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Research Article | DOI: https://doi.org/10.31579/2639-4162/277
1Lead Scientist, Dr Lal Path Labs, Department of Microbiology and Serology.
2Technical Director, Dr Lal Path Labs, Department of Microbiology and Serology.
3Senior Consultant, Dr Lal Path Labs, Department of Microbiology and Serology.
4Executive Director, Dr Lal Path Labs, National Reference Laboratory, Delhi, India.
*Corresponding Author: Puneeta Singh, Senior Scientist, Dr Lal Path Labs, Department of Microbiology and Serology,
Citation: Puneeta Singh, Shalabh Malik, Anirudh Gupta, Vandana Lal, (2025), Prevalence and Antimicrobial Susceptibility Patterns of Salmonella Serovars (Typhi, Paratyphi A & B, and Non-Typhoidal) Across Age and Gender Groups: A Retrospective Study, J. General Medicine and Clinical Practice, 8(7); DOI:10.31579/2639-4162/277
Copyright: © 2025, Puneeta Singh. This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
Received: 03 June 2025 | Accepted: 23 June 2025 | Published: 30 June 2025
Keywords: salmonella enterica serovar typhi (s. typhi); salmonella enterica serovar paratyphi a; b and c (s. paratyphi a; b and c); non- typhoidal salmonella species (NTS); invasive infection
Introduction: Salmonella is a bacterial pathogen responsible for both typhoidal (e.g., typhoid fever) and non-typhoidal infections. While non-typhoidal Salmonella typically causes self-limiting gastrointestinal illness, typhoidal Salmonella, particularly Salmonella typhi and Salmonella paratyphi, can enter the bloodstream, leading to invasive systemic disease. This is particularly dangerous in young children, where it contributes significantly to morbidity and mortality. In recent years, the misuse and overuse of antibiotics have led to the emergence of multi-drug-resistant (MDR) strains of Salmonella, making treatment more complex and less effective. In such cases, third-generation Cephalosporins, such as Ceftriaxone, are commonly used due to their broad-spectrum efficacy. This study focuses on the incidence, serotype distribution, seasonal trends, and antimicrobial resistance patterns of Salmonella, with an emphasis on Ceftriaxone resistance, based on data from Dr. Lal Path Labs, Delhi, over a four-year period (January 2021 to December 2024).
Results and Discussion: A retrospective study conducted at Dr. Lal Path Labs between 2021 and 2024 analyzed 245,600 positive bacterial cultures from various clinical samples, identifying 6,332 cases (2.6%) as Salmonella species. The majority (99.1%) were isolated from blood, highlighting the invasive nature of typhoidal infections. Salmonella typhi accounted for 90.1% of cases, followed by other Salmonella spp. (4.9%), S. paratyphi A (3.8%), and S. paratyphi B (1.1%). A small number of isolates were also detected in abscesses, stool, and urine samples. Most cases occurred in males (58.9%) and in children aged <=12 years (49.1%). MDR strains were primarily seen in children under five, with no such cases reported in older age groups.
Seasonal analysis revealed peaks in spring and summer, with a notable increase in 2024, suggesting environmental influences such as water quality and hand hygiene playing a role in transmission. Despite the growing issue of antimicrobial resistance, most isolates remained susceptible to key antibiotics: Ampicillin (93%), Cefixime (97.4%), Ceftriaxone (95.4%), Ertapenem (98.6%), Cotrimoxazole (97.5%), Azithromycin (98.8%), and Chloramphenicol (97.8%). However, resistance to fluoroquinolones was alarmingly high with 99.8% to Ciprofloxacin, emphasizing the need for antibiotic stewardship and susceptibility-guided therapy.
Conclusion: This study highlights the ongoing public health burden of typhoid fever, particularly among children and during warmer months. The presence of multidrug-resistant Salmonella strains in young children further stresses the need for targeted preventive strategies. Effective management requires continued surveillance, responsible antibiotic use, and enhanced diagnostic capabilities to limit the spread of resistant infections and improve clinical outcomes.
Salmonella is a gram-negative bacterium a foodborne pathogen from the Enterobacteriaceae family, affecting warm-blooded animals, with around 2,600 serovars classified as typhoidal or non-typhoidal [1, 6, 11, 13, 15]. The severity of Salmonella infections in humans depends on both the bacterial serotype and the host's immune status. Typhoidal infections, caused by Salmonella enterica serovar Typhi (S. Typhi) and Salmonella enterica serovar Paratyphi A, B and C (S. Paratyphi), while non-typhoidal fever is caused by Non Typhoidal Salmonella species (S. typhimurium and S. enteritidis) typically result in acute symptoms like diarrhea, abdominal cramps, and fever leading to self-limiting gastroenteritis, resolving within 1 to 7 days without treatment. However, approximately 5% of cases, particularly in immunocompromised individuals, infants, and the elderly, may develop severe invasive infections, including bacteremia, meningitis, and osteomyelitis [1, 13, 14, 20, 21]. Typhoidal Salmonella can cause disseminated infections, presenting with prolonged fever, headache, gastrointestinal symptoms, loss of appetite, and relative bradycardia. While typhoid fever is prevalent in developing countries, non-typhoidal infections occur worldwide. Infants and young children are especially susceptible, usually through contaminated food or water [1, 4, 6, 8, 13].
It has a significant impact on global health and the economy. According to the World Health Organization (WHO), Salmonella is one of the four leading causes of diarrhea worldwide. Among 14 major foodborne pathogens, Salmonella ranks as the third largest contributor to economic burden, with an estimated annual cost of $3.3 billion [13]. Typhoid fever is a serious systemic infection that poses a significant global health threat. According to the World Health Organization (WHO, 2018), it affects an estimated 11 to 20 million people annually and causes between 128,000 and 161,000 deaths worldwide, with the highest burden observed among children in South-East Asia, and in the WHO African, Eastern Mediterranean, and Western Pacific Regions [18]. While Salmonella infections generally result in moderate morbidity and relatively low fatality rates, they still represent a notable public health. Infections tend to be more severe in vulnerable populations, including young children, the elderly, and immunocompromised individuals. Complications such as cholecystitis, pancreatitis, and appendicitis can progress to life-threatening conditions, including meningitis and sepsis. Prolonged fluid loss may lead to dehydration, particularly in newborns and older adults [13,25]
Despite the WHO's recommendation for typhoid vaccination since 2008, vaccine coverage remains low, particularly among young children. In 2018, the WHO reinforced the use of Vi polysaccharide-based typhoid conjugate vaccines, with a focus on countries experiencing the highest disease burden [2, 10, 11, 22, 26]. Current typhoid vaccines offer only moderate, short-term protection. High genetic diversity among Salmonella serotypes further complicates control efforts [13].
At the same time, growing resistance to Ampicillin, now commonly used due to fluoroquinolone resistance, and resistance to third-generation Cephalosporins, are becoming significant concerns [1, 9, 24, 26]. In India, which accounts for over half of the global typhoid burden, the implementation of public vaccination programs has been limited, partly due to a lack of comprehensive data on the current disease burden.
