Trends of Enteric Fever and Emergence of Extensively Drug-Resistant Typhoid in Pakistan: Population-Based Laboratory Data From 2017–2019 - Summary - MDSpire
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Trends of Enteric Fever and Emergence of Extensively Drug-Resistant Typhoid in Pakistan: Population-Based Laboratory Data From 2017–2019
To understand antimicrobial resistance patterns associated with multidrug-resistant (MDR) and extensively drug-resistant (XDR) typhoid fever cases in Pakistan, highlighting public health implications.
Key Findings:
Sindh had the highest proportion of S. Typhi cases (72%), followed by Punjab (46.9%).
The 5–14 years age group had the highest proportion of S. Typhi (MDR: 46.1%; XDR: 44.2%).
57% of S. Typhi isolates were XDR.
Resistance to first-line antibiotics was high: ampicillin (79.8%), chloramphenicol (80.8%), cefixime (64.6%), ciprofloxacin (66.4%), ceftriaxone (63.3%), and co-trimoxazole (80.2%).
S. Paratyphi isolates were mostly responsive to antibiotics, with high susceptibility to ampicillin (97.2%) and others, but resistance to ciprofloxacin was noted at 85.9%.
Interpretation:
The increasing prevalence of XDR S. Typhi cases, particularly in Sindh, highlights a significant public health challenge in managing typhoid fever in Pakistan, necessitating urgent policy responses.
Limitations:
Data primarily from large laboratory networks may not represent the entire population.
Challenges in establishing a robust surveillance system in Pakistan, including potential biases in data collection.
Conclusion:
The study underscores the urgent need for improved surveillance and management strategies to address the rising antimicrobial resistance in typhoid fever in Pakistan, emphasizing the critical nature of this public health issue.
by Farah Naz Qamar, Mohammad Tahir Yousafzai, Ibtisam Qazi, Sonia Qureshi, Naor Bar-Zeev, Shazia Sultana, Muhammad Jawwad, Aneeta Hotwani, Seema Irfan, Muhammad Ashraf Memon, Irim Iftikhar, Summiya Nizamuddin, Ikram Ujjan, Ejaz Ahmed Khan, Mohsina Noor Ibrahim
