Ceftriaxone-resistant Salmonella enterica serotype Typhi in a pregnant traveller returning from Karachi, Pakistan to Denmark, 2019

Engsbro, Anne Line; Jespersen, Hans Søe Riis; Goldschmidt, Maria Ingeborg; Mollerup, Sarah; Worning, Peder; Pedersen, Martin Schou; Westh, Henrik; Schneider, Uffe Vest

doi:10.2807/1560-7917.es.2019.24.21.1900289

Cited by 30 publications

(20 citation statements)

References 14 publications

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“…The only treatment options that remain in this situation are azithromycin, meropenem, and piperacillin/tazobactam. The treatment strategy for XDR typhoid is intravenous meropenem for seven days, which costs 260 USD followed up by oral azithromycin; this is being used in Pakistan as well as in internationally exported cases [ 16 ] but many patients skip treatment and return later with complications (Asst. Prof. Fahad Aman Khan, personal communication).…”

Section: Discussionmentioning

confidence: 99%

“…Prof. Fahad Aman Khan, personal communication). Carbapenems are a potent class of antibiotics and an effective treatment for typhoid fever but the presence of carbapenemase-producing Enterobacteriaceae is a critical threat [ 16 , 32 ]. This leaves many patients with azithromycin as their only viable option (Asst.…”

Section: Discussionmentioning

confidence: 99%

“…Whole genome sequencing (WGS) has been used in the past to understand the evolution of antibiotic resistance mechanisms and to track bacterial and viral pathogen spread [ 12 , 13 ]. WGS of individual cases of XDR S. Typhi from Taiwan, Canada and Denmark have shown a close relationship (100% nucleotide match) to the nearest sequenced XDR isolate from Pakistan [ 14 , 15 , 16 ]. This highlights the international impact of this ongoing outbreak and that any SNPs found between isolates of S. Typhi during an outbreak suggest prolonged transmission.…”

Section: Introductionmentioning

confidence: 99%

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Emergence of Resistance to Fluoroquinolones and Third-Generation Cephalosporins in Salmonella Typhi in Lahore, Pakistan

et al. 2020

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Extensively drug-resistant (XDR) Salmonella Typhi has been reported in Sindh province of Pakistan since 2016. The potential for further spread is of serious concern as remaining treatment options are severely limited. We report the phenotypic and genotypic characterization of 27 XDR S. Typhi isolated from patients attending Jinnah Hospital, Lahore, Pakistan. Isolates were identified by biochemical profiling; antimicrobial susceptibility was determined by a modified Kirby–Bauer method. These findings were confirmed using Illumina whole genome nucleotide sequence data. All sequences were compared to the outbreak strain from Southern Pakistan and typed using the S. Typhi genotyping scheme. All isolates were confirmed by a sequence analysis to harbor an IncY plasmid and the CTX-M-15 ceftriaxone resistance determinant. All isolates were of the same genotypic background as the outbreak strain from Sindh province. We report the first emergence of XDR S. Typhi in Punjab province of Pakistan confirmed by whole genome sequencing.

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Section: Discussionmentioning

confidence: 99%

Section: Discussionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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Emergence of Resistance to Fluoroquinolones and Third-Generation Cephalosporins in Salmonella Typhi in Lahore, Pakistan

et al. 2020

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“…Salmonella Typhi (S. Typhi) causes typhoid fever, a major public health problem in developing countries [1,2]. Typhoid fever is common in areas where safe drinking water and sanitation are inadequate.…”

Section: Introductionmentioning

confidence: 99%

Ciprofloxacin Resistant Salmonella Typhi Isolated at National Microbiology Reference Laboratory in Harare, Zimbabwe (January to April 2016)

Mutaurwa¹,

Munemo²,

Malunga³

et al. 2020

TOPHJ

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Background: Typhoid is a life-threatening infectious disease requiring the administration of antibiotics for treatment. Ciprofloxacin is the antibiotic of choice for diarrheal cases in Zimbabwe, adopted by the Ministry of Health and Child Care, from current World Health Organisation (WHO) guidelines. However, there has been an increase in the emergence and spread of multidrug resistance against ciprofloxacin and conventional drugs antibiotics for the treatment of typhoid. Objective: This cross-sectional study aimed to determine the prevalence of ciprofloxacin-resistant Salmonella Typhi (S. Typhi) isolated in Harare for the first quarter of 2016. Methods: This study was carried out at the National Microbiology Reference Laboratory (NMRL), located at Harare Central Hospital, in Zimbabwe. The NMRL carries out confirmatory tests and molecular typing of pathogens isolated at different national laboratories. The current study retrieved demographics, clinical data, and isolates for confirmed typhoid cases out of 402 suspected specimens. The isolates from Harare, confirmed as S. Typhi, between January and April 2016, were evaluated for ciprofloxacin resistance. Results: A total of 35 S. Typhi isolates were recovered for the period from January to April 2016. When the 35 isolates were characterised, nine (25.7%) were resistant to ciprofloxacin. The area with the highest recorded cases of typhoid fever was Budiriro High-Density Suburb in Harare. This area has been hit by other diarrheal outbreaks in the past, most likely due to the intermittent supply of safe water. Conclusion: Most high-density areas, where S. Typhi positive specimens originated, are overpopulated and have regular water cuts, resulting in a decrease in hygiene. More than a quarter of isolates are resistant to ciprofloxacin, agreeing with other reports from Zimbabwe. The misuse of antibiotics could be associated with resistance, necessitating education on the correct use of antibiotics in the community and other preventive measures. Additionally, molecular research on geographic and phylogenetic relatedness of isolates and other holistic approaches for studying the development of antimicrobial resistance mutations, using whole-genome sequencing, in this setting, are warranted.

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“…Our rapid communications on ongoing or emerging threats were published within 2 to 3 weeks of submission, creating awareness and providing evidence to support rapid public health action. Some examples of the rapids we published included the worsening epidemiological situation of carbapenemase-producing Enterobacteriaceae in Europe [13], a case of extensively drug-resistant typhoid fever imported from Pakistan to Denmark [14] and the detection of a Chlamydia trachomatis variant escaping detection by a widely used assay in Finland that was found in other European countries thereafter [15][16][17].…”

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confidence: 99%

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Eurosurveillance

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Ceftriaxone-resistant Salmonella enterica serotype Typhi in a pregnant traveller returning from Karachi, Pakistan to Denmark, 2019

Cited by 30 publications

References 14 publications

Emergence of Resistance to Fluoroquinolones and Third-Generation Cephalosporins in Salmonella Typhi in Lahore, Pakistan

Emergence of Resistance to Fluoroquinolones and Third-Generation Cephalosporins in Salmonella Typhi in Lahore, Pakistan

Ciprofloxacin Resistant Salmonella Typhi Isolated at National Microbiology Reference Laboratory in Harare, Zimbabwe (January to April 2016)

Note from the editors: Don’t stop thinking about tomorrow

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