ArticleClinical infectious diseases : an official publication of the Infectious Diseases Society of America2020
Antimicrobial Resistance in Typhoidal Salmonella: Surveillance for Enteric Fever in Asia Project, 2016-2019.
Article in Clinical infectious diseases : an official publication of the Infectious Diseases Society of America, 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 42 papers, 1 of them a synthesis that pooled it.
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Who cites it
42 citing papers in PubMed, 1 synthesis or guideline pooled it, 81 citations in OpenAlex.
- Typhoid Fever in the Eastern Mediterranean Region: A Systematic Review, 1990-2021.The American journal of tropical medicine and hygiene · 2023Pooled it
- Safety and immunogenicity of conjugate vaccine for typhoid (Vi-DT): Finding from an observer-blind, active-controlled, randomized, non-inferiority, phase III clinical trial among healthy volunteers.Human vaccines & immunotherapeutics · 2024Trial
- Programmatic Effectiveness of a Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India.Clinical infectious diseases : an official publication of the Infectious Diseases Society of America · 2023Trial
- Azithromycin Resistance in Salmonella Typhi and Paratyphi Across South Asia: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2026Review
- Serotype Distribution and Antimicrobial Resistance ofAnnals of laboratory medicine · 2026Article
- Use of Salmonella enterica Serovar Typhi Hemolysin E and Lipopolysaccharide IgA to Identify Enteric Fever Cases, South Asia.Emerging infectious diseases · 2026Article
- Meropenem Use and Challenges in Treating Severe Infections in Pakistan Amid Antimicrobial Resistance.Interdisciplinary perspectives on infectious diseases · 2026Review
- A contemporary genomic snapshot ofMicrobial genomics · 2025Article
- Patterns of Antibiotic Resistance in Community-Acquired Infections: A Study From a Tertiary Care Hospital.Cureus · 2025Article
- The Central Importance of Vaccines to Mitigate the Threat of Antibiotic-Resistant Bacterial Pathogens.Vaccines · 2025Review
- Ciprofloxacin resistance and bile-induced biofilm enhancement inNew microbes and new infections · 2025Article
- Assessing Salmonella Typhi Pathogenicity and Prevention: The Crucial Role of Vaccination in Combating Typhoid Fever.International journal of molecular sciences · 2025Review
- Trends of Enteric Fever and Emergence of Extensively Drug-Resistant Typhoid in Pakistan: Population-Based Laboratory Data From 2017-2019.Open forum infectious diseases · 2025Article
- Epidemiological characteristics and trends of notified enteric fevers in Germany, 2001 to 2023.Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin · 2025Article
- Changes in enteric fever trends during the COVID-19 pandemic from the Surveillance for Enteric Fever in Asia Project: a cross-sectional study.The Lancet regional health. Southeast Asia · 2025Article
- Antibiotic resistance in the Middle East and Southern Asia: a systematic review and meta-analysis.JAC-antimicrobial resistance · 2025Review
- Seroprevalence of Typhoid Fever and Its Associated Risk Factors Among Clinically Diagnosed Febrile Patients Visiting the Outpatient Department at Debark Hospital and Drug Susceptibility Patterns of Isolates.BioMed research international · 2025Article
- Factors Influencing Vaccine Receipt During a 2018 Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India.The American journal of tropical medicine and hygiene · 2024Article
- Field Effectiveness of a Typhoid Conjugate Vaccine: The 2018 Navi Mumbai Pediatric TCV Campaign.The American journal of tropical medicine and hygiene · 2024Article
- 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
Corrections and comments
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Authors and funding
18 authors at 7 institutions in 3 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundClinicians have limited therapeutic options for enteric as a result of increasing antimicrobial resistance, and therefore typhoid vaccination is recommended as a preventive measure. As a part of the Surveillance for Enteric Fever in Asia Project (SEAP), we investigated the extent measured the burden of antimicrobial resistance (AMR) among confirmed enteric fever cases in Bangladesh, Nepal, and Pakistan.
methodsFrom September 2016-September 2019, SEAP recruited study participants of all age groups from its outpatient, inpatient, hospital laboratory, laboratory network, and surgical sites who had a diagnosis of febrile illness that was either suspected or blood culture confirmed for enteric fever. Antimicrobial resistance of isolates was determined by disc diffusion using Clinical and Laboratory Standard Institute cut-off points. We reported the frequency of multidrug resistance (MDR)(resistance to ampicillin, cotrimoxazole, and chloramphenicol), extensive drug resistance (XDR) (MDR plus non-susceptible to fluoroquinolone and any 3rd generation cephalosporins), and fluoroquinolone (FQ) and azithromycin non-susceptibility.
resultsWe enrolled 8,705 blood culture confirmed enteric fever cases: 4,873 (56%) from Bangladesh, 1,602 (18%) from Nepal and 2,230 (26%) from Pakistan. Of these, 7,591 (87%) were Salmonella Typhi and 1114 (13%) were S. Paratyphi. MDR S. Typhi was identified in 17% (701/4065) of isolates in Bangladesh, and 1% (19/1342) in Nepal. In Pakistan, 16 % (331/2084) of S. Typhi isolates were MDR, and 64% (1319/2074) were XDR. FQ nonsusceptibility among S. Typhi isolates was 98% in Bangladesh, 87% in Nepal, and 95% in Pakistan. Azithromycin non-susceptibility was detected in 77 (2%) in Bangladesh, 9 (.67%) in Nepal and 9 (.59%) isolates in Pakistan. In Pakistan, three (2%) S. Paratyphi isolates were MDR; no MDR S. Paratyphi was reported from Bangladesh or Nepal.
conclusionsAlthough AMR against S. Paratyphi was low across the three countries, there was widespread drug resistance among S. Typhi, including FQ non-susceptibility and the emergence of XDR S. Typhi in Pakistan, limiting treatment options. As typhoid conjugate vaccine (TCV) is rolled out, surveillance should continue to monitor changes in AMR to inform policies and to monitor drug resistance in S. Paratyphi, for which there is no vaccine.
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