A retrospective study was conducted in the Department of Microbiology at Dr. Lal Path Labs, Delhi, India, and a tertiary healthcare laboratory offering a full range of testing services. The study was carried out from January 2021 to December 2024. A total of 245,600 clinical isolates, collected from urine, pus, blood, sputum, vaginal swabs, and body fluids, were analyzed for routine culture in the microbiology department. Of these samples, 6,332 (2.6%) isolates were identified as Salmonella species.
Approximately Whole blood samples (1–5 mL for pediatric patients and 8–10 mL for adults) were collected and inoculated into (BD BACTECTM, BD) culture bottles—pediatric bottles (BD BACTECTM, BD) and adult bottles, respectively. The inoculated bottles were incubated in an automated blood culture system (BD BACTECTM) for up to five days. Upon a positive growth signal from the system, specimens were sub-cultured onto Blood agar, Mc Conkey, Choclate agar plates and incubated at 37 °C for 24 hours. Cultures showing no visible growth after 24 hours were further incubated for an additional 24 hours (total 48 hours) to ensure detection of slow-growing organisms. Pus, Body fluids, and miscellaneous samples were directly cultured onto blood agar, McConkey, Choclate and CHROM agar and incubated at 37 °C for 18–48 hours. Fresh stool samples were inoculated onto Selenite F broth and incubated for 4-6 hrs there after inoculated on XLD (Xylose Lysine Deoxycholate) agar plates and incubated at 37 °C for 18–48 hours. Urine samples inoculated on CHROM agar and incubated at 37 °C for 18–48 hours. Suspected colonies from all media were selected for further identification and antimicrobial susceptibility testing.
Bacterial identification was made using MALDI-TOF and Serotyping. Antimicrobial susceptibility was evaluated on VITEK® 2 with respective susceptibility cards (AST N235, BioMerieux, India) as per as CLSI M100-S33 [7]. The following antibiotics were used for the isolates, Ampicillin (AMP), Ciprofloxacin (CIP), Trimethoprim/Sulphomethoxazole(TM/SXT), Cefixime (CFM), Ceftriaxone (CTR), Azithromycin (AZM), Chloramphenicol(C) and Ertapenem (ETP). Standard strains of E. coli (ATCC 25922) were used routinely in this study as control. No data collected on the clinical background of the patients.
The analysis done using the statistical software package Myla (Biomerieux) to compare age, antibiotic susceptibility pattern with MIC were included as variables in this study between various clinical isolates among Salmonella species.
A laboratory-based retrospective study was conducted from January 1, 2021, to December 31, 2024, at Dr. Lal Path Labs, Delhi. This study analyzes the distribution and antimicrobial susceptibility of Salmonella species isolated from a large number of clinical samples collected over a 60-month period as part of routine analyses from unselected community patients (male and female of all ages and clinical conditions) residing in northern India.
Over the five-year period, the Microbiology department identified 2,45,600 positive bacterial growths from various clinical samples, of which 6,332 (2.6%) were Salmonella species. Of these, 6,277 (99.1%) were isolated from blood, followed by 20 from pus, 17 from stool, 9 from urine, and 9 from other body fluids (see Table 1).
| Total (N=6332) | Blood (n= 6277) | Pus (n= 20) | Fluid (n= 9) | stool (n= 17) | Urine (n= 9) | |
Salmonella Typhi, N=5706 (90.1%) | 5674 | 12 | 6 | 9 | 5 | |
| Salmonella Paratyphi A, N=242 (3.8%) | 241 | 0 | 0 | 1 | 0 | |
| Salmonella Paratyphi B, N=69 (1.08%) | 69 | 0 | 0 | 0 | 0 | |
| Non Typhoidal Salmonella species, N=315 (4.9%) | 293 | 8 | 3 | 7 | 4 |
Table 1: Distribution of Salmonella species isolated from diverse samples at Dr Lal Path Labs during 4 years.
Among these isolates, S. typhi was the most common species, accounting for 5,706 (90.1%) of the cases, followed by Salmonella species (315, 4.9%), S. paratyphi A (242, 3.8%), and S. paratyphi B (69, 1.1%) [Table 1]. This data highlights that Salmonella Typhi and Salmonella Paratyphi A are predominantly found in blood cultures, signifying their dominant role in bloodstream infections. Salmonella Paratyphi B also shows a similar pattern, with the highest occurrence in blood samples. Other Salmonella species were most commonly found in blood cultures (93.8%), but were also detected in abscesses (2.5%), stool (2.2%) and urine (1.2%).These findings suggest that while these species are mainly associated with bloodstream infections, they may occasionally contribute to extra-intestinal infections, such as abscesses or urinary tract infections.
Age Groups (MDRO %) | Total No. of Salmonella Species N=6332 (%) | Male N=3734 (58.9%) | Female N= 2598 (41.1%) |
| 0-5 (5.6%) | 1262 (19.9%) | 798 | 464 |
| 6-12 (4.7%) | 1848 (29.2%) | 1085 | 763 |
| 13-35 (3.4%) | 2603 (41.1%) | 1574 | 1029 |
| 36-50 (**) | 413 (6.5%) | 189 | 224 |
| 51-65 (**) | 168 (2.7%) | 72 | 96 |
| >=66 (**) | 38 (0.6%) | 16 | 22 |
Table 2: Age and Gender wise prevalence of Salmonella species isolated from diverse sample during Jan 2021 - Dec 2024.
The total prevalence of Salmonella species in male patients was found to be 3,734 (58.9%), while in female patients, it was 2,598 (41.1%). These results indicate a higher prevalence of Salmonella infection in male patients compared to females. The most affected age group, regardless of gender, was 0-12 years (49.1%), and followed by 13-35 years (41.1%), 36-50 years (6.5%), and those aged 51 years and above (3.3%). The retrospective data from this study also highlights the distribution of multi-drug-resistant organisms (MDROs) across different age groups and genders. The prevalence of MDROs was higher in younger age groups, particularly in the 0-5 years range, and decreased with age. No MDRO prevalence was observed in older age groups [Table 2].
