ArticlePLoS neglected tropical diseases2025
Detection of Salmonella Typhi and blaCTX-M genes in drinking water, wastewater, and environmental biofilms in Sindh Province, Pakistan.
Article in PLoS neglected tropical diseases, 2025. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 4 papers, 1 of them a synthesis that pooled it.
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Who cites it
4 citing papers in PubMed, 1 synthesis or guideline pooled it.
- Systematic review on the laboratory methodology for conducting wastewater and environmental surveillance forFrontiers in public health · 2026Pooled it
- Socio-economic impact of antimicrobial resistance in Pakistan: a comprehensive review.Frontiers in public health · 2026Review
- Clinical outcomes, environmental exposure factors, and antibiotic resistance patterns of extensively drug-resistant (XDR) typhoid fever in Pakistan: A prospective observational study.Therapeutic advances in infectious diseaseArticle
- Clinical Characteristics and Resistance Patterns of Extensively Drug-ResistantSage open pediatricsArticle
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Authors and funding
5 authors.
Funding
Abstract
Typhoid fever poses a significant public health risk, particularly in low- and middle-income countries where access to clean water and improved sanitation may be limited. In Pakistan, this risk is especially serious given the emergence of an extensively drug-resistant (XDR) Salmonella Typhi strain, a strain attributed to S. Typhi acquisition of the blaCTX-M-15 gene. The now-dominant XDR S. Typhi strain, non-XDR S. Typhi, and blaCTX-M genes are readily disseminated via drinking water and wastewater in Pakistan and may also be present in biofilm associated with these environmental sources. This study investigates the presence of S. Typhi and blaCTX-M genes within these environmental compartments. Drinking water (n=35) or wastewater samples (n=35) and samples of their associated biofilms were collected in Karachi and Hyderabad, Pakistan. Samples were tested by PCR for S. Typhi and blaCTX-M group 1 genes as a proxy for blaCTX-M-15. Heterotrophic plate counts (HPC) were conducted to assess microbial load. S. Typhi was detected by PCR in one bulk wastewater sample and one drinking water biofilm. BlaCTX-M group 1 genes were detected in all sample types and were detected more frequently in bulk wastewater (n=13/35) than in drinking water (n=2/35) and more frequently overall in biofilm samples (n=22/70) versus bulk water (n=15/70). Detection of blaCTX-M in biofilm was not significantly associated with detection in the associated bulk water sample. This study marks the first detection of S. Typhi in drinking water biofilm and the first report of blaCTX-M genes in environmental biofilm in Pakistan. Environmental biofilm, particularly in drinking water systems, may serve as reservoirs for human exposure to S. Typhi and drug resistance genes. This study underscores the importance of expanding surveillance strategies to include biofilm sampling, providing valuable insights into pathogen dissemination in water systems, and informing targeted public health interventions to prevent waterborne diseases.
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