ArticlePLoS neglected tropical diseases2023
Trends in antimicrobial resistance amongst Salmonella Paratyphi A isolates in Bangladesh: 1999-2021.
Article in PLoS neglected tropical diseases, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 7 papers.
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Who cites it
7 citing papers in PubMed, 10 citations in OpenAlex.
- Azithromycin Resistance in Salmonella Typhi and Paratyphi Across South Asia: A Systematic Review and Meta-Analysis.Open forum infectious diseases · 2026Review
- Clinical and Antimicrobial Resistance Patterns of Salmonella enterica Serovar Paratyphi A Infections in Pediatric Population.Indian pediatrics · 2026Article
- Comparative Epidemiology of Salmonella enterica Serovers Paratyphi A and Typhi Causing Enteric Fever, Bangladesh, 2018-2020.Emerging infectious diseases · 2025Article
- Paratyphoid fever and the genomics of Salmonella enterica serovar Paratyphi A in Taiwan.PLoS neglected tropical diseases · 2025Article
- Ciprofloxacin resistance and bile-induced biofilm enhancement inNew microbes and new infections · 2025Article
- Trends in antimicrobial resistance amongst Salmonella Typhi in Bangladesh: A 24-year retrospective observational study (1999-2022).PLoS neglected tropical diseases · 2024Observational
- Typhoid & paratyphoid vaccine development in the laboratory: a review & in-country experience.The Indian journal of medical research · 2024Review
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Authors and funding
17 authors at 5 institutions in 2 countries.
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No grant is acknowledged in the PubMed record.
Abstract
backgroundTyphoid and paratyphoid remain common bloodstream infections in areas with suboptimal water and sanitation infrastructure. Paratyphoid, caused by Salmonella Paratyphi A, is less prevalent than typhoid and its antimicrobial resistance (AMR) trends are less documented. Empirical treatment for paratyphoid is commonly based on the knowledge of susceptibility of Salmonella Typhi, which causes typhoid. Hence, with rising drug resistance in Salmonella Typhi, last-line antibiotics like ceftriaxone and azithromycin are prescribed for both typhoid and paratyphoid. However, unlike for typhoid, there is no vaccine to prevent paratyphoid. Here, we report 23-year AMR trends of Salmonella Paratyphi A in Bangladesh.
methodsFrom 1999 to 2021, we conducted enteric fever surveillance in two major pediatric hospitals and three clinics in Dhaka, Bangladesh. Blood cultures were performed at the discretion of the treating physicians; cases were confirmed by culture, serological and biochemical tests. Antimicrobial susceptibility was determined following CLSI guidelines.
resultsOver 23 years, we identified 2,725 blood culture-confirmed paratyphoid cases. Over 97% of the isolates were susceptible to ampicillin, chloramphenicol, and cotrimoxazole, and no isolate was resistant to all three. No resistance to ceftriaxone was recorded, and >99% of the isolates were sensitive to azithromycin. A slight increase in minimum inhibitory concentration (MIC) is noticed for ceftriaxone but the current average MIC is 32-fold lower than the resistance cut-off. Over 99% of the isolates exhibited decreased susceptibility to ciprofloxacin.
conclusionsSalmonella Paratyphi A has remained susceptible to most antibiotics, unlike Salmonella Typhi, despite widespread usage of many antibiotics in Bangladesh. The data can guide evidence-based policy decisions for empirical treatment of paratyphoid fever, especially in the post typhoid vaccine era, and with the availability of new paratyphoid diagnostics.
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