| Antibiotics | Range | Salmonella Typhi (n=5706) | Salmonella Paratyphi A (n=242) | Salmonella Parayphi B (n=69) | Non typhoidal Salmonella species (n =315) | ||||
MDRO n=240 (4.2%) | MDRO n=1 (0.4%) | MDRO 0% | MDRO n =43 (13.6%) | ||||||
| %S | MIC 50/90 | %S | MIC 50/90 | %S | MIC 50/90 | %S | MIC 50/90 | ||
| Ampicillin | ≤ 8 -≥32 | 93.8 | <=2/8 | 93.4 | <=2/8 | 92.7 | <=2/8 | 91.7 | <=2/8 |
| Cefixime | ≤ 1 -≥ 4 | 97.3 | <=0.25/0.5 | 98.6 | <=0.25/0.5 | 98.6 | <=0.25/0.5 | 94.9 | <=0.25/0.5 |
| Ceftriaxone | ≤ 1 -≥4 | 95.6 | 1/1. | 100 | 1/1. | 100 | 1/1. | 86.1 | <=2/8. |
| Ciprofloxacin | ≤ 0.06 -≥1 | 0 | 1/4. | 0.4 | 1/4. | 0 | 1/4. | 0.3 | 1/4. |
| Ertapenem | ≤ 0.5-≥2 | 98.7 | 0.5/0.5 | 100 | 0.5/0.5 | 100 | 0.5/0.5 | 95.4 | 0.5/0.5 |
| TM/SXT | ≤ 40 -≥80 | 96.6 | <=20/<=20 | 100 | <=20/<=20 | 100 | <=20/<=20 | 93.6 | <=20/<=20 |
| Azithromycin* | 98.7 | NA | 100 | NA | 100 | NA | 96.2 | NA | |
| Chloramphenicol* | 95.6 | NA | 100 | NA | 100 | NA | 95.4 | NA | |
* Antibiotic susceptibility testing by Disc diffusion, NA: Not applicable
Table 3: Cumulative interpretation with cumulative MIC (50/90) of antimicrobial susceptibility pattern among Salmonella species in diverse samples during 4 year period.
The [Table 3] presents data on the antibiotic susceptibility patterns of Salmonella species, specifically Salmonella Typhi (90.1%), Salmonella Paratyphi A (3.8%), Salmonella Paratyphi B (1.08%), and other Salmonella species (4.8%). It also highlights the prevalence of multi-drug-resistant organisms (MDROs) within each group. A total of 6,332 isolates were analyzed, and the prevalence of MDROs across different Salmonella species was assessed. Of the 5,706 cases of Salmonella Typhi, 4.2% were identified as multi-drug-resistant. Salmonella Typhi, which had the highest number of cases, demonstrated a mixed resistance pattern across various antibiotics.
Among 242 Salmonella Paratyphi A isolates, 0.4% were identified as multidrug-resistant organisms (MDRO), while none of the 69 Salmonella Paratyphi B isolates exhibited MDRO characteristics. Both serovars demonstrated very low resistance, particularly to first-line antibiotics such as Cefixime and Ampicillin. Additionally, 13.6% of the 315 cases of various Non typhoidal Salmonella species were found to be MDRO. This indicates that while Salmonella Typhi had the highest number of cases, the overall prevalence of MDROs was more pronounced in the broader category of Salmonella species. Other Salmonella species showed the highest resistance rates, particularly to Ceftriaxone (13.9%) and Ciprofloxacin (99.7%).
Resistance to Azithromycin and Chloramphenicol was notable in Salmonella Typhi and Non typhoidal Salmonella species, while other species showed full susceptibility. A significant concern was the high resistance to Ciprofloxacin with nearly all species exhibiting elevated resistance to these drugs.
Antibiotics | Salmonella spp. Isolates AST pattern | ||||||||
| Ranges | Total | S | %S | MIC50/90 | I | %I | R | %R | |
| Ampicillin | ≤ 8 -≥32 | 6332 | 5888 | 93 | <=2/8 | 88 | 1.4 | 356 | 5.6 |
| Cefixime | ≤ 1 -≥ 4 | 6332 | 6167 | 97.4 | <=0.25/0.5 | 38 | 0.6 | 127 | 2 |
| Ceftriaxone | ≤ 1 -≥ 4 | 6332 | 6040 | 95.4 | 1/1 | 18 | 0.3 | 274 | 4.3 |
| Ertapenem | ≤ 0.5-≥2 | 6332 | 6244 | 98.6 | 0.5/0.5 | 38 | 0.6 | 50 | 0.8 |
| Ciprofloxacin | ≤ 0.06 -≥1 | 6332 | 13 | 0.2 | 1/4 | 1476 | 23.3 | 4843 | 76.5 |
| Cotrimoxazole | ≤ 40 -≥80 | 6332 | 6173 | 97.5 | <=20/<=20 | 0 | 0 | 159 | 2.5 |
| Azithromycin | ** | 2335 | 2307 | 98.8 | ** | 0 | 0 | 28 | 1.2 |
| Chloramphenicol | ** | 2335 | 2283 | 97.8 | ** | 9 | 0.4 | 43 | 1.8 |
Table 3: Cumulative interpretation with cumulative MIC (50/90) of antimicrobial susceptibility pattern among Salmonella species in diverse samples during 4 year period.
The antibiotic resistance and susceptibility patterns of Salmonella species reveal varying degrees of effectiveness across different drugs. For Ampicillin, 93% of isolates are susceptible, while 7% exhibit resistance. Cefixime shows a high susceptibility rate of 97.4 %, with only 2% resistance. Similarly, Ceftriaxone demonstrates good effectiveness with 95.4% susceptibility and 4.3% resistance. Ertapenem shows a very high susceptibility rate of 98.6%, indicating minimal resistance. Cotrimoxazole shows high efficacy with 97.5% susceptibility and 2.5% resistance. Azithromycin is similarly effective, with 98.8% susceptible isolates and 1.2% resistance. Chloramphenicol remains effective (97.8% susceptible), though 1.8% resistance and 0.4% intermediate susceptible are noted. While
these antibiotics are generally effective for treating Salmonella, susceptibility testing is recommended, particularly for Azithromycin and Chloramphenicol, due to occasional resistance.
Ciprofloxacin exhibit high resistance rates in all Salmonella species, with 76.5% resistance for Ciprofloxacin. Only a small percentage of isolates are susceptible (0.2% for Ciprofloxacin), while intermediate is observed (23.3% for Ciprofloxacin).Due to the high resistance rates, Ciprofloxacin may not be effective for treating Salmonella infections in this population. Alternative therapies should be explored, and susceptibility testing should guide treatment decisions.
| No. of Salmonella isolates (N=6332) | ||||
| Year | 2021 (N=1178) (%) | 2022 (N=1434) (%) | 2023 (N=1501) (%) | 2024 (N=2219) (%) |
| Jan | 0 | 91 (6.3) | 4 (0.2) | 141 (6.3) |
| Feb | 0 | 43 (2.9) | 7 (0.4) | 93 (4.2) |
| Mar | 71 (6) | 105 (7.3) | 0 | 148 (6.6) |
| Apr | 112 (9.5) | 285 (19.8) | 0 | 261 (11.7) |
| May | 109 (9.2) | 311 (21.7) | 0 | 292 (13.1) |
| Jun | 112 (9.5) | 271 (18.8) | 41 (2.7) | 253 (11.4) |
| Jul | 129 (10.9) | 173 (12) | 274 (18.2) | 215 (9.7) |
| Aug | 46 (3.9) | 24 (1.7) | 316 (21) | 154 (6.9) |
| Sep | 43 (3.6) | 2 (0.1) | 251 (16.7) | 183 (8.2) |
| Oct | 163 (13.8) | 7 (0.5) | 235 (15.6) | 204 (9.1) |
| Nov | 211 (17.9) | 91 (6.3) | 189 (12.6) | 164 (7.4) |
| Dec | 182 (15.4) | 31 (2.1) | 184 (12.2) | 111 (5) |
Table 3: Cumulative analysis of seasonal patterns in Salmonella species across various samples over a 4-year period.
