Antimicrobial resistance inSalmonella entericaserovar typhi and paratyphi in South Asia-current status, issues and prospects

Abstract

The human race owes a debt of gratitude to antimicrobial agents, penicillin and its successors that have saved people from tremendous pain and suffering in the last several decades. Unfortunately, this consideration is no more true, as millions of people are prone to the challenging threat of emergence of antimicrobial resistance worldwide and the menace is more distressing in developing countries. Comparable with other bacterial species, Salmonella enterica serovar Typhi (S. typhi) and Paratyphi (S. paratyphi) have been evolving multidrug resistance (MDR) against a wide array of antibiotics, including chloramphenicol, ampicillin and co-trimoxazole, and globally affecting 21 million people with 220,000 deaths each year. S. typhi and S. paratyphi infections are also endemic in South Asia and a series of antibiotics used to treat these infections, have been losing efficacy against enteric fever. Currently, quinolones are regarded as a choice to treat MDR Salmonella in these regions. Travel-related cases of enteric fever, especially from South Asian countries are the harbinger of the magnitude of MDR Salmonella in that region. Conclusively, the MDR will continue to grow and the available antimicrobial agents would become obsolete. Therefore, a radical and aggressive approach in terms of rational use of antibiotics during treating infections is essentially needed.

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

“…The first outbreak caused by chloramphenicol-resistant S. typhi occurred in Mexico in 1972, followed by notifications in other endemic areas (i.e., South Asia andAfrica) [60]. Moreover,~66% of isolates in European countries [17], shows decreased susceptibility to ciprofloxacin, although it was considered in the past as first therapeutic choice [61] by the World Health Organization guidelines.…”

Utilization of clinical practice guideline on antimicrobial in China: an exploratory survey on multilevel determinants

“…Many studies have been carried out on the status of the antimicrobial application [7][8][9][10], put forward the concerns of irrational use and drug resistance of antimicrobial. Some scholars investigated the reasons for irrational use of antimicrobial, such as the compensating scheme of health insurance, lack of knowledge in the rational use of antimicrobial, a tense doctor-patient relationship [9], etc.…”

Prevalence and antibiotic resistance of <Salmonella> spp. in South Punjab-Pakistan

“…For example more than 14 million cases of enteric fever are reported annually resulting in 135,000 deaths. S. typhi and S. paratyphi infections have been shown to be more prevalent in South Asian regions where excessive use of antibiotic has been exacerbating the emergence of multidrug resistance in these strains [14,15]. Multi-drug resistance (MDR) Salmonella serotypes have become widespread in developed economies as well including USA.…”