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. 2019 Mar 7;68(Suppl 2):S165-S170.
doi: 10.1093/cid/ciy1111.

Antibiotic Resistance and Typhoid

Zoe A Dyson  1 , Elizabeth J Klemm  1   2 , Sophie Palmer  1 , Gordon Dougan  1   2
Affiliations

Antibiotic Resistance and Typhoid

Zoe A Dyson et al. Clin Infect Dis. .

Abstract

Multiple drug (antibiotic) resistance (MDR) has become a major threat to the treatment of typhoid and other infectious diseases. Since the 1970s, this threat has increased in Salmonella enterica serovar Typhi, driven in part by the emergence of successful genetic clades, such as haplotype H58, associated with the MDR phenotype. H58 S. Typhi can express multiple antibiotic resistance determinants while retaining the ability to efficiently transmit and persist within the human population. The recent identification of extensively drug resistant S. Typhi only highlights the dangers of ignoring this threat. Here we discuss the evolution of the S. Typhi MDR phenotype and consider options for management.

Keywords: S. Typhi; H58; MDR; multiple drug resistance; typhoid.

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Figures

Figure 1.
Figure 1.
Outline genetic structure of XDR S. Typhi in Pakistan. A, Oval outlines represent individual bacteria harboring chromosome (wiggly, green) and plasmid (red and blue circles) elements. Red and blue triangles represent acquired resistance loci. Small purple triangles represent SNPs in the chromosome associated with resistance. B, Detailed structures with color codes as per A of the different acquired resistance elements on plasmid and chromosome. Abbreviations: AMR, antimicrobial resistance; MDR, multiple drug resistance; SNP, single nucleotide polymorphism; XDR, extensively drug resistant.
See this image and copyright information in PMC

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