The table presents the number of Salmonella isolates recorded each month from 2021 to 2024, with a total of 6332 isolates across all four years. The data reflects monthly fluctuations and highlights significant peak periods throughout the years. Over the years, there is a noticeable increase, with 2024 recording the highest number at 2,219 isolates, compared to 1,178 isolates in 2021, which had the lowest count. This indicates a steady rise in Salmonella infections year by year.
In 2024 generally shows an upward trend compared to 2021, with significant increases in early months (January, February, March), though it does not always surpass peaks from 2022 and 2023. Notable peaks were recorded in March, April, May, June, and July, particularly in 2022 and 2024.Top of Form
In 2021, 1,178 isolates were recorded, with significant peaks in October (13.8%) and November (17.9%), but early months (January and February) showed no isolates, indicating a slow start to the year. 2022 saw an increase to 1,434 isolates, with sharp peaks in April (19.8%) and May (21.7%), highlighting a significant rise in spring. However, December experienced a sharp decline to 2.1%, while mid-year months like June (18.8%) remained relatively steady.
In 2023, 1,501 isolates were recorded, with the highest peaks in August (21%), July (18.2%), and September (16.7%), marking peak seasonal activity during summer and fall. Early months again showed lower numbers (January: 0.2% and February: 0.4%), similar to previous years. 2024 saw the highest total of 2,219 isolates, with notable increases in early months like January (6.3%), February (4.2%), and March (6.6%), signaling an early rise compared to earlier years. The trend continued into April (11.7%) and May (13.1%), although August (6.9%) and October (9.1%) showed a decrease compared to the previous years.
Despite a decrease in August and October 2024 compared to 2023, 2024 still had higher counts than 2022, which reported the lowest values for these months. The overall data indicates a gradual increase in Salmonella isolates, with 2024 showing the highest total number of isolates. However, certain months like August still saw a dip compared to 2023, which had the highest counts for July and August across all years.
A clear seasonal pattern is evident, with higher rates of Salmonella isolates in spring and summer (April-May), especially in 2022 and 2023. The early rise in 2024 during January-April suggests either an increase in Salmonella infections or improved detection methods. Over the four-year period, 2021 had the fewest isolates and a slow start, while 2022 and 2023 experienced significant surges, especially in spring and summer. Despite some months showing a decline in 2024, the data reveals a general upward trend in Salmonella infections, with distinct seasonal peaks and fluctuations, particularly in July-September.
In conclusion, the data reflects a consistent increase in Salmonella infections, with 2024 having the highest total number of isolates. The clear seasonal peaks, especially in spring and summer, along with significant fluctuations, point to both seasonal trends and potential improvements in detection methods.
Typhoid fever remains a significant public health concern in developing countries, with an estimated 11–20 million cases and 128,000 to 161,000 deaths as well as Paratyphoid fever cause 6 million cases and 54,000 deaths every year worldwide. Though there is no licensed vaccine for Paratyphoid fever, the World Health Organization recommended the use of typhoid conjugate vaccine in 2017 for typhoid fever [2,10,13] Salmonella enterica serovar Typhi (S. Typhi) is the primary etiological agent, often leading to bloodstream infections [10, 11,16]. Our retrospective study underscores the fact that Salmonella organisms represent a major health threat across all age groups, with an estimated prevalence of 2.6%. These findings are consistent with those of previous research [10, 24]
Global data show that Salmonella is the fourth most common pathogen in blood infections, with Salmonella Typhi being the most frequently isolated bacterium in cases of bacteremia (responsible for 99% of these cases). In our study, Salmonella ser. Typhi was the most commonly identified strain (n = 5706, 90.1%), followed by other Salmonella species (n = 315, 4.9%), Salmonella Paratyphi A (n = 242, 3.8%), and Salmonella Paratyphi B (n=69, 1.08%), a distribution that mirrors the trends found in other studies [6, 9, 10, 11, 16, 22]. Most research agrees with our findings, identifying Salmonella typhi as the predominant pathogen, particularly among males in the community constituting more than half (n = 3734, 58.9%) of the cases, with similar observations made in countries such as South asia and African countries, as well as in a population-based enteric fever surveillance [5,18,10,19, 26]. Our study also shows a higher incidence of Salmonella infections in children 6-12 years, who comparatively have a higher exposure to the external environment and outdoor activities than younger ones (<=5 years). Similarly to the findings with other studies [6, 10, 15]. The age-related variation in our findings highlights the possibility of reduced documentation of the disease, poor clinical suspicion, prior antimicrobial treatment before blood culture, and difficulty in withdrawing blood resulting in poor laboratory and clinical outcomes, along with immunological reasons such as immature and unstable gut microbiome and gut immune function in children between 1 and 5 years of age, easily exposing them to bacterial infections such as S. typhi in comparison to older ones [14, 18].
The data on Salmonella isolates from 2021 to 2024 reveals notable trends in both annual and seasonal distributions. A significant increase in the total number of isolates is observed over the four-year period, rising from 1,194 in 2021 to 2,246 in 2024. This upward trajectory suggests a growing incidence of Salmonella infections, which may be attributed to factors such as population growth, enhanced diagnostic capabilities, or changes in environmental conditions and also restricted movement during 2020-2021 because of pandemic.
Seasonal analysis indicates a higher prevalence of Salmonella isolates during the months of April to June and July to September. This pattern aligns with findings from a study conducted in other country, which reported the highest incidence of enteric fever cases during these periods, corresponding to the dry and monsoon seasons, respectively. The increased incidence during these seasons could be linked to factors such as elevated ambient temperatures and increased humidity, which may facilitate the proliferation of Salmonella bacteria. Additionally, the monsoon season often leads to contamination of water sources, further elevating the risk of infection. Our findings were concordant with studies conducted in South Asia [11,18], where cases were seen throughout the year with increased frequency during the peak of the wet months (July–October). The isolation of the bacteria throughout the year in our study with comparatively higher prevalence during spring could be subjected to the microbial contamination of drinking water above the recommended levels.
The observed fluctuations in monthly isolate counts, including the absence of isolates in certain months (e.g., March to May 2023 and September 2022), warrant further investigation. These anomalies could result actual decreases in infection rates during those periods. Understanding the underlying causes of these fluctuations is essential for implementing targeted public health interventions.
