Typhoid bacteria more resistant to antibiotics now: Lancet study
Typhoid-causing bacteria have increasingly become resistant to critically important antibiotics like quinolone, and have spread widely over the past 30 years, according to the study published in the Lancet, which also said that quinolone-resistant strains in India increased to more than 95% in the 2000s.
According to the study, quinolone-resistant strains accounted for more than 85% of S Typhi (the bacteria that causes Typhoid fever) in Bangladesh by the early 2000s, increasing to more than 95% in India, Pakistan and Nepal by 2010.
The mutations causing resistance to azithromycin-a widely used macrolide antibiotic-also have emerged at least seven times in the past 20 years, it said.
Analysis of more than 7,500 S Typhi genomes-mostly from South Asia-showed resistant strains have spread between countries at least 197 times in the past 30 years, according to the largest genome sequencing study of S Typhi that charted the emergence and spread of antibiotic-resistant strains.
The authors of the study performed whole-genome sequencing on 3,489 S Typhi isolates obtained from blood samples collected between 2014 and 2019 from people in Bangladesh, India, Nepal and Pakistan with confirmed cases of typhoid fever.
A collection of 4,169 S Typhi samples isolated from more than 70 countries between 1905 and 2018 was also sequenced and included in the analysis.
While multi-drug resistance to first-line antibiotics has generally declined in South Asia, strains resistant to macrolides and quinolones-two of the most important antibiotics-have risen sharply and spread frequently to other countries, the study said.
“The largest genome analysis of Salmonella enterica serovar Typhi (S Typhi) also reveals that resistant strains-almost all originating in South Asia-have spread to other countries nearly 200 times since 1990,” it said.
Typhoid fever is a global public health concern-there are some 11 million infections and more than 100,000 deaths every year. It is most prevalent in South Asia, accounting for 70% of the global disease burden.
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