ArticleTherapeutic advances in infectious disease
Clinical outcomes, environmental exposure factors, and antibiotic resistance patterns of extensively drug-resistant (XDR) typhoid fever in Pakistan: A prospective observational study.
Article in Therapeutic advances in infectious disease. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
Background: Extensively drug-resistant (XDR) typhoid fever is a major public health concern in Pakistan, with limited treatment options and rising morbidity. There is a limited amount of evidence available on the role of the environmental factors that may impact the severity of the disease in adults. Objectives: To evaluate clinical outcomes, antimicrobial resistance patterns, and environmental factors associated with disease severity among adults with XDR typhoid fever in Northern Punjab, Pakistan. Design: Prospective observational study. Methods: A prospective observational study was conducted from January 2024 to January 2025 at a tertiary care hospital in Northern Punjab. The enrollment occurred among adult patients (18- 60 years) with blood culture-confirmed XDR Results: Among 110 patients, meropenem (98.2%) and azithromycin (96.4%) showed the highest antimicrobial susceptibility. Contaminated drinking water, poor sanitation, street food and season of diagnosis were also significantly associated with severe disease (p<0.05). Conclusion: XDR typhoid fever in Northern Punjab was characterized by extensive antimicrobial resistance, while poor sanitation, contaminated drinking water, street food consumption, and season of diagnosis were significantly associated with severe disease. There is an immediate need to strengthen water, sanitation, antibiotic stewardship, and vaccination strategies. Registration: Not applicable.
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