Emerging ceftriaxone, a third-generation cephalosporin resistance commonly used to treat invasive Salmonella infections by disrupting bacterial cell walls, in both typhoidal and Non-typhoidal Salmonella is a rising concern for healthcare providers, highlighting the need for continuous monitoring and alternative treatment options [1, 6, 8, 23, 17]. It has a cure rate of 72%-97%, with no relapses when used for 8–14 days. However, Ceftriaxone resistance, mainly driven by β-lactamase production, has been reported in several Salmonella serovars, including S. Typhimurium, S. Enteritidis, and S. Newport. Alarmingly, these ceftriaxone-resistant strains often show multidrug resistance, including resistance to Ampicillin, Chloramphenicol, and even Azithromycin. Such resistance patterns have now been documented in over 43 countries, including the USA, France, Turkey, and various regions of Asia, highlighting the global spread of antimicrobial-resistant (AMR) Salmonella[1, 14, 17, 24, 26]. Since the 1980s, fluoroquinolones and cephalosporins have been the preferred treatments for multi-drug-resistant Salmonella strains. Among these, ciprofloxacin and other fluoroquinolones were more commonly prescribed than Cephalosporins, largely due to their oral availability and lower cost. However, the effectiveness of fluoroquinolones has been increasingly compromised due to rising resistance in Salmonella enterica, including S. Typhi, S. Paratyphi A, S. Paratyphi B, and non-typhoidal Salmonella (NTS) strains. Our findings align with global studies reporting similar resistance patterns [1, 5, 6, 12, 13, 18, 20, 24].
Historically, first-line antibiotics such as chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole were commonly used to treat Salmonella infections [1, 6, 9]. Interestingly, our study observed low resistance to Chloramphenicol, reflecting a renewed susceptibility of Salmonella strains to older first-line antibiotics. Historically regarded as the gold standard for treating uncomplicated typhoid fever, chloramphenicol may be regaining effectiveness likely due to its reduced usage, especially in pediatric cases, over concerns about its adverse effects. Recent evidence of increased sensitivity to traditional antibiotics has revived interest in reintroducing them for treatment, a concept known as "antibiotic recycling" [3, 6, 19, 25]. Our findings support this trend, advocating for the reconsideration of older antimicrobials in current treatment protocols. However, some studies, such as Amsalu’s [2] report contrasting results, with 83% resistance observed against chloramphenicol, which disagrees with our findings.
Azithromycin, once a promising treatment for typhoid fever with cure rates of 81–100%, is now showing emerging resistance in some Salmonella serovars. The rise of MDR Salmonella Typhi and Non-typhoidal Salmonella (NTS) has prompted evaluation of alternative antimicrobials. Azithromycin is increasingly used in areas with high MDR and fluoroquinolone resistance. Our findings align with other studies supporting the use of azithromycin for empiric treatment of uncomplicated enteric fever [6, 25].
The prevalence of MDR S. Typhi and non-typhoidal Salmonella species has been reported to be high in Africa, South Asia, Central Asia, and the Middle East [6, 9, 12, 13, 15, 16, 19, 21, 25, 26]. In contrast, our study demonstrated a lower MDR prevalence, showing discordance particularly with data from South Asia, Central Asia, and the Middle East. Importantly, no XDR cases were detected in our findings.
Salmonella Paratyphi A remains largely sensitive to most antibiotics, unlike Salmonella Typhi, which has developed greater resistance over time [24]. Because typhoid and paratyphoid fever have nearly identical symptoms, physicians often use broad-spectrum antibiotics like ceftriaxone and azithromycin to treat both conditions. Our study found that Salmonella paratyphi A continues to respond well to older antibiotics such as Ceftriaxone, Chloramphenicol, and Cotrimoxazole, though reduced sensitivity was noted with ampicillin. [Bhatia, manoharan] Notably, none of the isolates were resistant to all three of these older drugs. While 99% of isolates showed decreased susceptibility to fluoroquinolones, all remained fully sensitive to both azithromycin and ceftriaxone. These findings are consistent with results from other studies [5, 17, 22].
Effective therapeutic options include Ertapenem, Chloramphenicol, and Azithromycin, with third-generation Cephalosporins still viable. However, emerging resistance to Cephalosporins and Ampicillin highlights the critical need for continuous surveillance and the development of new treatment strategies.
The increasing prevalence of Salmonella Typhi, Paratyphi A and B, and non-typhoidal Salmonella (NTS), along with rising antimicrobial resistance, underscores the urgent need for improved surveillance, sanitation, and vaccination. Typhoid fever remains a significant public health issue, particularly among children and during high-risk seasons. The emergence of multidrug-resistant strains in younger populations highlights the importance of targeted preventive measures through vaccination, improving water quality and food safety, especially during monsoon season. While third-generation Cephalosporins and Azithromycin are still effective, growing resistance calls for continuous monitoring and exploration of alternative therapies. Effective control requires rational antibiotic use, enhanced diagnostic capacity, and focused public health interventions in vulnerable groups.
It is not applicable.
There are no conflicts of interest.
We extend our sincere thanks to Dr. Reena Nakra, Principal Lab Director, Operations, National Reference Laboratory, Dr. Lal Path Labs, Delhi, for her invaluable operational support, and to the Microbiology Team for their technical assistance in this study.
Clearly Auctoresonline and particularly Psychology and Mental Health Care Journal is dedicated to improving health care services for individuals and populations. The editorial boards' ability to efficiently recognize and share the global importance of health literacy with a variety of stakeholders. Auctoresonline publishing platform can be used to facilitate of optimal client-based services and should be added to health care professionals' repertoire of evidence-based health care resources.
Journal of Clinical Cardiology and Cardiovascular Intervention The submission and review process was adequate. However I think that the publication total value should have been enlightened in early fases. Thank you for all.
Journal of Women Health Care and Issues By the present mail, I want to say thank to you and tour colleagues for facilitating my published article. Specially thank you for the peer review process, support from the editorial office. I appreciate positively the quality of your journal.
Journal of Clinical Research and Reports I would be very delighted to submit my testimonial regarding the reviewer board and the editorial office. The reviewer board were accurate and helpful regarding any modifications for my manuscript. And the editorial office were very helpful and supportive in contacting and monitoring with any update and offering help. It was my pleasure to contribute with your promising Journal and I am looking forward for more collaboration.
We would like to thank the Journal of Thoracic Disease and Cardiothoracic Surgery because of the services they provided us for our articles. The peer-review process was done in a very excellent time manner, and the opinions of the reviewers helped us to improve our manuscript further. The editorial office had an outstanding correspondence with us and guided us in many ways. During a hard time of the pandemic that is affecting every one of us tremendously, the editorial office helped us make everything easier for publishing scientific work. Hope for a more scientific relationship with your Journal.
The peer-review process which consisted high quality queries on the paper. I did answer six reviewers’ questions and comments before the paper was accepted. The support from the editorial office is excellent.
Journal of Neuroscience and Neurological Surgery. I had the experience of publishing a research article recently. The whole process was simple from submission to publication. The reviewers made specific and valuable recommendations and corrections that improved the quality of my publication. I strongly recommend this Journal.
Dr. Katarzyna Byczkowska My testimonial covering: "The peer review process is quick and effective. The support from the editorial office is very professional and friendly. Quality of the Clinical Cardiology and Cardiovascular Interventions is scientific and publishes ground-breaking research on cardiology that is useful for other professionals in the field.
Thank you most sincerely, with regard to the support you have given in relation to the reviewing process and the processing of my article entitled "Large Cell Neuroendocrine Carcinoma of The Prostate Gland: A Review and Update" for publication in your esteemed Journal, Journal of Cancer Research and Cellular Therapeutics". The editorial team has been very supportive.
