Scientists have discovered a significant increase in extensively drug-resistant (XDR) S. Typhi strains across South Asia, posing a major threat to global public health. The study, which sequenced 3,489 strains from Nepal, Bangladesh, Pakistan, and India between 2014 and 2019, found these superbugs are spreading rapidly internationally. With resistance already high against quinolones and cephalosporins, and emerging azithromycin resistance threatening all oral antibiotics, researchers urge urgent expansion of prevention measures, including typhoid conjugate vaccines in endemic countries and beyond due to the risk of international spread.
Typhi). Yet over the past three decades, the bacterium's resistance to oral antibiotics has been growing and spreading. In their study, scientists from multiple countries sequenced the genomes of 3,489 S. Typhi strains contracted from 2014 to 2019 in Nepal, Bangladesh, Pakistan, and India, and found a rise in extensively drug-resistant Typhi.
Even worse, these strains are spreading globally at a rapid rate. While most XDR Typhi cases stem from South Asia, researchers have identified nearly 200 instances of international spread since 1990. Most strains have been exported to Southeast Asia, as well as East and Southern Africa, but typhoid superbugs have also been found in the UK, the US, and Canada.
"The speed at which highly resistant strains of S. Typhi have emerged and spread in recent years is a real cause for concern, and highlights the need to urgently expand prevention measures, particularly in countries at greatest risk,"But by the early 2000s, mutations that confer resistance to quinolones accounted for more than 85 percent of all cases in Bangladesh, India, Pakistan, Nepal, and Singapore. At the same time, cephalosporin resistance was also taking over.that mutations that confer resistance to azithromycin are now also spreading,"threatening the efficacy of all oral antimicrobials for typhoid treatment".
While these mutations have not yet been adopted by XDR S Typhi, if they are, we are in serious trouble.
"The recent emergence of XDR and azithromycin-resistant S. Typhi creates greater urgency for rapidly expanding prevention measures, including use of typhoid conjugate vaccines in typhoid-endemic countries," the authors "Such measures are needed in countries where antimicrobial resistance prevalence among S. Typhi isolates is currently high, but given the propensity for international spread, should not be restricted to such settings. "in India, for instance, estimated that if children are vaccinated against typhoid in urban areas, it could prevent up to 36 percent of typhoid cases and deaths. An earlier version of this article was published in June 2022.
Typhoid Drug Resistance XDR Antibiotics Global Spread Vaccines Public Health S. Typhi
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