TY - JOUR AU - Saeed, Muhammad AU - Rasool, Muhammad Hidayat AU - Rasheed, Farhan AU - Saqalein, Muhammad AU - Nisar, Muhammad Atif AU - Imran, Ambreen Anwar AU - Tariq, Saba AU - Amir, Afreenish AU - Ikram, Aamer AU - Khurshid, Mohsin PY - 2020/02/29 Y2 - 2024/03/29 TI - Extended-spectrum beta-lactamases producing extensively drug-resistant Salmonella Typhi in Punjab, Pakistan JF - The Journal of Infection in Developing Countries JA - J Infect Dev Ctries VL - 14 IS - 02 SE - Original Articles DO - 10.3855/jidc.12049 UR - https://www.jidc.org/index.php/journal/article/view/32146451 SP - 169-176 AB - <p>Introduction: The multidrug-resistant (MDR) <em>Salmonella enterica</em> serovar Typhi isolates have been increasingly reported from the Asian and African countries. The emergence of isolates with decreased susceptibility to fluoroquinolones and cephalosporins has worsened the situation. Recently, an outbreak from Sindh, Pakistan was reported caused by extensively drug-resistant (XDR) <em>S.</em> Typhi strains.</p><p>Methodology: In the present study, a total of 82 cases of typhoid have been investigated during 2018 from the febrile children referred to a tertiary care hospital in the population-wise largest province (Punjab) of Pakistan. <em>S.</em> Typhi was identified by standard microbiological techniques and isolates were characterized for antimicrobial resistance profiling and minimum inhibitory concentrations were determined. The presence of various ESBL genes in <em>S.</em> Typhi was confirmed by the PCR.</p><p>Results: Out of the 82 isolates tested, 35 (43%) were found to be XDR; resistant to the first-line drugs. The resistance to third-generation cephalosporins was mainly mediated by extended-spectrum beta-lactamases i.e. <em>bla</em>TEM and <em>bla</em>CTX-M genes.</p><p>Conclusions: The higher prevalence of ESBL producing <em>Salmonella</em> typhi clinical strains raises the concern about transmission prevention and infection management in the community as well as clinical settings. Moreover, the study highlights the problem concerning the declining antibiotic arsenal for the therapeutic management of typhoid fever and the emergence and spread of XDR strains in Pakistan.</p> ER -