Testimony of Journal of Clinical Otorhinolaryngology: work with your Reviews has been a educational and constructive experience. The editorial office were very helpful and supportive. It was a pleasure to contribute to your Journal.
Dr. Bernard Terkimbi Utoo, I am happy to publish my scientific work in Journal of Women Health Care and Issues (JWHCI). The manuscript submission was seamless and peer review process was top notch. I was amazed that 4 reviewers worked on the manuscript which made it a highly technical, standard and excellent quality paper. I appreciate the format and consideration for the APC as well as the speed of publication. It is my pleasure to continue with this scientific relationship with the esteem JWHCI.
This is an acknowledgment for peer reviewers, editorial board of Journal of Clinical Research and Reports. They show a lot of consideration for us as publishers for our research article “Evaluation of the different factors associated with side effects of COVID-19 vaccination on medical students, Mutah university, Al-Karak, Jordan”, in a very professional and easy way. This journal is one of outstanding medical journal.
Dear Hao Jiang, to Journal of Nutrition and Food Processing We greatly appreciate the efficient, professional and rapid processing of our paper by your team. If there is anything else we should do, please do not hesitate to let us know. On behalf of my co-authors, we would like to express our great appreciation to editor and reviewers.
As an author who has recently published in the journal "Brain and Neurological Disorders". I am delighted to provide a testimonial on the peer review process, editorial office support, and the overall quality of the journal. The peer review process at Brain and Neurological Disorders is rigorous and meticulous, ensuring that only high-quality, evidence-based research is published. The reviewers are experts in their fields, and their comments and suggestions were constructive and helped improve the quality of my manuscript. The review process was timely and efficient, with clear communication from the editorial office at each stage. The support from the editorial office was exceptional throughout the entire process. The editorial staff was responsive, professional, and always willing to help. They provided valuable guidance on formatting, structure, and ethical considerations, making the submission process seamless. Moreover, they kept me informed about the status of my manuscript and provided timely updates, which made the process less stressful. The journal Brain and Neurological Disorders is of the highest quality, with a strong focus on publishing cutting-edge research in the field of neurology. The articles published in this journal are well-researched, rigorously peer-reviewed, and written by experts in the field. The journal maintains high standards, ensuring that readers are provided with the most up-to-date and reliable information on brain and neurological disorders. In conclusion, I had a wonderful experience publishing in Brain and Neurological Disorders. The peer review process was thorough, the editorial office provided exceptional support, and the journal's quality is second to none. I would highly recommend this journal to any researcher working in the field of neurology and brain disorders.
Dear Agrippa Hilda, Journal of Neuroscience and Neurological Surgery, Editorial Coordinator, I trust this message finds you well. I want to extend my appreciation for considering my article for publication in your esteemed journal. I am pleased to provide a testimonial regarding the peer review process and the support received from your editorial office. The peer review process for my paper was carried out in a highly professional and thorough manner. The feedback and comments provided by the authors were constructive and very useful in improving the quality of the manuscript. This rigorous assessment process undoubtedly contributes to the high standards maintained by your journal.
International Journal of Clinical Case Reports and Reviews. I strongly recommend to consider submitting your work to this high-quality journal. The support and availability of the Editorial staff is outstanding and the review process was both efficient and rigorous.
Thank you very much for publishing my Research Article titled “Comparing Treatment Outcome Of Allergic Rhinitis Patients After Using Fluticasone Nasal Spray And Nasal Douching" in the Journal of Clinical Otorhinolaryngology. As Medical Professionals we are immensely benefited from study of various informative Articles and Papers published in this high quality Journal. I look forward to enriching my knowledge by regular study of the Journal and contribute my future work in the field of ENT through the Journal for use by the medical fraternity. The support from the Editorial office was excellent and very prompt. I also welcome the comments received from the readers of my Research Article.
Dear Erica Kelsey, Editorial Coordinator of Cancer Research and Cellular Therapeutics Our team is very satisfied with the processing of our paper by your journal. That was fast, efficient, rigorous, but without unnecessary complications. We appreciated the very short time between the submission of the paper and its publication on line on your site.
I am very glad to say that the peer review process is very successful and fast and support from the Editorial Office. Therefore, I would like to continue our scientific relationship for a long time. And I especially thank you for your kindly attention towards my article. Have a good day!
"We recently published an article entitled “Influence of beta-Cyclodextrins upon the Degradation of Carbofuran Derivatives under Alkaline Conditions" in the Journal of “Pesticides and Biofertilizers” to show that the cyclodextrins protect the carbamates increasing their half-life time in the presence of basic conditions This will be very helpful to understand carbofuran behaviour in the analytical, agro-environmental and food areas. We greatly appreciated the interaction with the editor and the editorial team; we were particularly well accompanied during the course of the revision process, since all various steps towards publication were short and without delay".
I would like to express my gratitude towards you process of article review and submission. I found this to be very fair and expedient. Your follow up has been excellent. I have many publications in national and international journal and your process has been one of the best so far. Keep up the great work.
We are grateful for this opportunity to provide a glowing recommendation to the Journal of Psychiatry and Psychotherapy. We found that the editorial team were very supportive, helpful, kept us abreast of timelines and over all very professional in nature. The peer review process was rigorous, efficient and constructive that really enhanced our article submission. The experience with this journal remains one of our best ever and we look forward to providing future submissions in the near future.
I am very pleased to serve as EBM of the journal, I hope many years of my experience in stem cells can help the journal from one way or another. As we know, stem cells hold great potential for regenerative medicine, which are mostly used to promote the repair response of diseased, dysfunctional or injured tissue using stem cells or their derivatives. I think Stem Cell Research and Therapeutics International is a great platform to publish and share the understanding towards the biology and translational or clinical application of stem cells.
I would like to give my testimony in the support I have got by the peer review process and to support the editorial office where they were of asset to support young author like me to be encouraged to publish their work in your respected journal and globalize and share knowledge across the globe. I really give my great gratitude to your journal and the peer review including the editorial office.
I am delighted to publish our manuscript entitled "A Perspective on Cocaine Induced Stroke - Its Mechanisms and Management" in the Journal of Neuroscience and Neurological Surgery. The peer review process, support from the editorial office, and quality of the journal are excellent. The manuscripts published are of high quality and of excellent scientific value. I recommend this journal very much to colleagues.
Dr.Tania Muñoz, My experience as researcher and author of a review article in The Journal Clinical Cardiology and Interventions has been very enriching and stimulating. The editorial team is excellent, performs its work with absolute responsibility and delivery. They are proactive, dynamic and receptive to all proposals. Supporting at all times the vast universe of authors who choose them as an option for publication. The team of review specialists, members of the editorial board, are brilliant professionals, with remarkable performance in medical research and scientific methodology. Together they form a frontline team that consolidates the JCCI as a magnificent option for the publication and review of high-level medical articles and broad collective interest. I am honored to be able to share my review article and open to receive all your comments.
