trends and Public Health Perspectives. 2024 Dec 17:61.
54. Durr HA, Leipzig ND. Advancements in bacteriophage therapies and delivery for bacterial infection. Materials Advances. 2023;4(5):1249-57.
55. Zhou S, Liu Z, Song J, Chen Y. Disarm the bacteria: what temperate phages can do. Current Issues in Molecular Biology. 2023 Feb 1;45(2):1149-67.
56. Singh B, Kumar D, Kumar G, Saroha P, Vikram K, Gupta SK, Singh H. Insecticidal Paint: An Alternate Integrated Vector Management Strategy for Mosquito Control. Process Safety and Environmental Protection. 2024 Mar 30.
57. Pandey RP, Konyak MB, Soni M, Saikia S, Chang T, Gogoi I, Khongstid I, Sharma M. Scrub typhus: epidemiology, clinical presentations, and diagnostic approaches.
58. Khairkar M, Vagha S, Deotale V. Review on Scrub Typhus: An Important Etiology of Acute Undifferentiated Fever Illness. Cureus. 2023 Oct;15(10).
59. Shaw JA. Vector-Borne/Zoonotic Diseases. InHistorical Diseases from a Modern Perspective: The American Experience 2024 Jun 30 (pp. 65-100). Cham: Springer Nature Switzerland.
60. Sumit, Gupta S, Kaushal A. Advanced Diagnostic Techniques for Scrub Typhus: From Conventional Methods to Nanotechnology Solutions. ChemistrySelect. 2024 Sep 11;9(34):e202402240.
61. Sulis G, Sayood S, Gandra S. How can we tackle the overuse of antibiotics in low-and middle-income countries?. Expert Review of Anti-infective Therapy. 2023 Nov 2;21(11):1189-201.
62. Srivastav AK, Das P, Srivastava AK. Future Trends, Innovations, and Global Collaboration. InBiotech and IoT: An Introduction Using Cloud-Driven Labs 2024 Sep 25 (pp. 309-398). Berkeley, CA: Apress.
63. Kumar R. Epidemiological Challenges in India. InHandbook of Epidemiology 2024 Apr 5 (pp. 1-27). New York, NY: Springer New York.
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J. Suriakumar, R. Akila, R. Gopinathan, & T. Murugalakshmi. (2025). EMERGING CHALLENGES IN TREATING SCRUB TYPHUS: THE ROLE OF ANTIBIOTIC RESISTANCE AND INNOVATIVE APPROACHES. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1154-1164. https://doi.org/10.53555/njm1kg13
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Author Biographies
J. Suriakumar
Department of Microbiology, Government Medical College, Dindigul, Tamil Nadu, India
R. Akila
Département of Pathology, Thanjavur Medical College, Thanjavur, Tamil Nadu, India.
R. Gopinathan
Department of Microbiology, Government Medical College, Dindigul, Tamil Nadu, India
T. Murugalakshmi
Department of Pharmacology, Government Medical College, Dindigul, Tamil Nadu, India
How to Cite
J. Suriakumar, R. Akila, R. Gopinathan, & T. Murugalakshmi. (2025). EMERGING CHALLENGES IN TREATING SCRUB TYPHUS: THE ROLE OF ANTIBIOTIC RESISTANCE AND INNOVATIVE APPROACHES. Journal of Population Therapeutics and Clinical Pharmacology, 32(1), 1154-1164. https://doi.org/10.53555/njm1kg13