ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2019
Ceftriaxone-resistant Salmonella Typhi Outbreak in Hyderabad City of Sindh, Pakistan: High Time for the Introduction of Typhoid Conjugate Vaccine.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 46 papers, 4 of them syntheses that pooled it.
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Who cites it
46 citing papers in PubMed, 4 syntheses or guidelines pooled it, 89 citations in OpenAlex.
- Risk Factors for Typhoid Fever: Systematic Review.JMIR public health and surveillance · 2025Pooled it
- Pooled it
- Antibiotic resistance in Pakistan: a systematic review of past decade.BMC infectious diseases · 2021Pooled it
- A Systematic Review and Meta-analysis of the Prevalence of Community-Onset Bloodstream Infections among Hospitalized Patients in Africa and Asia.Antimicrobial agents and chemotherapy · 2019Pooled it
- Prevention of Typhoid by Vi Conjugate Vaccine and Achievable Improvements in Household Water, Sanitation, and Hygiene: Evidence From a Cluster-Randomized Trial in Dhaka, Bangladesh.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2022Trial
- Efficacy of typhoid conjugate vaccine in Nepal: final results of a phase 3, randomised, controlled trial.The Lancet. Global health · 2021Trial
- Ceftriaxone-Resistant Enteric Fever Outbreak in Children From Thane: A Multicenter Prospective Study.Indian pediatrics · 2026Article
- The missing link in combating antimicrobial resistance: leveraging vaccines for prevention.Antimicrobial resistance and infection control · 2026Article
- Time series data on typhoid fever incidence during outbreaks from 2000 to 2022.Scientific data · 2025Article
- Longevity of immune response after a single dose of typhoid conjugate vaccine against Salmonella Typhi among children in Hyderabad, Pakistan.International journal of infectious diseases : IJID : official publication of the International Society for Infectious Diseases · 2024Article
- Exploring the Antimicrobial Resistance Profile ofAntibiotics (Basel, Switzerland) · 2024Article
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- Typhoidal salmonella disease in Mukuru informal settlement, Nairobi Kenya; carriage, diversity, and antimicrobial resistant genes.PloS one · 2024Article
- Exploring the antimicrobial efficacy of Manuka honey against multidrug-resistant and extensively drug-resistantFuture microbiology · 2024Article
- RETRACTED: Empowering Low- and Middle-Income Countries to Combat AMR by Minimal Use of Antibiotics: A Way Forward.Antibiotics (Basel, Switzerland) · 2023Article
- Dynamic Incidence of Typhoid Fever over a 10-Year Period (2010-2019) in Kibera, an Urban Informal Settlement in Nairobi, Kenya.The American journal of tropical medicine and hygiene · 2023Article
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- Typhoid Control in an Era of Antimicrobial Resistance: Challenges and Opportunities.Open forum infectious diseases · 2023Article
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Corrections and comments
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Authors and funding
13 authors at 3 institutions in 2 countries.
Funding
Abstract
backgroundThe Aga Khan University clinical microbiology laboratory identified an outbreak of ceftriaxone-resistant Salmonella Typhi in Hyderabad, Pakistan, through antimicrobial resistance surveillance. An outbreak investigation was carried out to identify the risk factors and institute control measures. Here we report the preliminary findings of this outbreak investigation, using data collected from 30 November 2016 to 28 March 2017.
methodsThe design for the investigation was a case-control study that included identification of culture-proven ceftriaxone-resistant S. Typhi cases, suspected cases from the households or neighborhood of the confirmed cases, and enrollment of controls matched by age to identify the risk factors. Data were collected through face-to-face interviews using a structured questionnaire. Blood cultures were obtained from all suspected cases. Drinking water samples from each household of cases and controls were obtained for microbiological testing. Geographic Information System coordinates were obtained for all cases and controls.
resultsOnly 2 subdistricts of Hyderabad (Latifabad and Qasimabad) were affected. A total of 101 confirmed cases of ceftriaxone-resistant S. Typhi had been reported in 4 months with the first case reported on 30 November 2016. Median age was 48 (interquartile range, 29-84) months. The majority (60% [61/101]) of the cases were 6-60 months old. More than half (56% [57/101]) of the cases were male. About 60% of the cases were admitted to hospital and treated as inpatient. More than half (57/101) of the patients developed complications related to typhoid.
conclusionsCommunity awareness was raised regarding chlorination of drinking water and sanitation measures in Hyderabad. These efforts were coordinated with the municipal water and sewage authority established to improve chlorination at processing plants and operationalize fecal sludge treatment plants. Outbreak investigation and control efforts have continued. Immunization of children with typhoid conjugate vaccine within Hyderabad city is planned.
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