“The peer review process of JPMHC is quick and effective. Authors are benefited by good and professional reviewers with huge experience in the field of psychology and mental health. The support from the editorial office is very professional. People to contact to are friendly and happy to help and assist any query authors might have. Quality of the Journal is scientific and publishes ground-breaking research on mental health that is useful for other professionals in the field”.
Dear editorial department: On behalf of our team, I hereby certify the reliability and superiority of the International Journal of Clinical Case Reports and Reviews in the peer review process, editorial support, and journal quality. Firstly, the peer review process of the International Journal of Clinical Case Reports and Reviews is rigorous, fair, transparent, fast, and of high quality. The editorial department invites experts from relevant fields as anonymous reviewers to review all submitted manuscripts. These experts have rich academic backgrounds and experience, and can accurately evaluate the academic quality, originality, and suitability of manuscripts. The editorial department is committed to ensuring the rigor of the peer review process, while also making every effort to ensure a fast review cycle to meet the needs of authors and the academic community. Secondly, the editorial team of the International Journal of Clinical Case Reports and Reviews is composed of a group of senior scholars and professionals with rich experience and professional knowledge in related fields. The editorial department is committed to assisting authors in improving their manuscripts, ensuring their academic accuracy, clarity, and completeness. Editors actively collaborate with authors, providing useful suggestions and feedback to promote the improvement and development of the manuscript. We believe that the support of the editorial department is one of the key factors in ensuring the quality of the journal. Finally, the International Journal of Clinical Case Reports and Reviews is renowned for its high- quality articles and strict academic standards. The editorial department is committed to publishing innovative and academically valuable research results to promote the development and progress of related fields. The International Journal of Clinical Case Reports and Reviews is reasonably priced and ensures excellent service and quality ratio, allowing authors to obtain high-level academic publishing opportunities in an affordable manner. I hereby solemnly declare that the International Journal of Clinical Case Reports and Reviews has a high level of credibility and superiority in terms of peer review process, editorial support, reasonable fees, and journal quality. Sincerely, Rui Tao.
Clinical Cardiology and Cardiovascular Interventions I testity the covering of the peer review process, support from the editorial office, and quality of the journal.
Clinical Cardiology and Cardiovascular Interventions, we deeply appreciate the interest shown in our work and its publication. It has been a true pleasure to collaborate with you. The peer review process, as well as the support provided by the editorial office, have been exceptional, and the quality of the journal is very high, which was a determining factor in our decision to publish with you.
The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews journal clinically in the future time.
Clinical Cardiology and Cardiovascular Interventions, I would like to express my sincerest gratitude for the trust placed in our team for the publication in your journal. It has been a true pleasure to collaborate with you on this project. I am pleased to inform you that both the peer review process and the attention from the editorial coordination have been excellent. Your team has worked with dedication and professionalism to ensure that your publication meets the highest standards of quality. We are confident that this collaboration will result in mutual success, and we are eager to see the fruits of this shared effort.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, I hope this message finds you well. I want to express my utmost gratitude for your excellent work and for the dedication and speed in the publication process of my article titled "Navigating Innovation: Qualitative Insights on Using Technology for Health Education in Acute Coronary Syndrome Patients." I am very satisfied with the peer review process, the support from the editorial office, and the quality of the journal. I hope we can maintain our scientific relationship in the long term.
Dear Monica Gissare, - Editorial Coordinator of Nutrition and Food Processing. ¨My testimony with you is truly professional, with a positive response regarding the follow-up of the article and its review, you took into account my qualities and the importance of the topic¨.
Dear Dr. Jessica Magne, Editorial Coordinator 0f Clinical Cardiology and Cardiovascular Interventions, The review process for the article “The Handling of Anti-aggregants and Anticoagulants in the Oncologic Heart Patient Submitted to Surgery” was extremely rigorous and detailed. From the initial submission to the final acceptance, the editorial team at the “Journal of Clinical Cardiology and Cardiovascular Interventions” demonstrated a high level of professionalism and dedication. The reviewers provided constructive and detailed feedback, which was essential for improving the quality of our work. Communication was always clear and efficient, ensuring that all our questions were promptly addressed. The quality of the “Journal of Clinical Cardiology and Cardiovascular Interventions” is undeniable. It is a peer-reviewed, open-access publication dedicated exclusively to disseminating high-quality research in the field of clinical cardiology and cardiovascular interventions. The journal's impact factor is currently under evaluation, and it is indexed in reputable databases, which further reinforces its credibility and relevance in the scientific field. I highly recommend this journal to researchers looking for a reputable platform to publish their studies.
Dear Editorial Coordinator of the Journal of Nutrition and Food Processing! "I would like to thank the Journal of Nutrition and Food Processing for including and publishing my article. The peer review process was very quick, movement and precise. The Editorial Board has done an extremely conscientious job with much help, valuable comments and advices. I find the journal very valuable from a professional point of view, thank you very much for allowing me to be part of it and I would like to participate in the future!”
Dealing with The Journal of Neurology and Neurological Surgery was very smooth and comprehensive. The office staff took time to address my needs and the response from editors and the office was prompt and fair. I certainly hope to publish with this journal again.Their professionalism is apparent and more than satisfactory. Susan Weiner
My Testimonial Covering as fellowing: Lin-Show Chin. The peer reviewers process is quick and effective, the supports from editorial office is excellent, the quality of journal is high. I would like to collabroate with Internatioanl journal of Clinical Case Reports and Reviews.
My experience publishing in Psychology and Mental Health Care was exceptional. The peer review process was rigorous and constructive, with reviewers providing valuable insights that helped enhance the quality of our work. The editorial team was highly supportive and responsive, making the submission process smooth and efficient. The journal's commitment to high standards and academic rigor makes it a respected platform for quality research. I am grateful for the opportunity to publish in such a reputable journal.
My experience publishing in International Journal of Clinical Case Reports and Reviews was exceptional. I Come forth to Provide a Testimonial Covering the Peer Review Process and the editorial office for the Professional and Impartial Evaluation of the Manuscript.
I would like to offer my testimony in the support. I have received through the peer review process and support the editorial office where they are to support young authors like me, encourage them to publish their work in your esteemed journals, and globalize and share knowledge globally. I really appreciate your journal, peer review, and editorial office.
Dear Agrippa Hilda- Editorial Coordinator of Journal of Neuroscience and Neurological Surgery, "The peer review process was very quick and of high quality, which can also be seen in the articles in the journal. The collaboration with the editorial office was very good."
I would like to express my sincere gratitude for the support and efficiency provided by the editorial office throughout the publication process of my article, “Delayed Vulvar Metastases from Rectal Carcinoma: A Case Report.” I greatly appreciate the assistance and guidance I received from your team, which made the entire process smooth and efficient. The peer review process was thorough and constructive, contributing to the overall quality of the final article. I am very grateful for the high level of professionalism and commitment shown by the editorial staff, and I look forward to maintaining a long-term collaboration with the International Journal of Clinical Case Reports and Reviews.
