This analysis of the genome is the largest to date.
The results are further evidence of the need for a global response, the authors said. Photo: Shutterstock.
The resistant strains of Salmonella enterica serovariedad Typhi (S. Typhi), the bacteria that cause typhoid fever, are increasingly resistant to common antibiotics around the world, a new analysis indicates.
The results of the study, led by Kesia Esther da Silva, Ph.D., of the Division of Infectious Diseases and Geographic Medicine at Stanford University, California, were published online June 21 in The Lancet Microbe
Until now, the analysis has been limited by small samples. This analysis of the genome is the largest to date and included 3,489 newly sequenced strains (obtained between 2014 and 2019) from prospective surveillance studies in four of the countries with the highest typhoid burden: Bangladesh, Nepal, Pakistan, and India.
The results of the study, led by Kesia Esther da Silva, MD, Division of Infectious Diseases and Geographic Medicine at Stanford University in California, were published online June 21 in The Lancet Microbe.
Deaths in the world: 100,000 a year
Typhoid fever remains a global public health threat, causing 11 million infections and more than 100,000 deaths each year. Most cases (70%) come from South Asia, but typhoid fever also has a significant presence in sub-Saharan Africa, Southeast Asia, and Oceania.
The results are further evidence of the need for a global response, the authors said.
Co-author Jason Andrews, MD, associate professor in the Division of Infectious Diseases and Geographic Medicine at Stanford University, told Medscape Medical News that the research helps determine where the greatest burden is and where the two flu vaccines are most needed. typhoid fever, which are very effective.
“We’re seeing higher levels of resistance than we’ve seen before against our newest and best antibiotics,” he said.
He said that, until now, strategies to deal with typhoid fever have involved country-level decisions and local funding, and that this has to become a global priority. “Given contemporary patterns of travel migration, what we see is that when antimicrobial resistance emerges in one country, it quickly spreads to other countries.”
Dr. Andrews stated that there are 300 to 500 cases of typhoid fever in the United States each year. “About 80% of those cases are in people traveling from South Asia,” he added.
Infections are also coming from people in the United States visiting high-burden countries, especially to see family members. They often don’t perceive the risk and skip vaccination, she noted. US doctors can help advise patients traveling to regions where typhoid is endemic to get vaccinated before traveling, she added.
It is also important for clinicians to know when patients have recently returned from those regions. The data from this study show the need to carefully consider which antibiotics will be effective in the face of growing resistance.
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