To Dear Erin Aust, I would like to express my heartfelt appreciation for the opportunity to have my work published in this esteemed journal. The entire publication process was smooth and well-organized, and I am extremely satisfied with the final result. The Editorial Team demonstrated the utmost professionalism, providing prompt and insightful feedback throughout the review process. Their clear communication and constructive suggestions were invaluable in enhancing my manuscript, and their meticulous attention to detail and dedication to quality are truly commendable. Additionally, the support from the Editorial Office was exceptional. From the initial submission to the final publication, I was guided through every step of the process with great care and professionalism. The team's responsiveness and assistance made the entire experience both easy and stress-free. I am also deeply impressed by the quality and reputation of the journal. It is an honor to have my research featured in such a respected publication, and I am confident that it will make a meaningful contribution to the field.
"I am grateful for the opportunity of contributing to [International Journal of Clinical Case Reports and Reviews] and for the rigorous review process that enhances the quality of research published in your esteemed journal. I sincerely appreciate the time and effort of your team who have dedicatedly helped me in improvising changes and modifying my manuscript. The insightful comments and constructive feedback provided have been invaluable in refining and strengthening my work".
I thank the ‘Journal of Clinical Research and Reports’ for accepting this article for publication. This is a rigorously peer reviewed journal which is on all major global scientific data bases. I note the review process was prompt, thorough and professionally critical. It gave us an insight into a number of important scientific/statistical issues. The review prompted us to review the relevant literature again and look at the limitations of the study. The peer reviewers were open, clear in the instructions and the editorial team was very prompt in their communication. This journal certainly publishes quality research articles. I would recommend the journal for any future publications.
Dear Jessica Magne, with gratitude for the joint work. Fast process of receiving and processing the submitted scientific materials in “Clinical Cardiology and Cardiovascular Interventions”. High level of competence of the editors with clear and correct recommendations and ideas for enriching the article.
We found the peer review process quick and positive in its input. The support from the editorial officer has been very agile, always with the intention of improving the article and taking into account our subsequent corrections.
My article, titled 'No Way Out of the Smartphone Epidemic Without Considering the Insights of Brain Research,' has been republished in the International Journal of Clinical Case Reports and Reviews. The review process was seamless and professional, with the editors being both friendly and supportive. I am deeply grateful for their efforts.
To Dear Erin Aust – Editorial Coordinator of Journal of General Medicine and Clinical Practice! I declare that I am absolutely satisfied with your work carried out with great competence in following the manuscript during the various stages from its receipt, during the revision process to the final acceptance for publication. Thank Prof. Elvira Farina
Dear Jessica, and the super professional team of the ‘Clinical Cardiology and Cardiovascular Interventions’ I am sincerely grateful to the coordinated work of the journal team for the no problem with the submission of my manuscript: “Cardiometabolic Disorders in A Pregnant Woman with Severe Preeclampsia on the Background of Morbid Obesity (Case Report).” The review process by 5 experts was fast, and the comments were professional, which made it more specific and academic, and the process of publication and presentation of the article was excellent. I recommend that my colleagues publish articles in this journal, and I am interested in further scientific cooperation. Sincerely and best wishes, Dr. Oleg Golyanovskiy.
Dear Ashley Rosa, Editorial Coordinator of the journal - Psychology and Mental Health Care. " The process of obtaining publication of my article in the Psychology and Mental Health Journal was positive in all areas. The peer review process resulted in a number of valuable comments, the editorial process was collaborative and timely, and the quality of this journal has been quickly noticed, resulting in alternative journals contacting me to publish with them." Warm regards, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. I appreciate the journal (JCCI) editorial office support, the entire team leads were always ready to help, not only on technical front but also on thorough process. Also, I should thank dear reviewers’ attention to detail and creative approach to teach me and bring new insights by their comments. Surely, more discussions and introduction of other hemodynamic devices would provide better prevention and management of shock states. Your efforts and dedication in presenting educational materials in this journal are commendable. Best wishes from, Farahnaz Fallahian.
Dear Maria Emerson, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. I am delighted to have published our manuscript, "Acute Colonic Pseudo-Obstruction (ACPO): A rare but serious complication following caesarean section." I want to thank the editorial team, especially Maria Emerson, for their prompt review of the manuscript, quick responses to queries, and overall support. Yours sincerely Dr. Victor Olagundoye.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews. Many thanks for publishing this manuscript after I lost confidence the editors were most helpful, more than other journals Best wishes from, Susan Anne Smith, PhD. Australian Breastfeeding Association.
Dear Agrippa Hilda, Editorial Coordinator, Journal of Neuroscience and Neurological Surgery. The entire process including article submission, review, revision, and publication was extremely easy. The journal editor was prompt and helpful, and the reviewers contributed to the quality of the paper. Thank you so much! Eric Nussbaum, MD
Dr Hala Al Shaikh This is to acknowledge that the peer review process for the article ’ A Novel Gnrh1 Gene Mutation in Four Omani Male Siblings, Presentation and Management ’ sent to the International Journal of Clinical Case Reports and Reviews was quick and smooth. The editorial office was prompt with easy communication.
Dear Erin Aust, Editorial Coordinator, Journal of General Medicine and Clinical Practice. We are pleased to share our experience with the “Journal of General Medicine and Clinical Practice”, following the successful publication of our article. The peer review process was thorough and constructive, helping to improve the clarity and quality of the manuscript. We are especially thankful to Ms. Erin Aust, the Editorial Coordinator, for her prompt communication and continuous support throughout the process. Her professionalism ensured a smooth and efficient publication experience. The journal upholds high editorial standards, and we highly recommend it to fellow researchers seeking a credible platform for their work. Best wishes By, Dr. Rakhi Mishra.
Dear Jessica Magne, Editorial Coordinator, Clinical Cardiology and Cardiovascular Interventions, Auctores Publishing LLC. The peer review process of the journal of Clinical Cardiology and Cardiovascular Interventions was excellent and fast, as was the support of the editorial office and the quality of the journal. Kind regards Walter F. Riesen Prof. Dr. Dr. h.c. Walter F. Riesen.
Dear Ashley Rosa, Editorial Coordinator, International Journal of Clinical Case Reports and Reviews, Auctores Publishing LLC. Thank you for publishing our article, Exploring Clozapine's Efficacy in Managing Aggression: A Multiple Single-Case Study in Forensic Psychiatry in the international journal of clinical case reports and reviews. We found the peer review process very professional and efficient. The comments were constructive, and the whole process was efficient. On behalf of the co-authors, I would like to thank you for publishing this article. With regards, Dr. Jelle R. Lettinga.
Dear Clarissa Eric, Editorial Coordinator, Journal of Clinical Case Reports and Studies, I would like to express my deep admiration for the exceptional professionalism demonstrated by your journal. I am thoroughly impressed by the speed of the editorial process, the substantive and insightful reviews, and the meticulous preparation of the manuscript for publication. Additionally, I greatly appreciate the courteous and immediate responses from your editorial office to all my inquiries. Best Regards, Dariusz Ziora
