Extensively Drug Resistant Typhoid Fever in Pakistan – Analysis of Current Situation

Abstract

Salmonella enterica are the pathogens that causes typhoid fever and it is the major leading cause of serious systemic infection encountered in Pakistan. Many antibiotics have been used to treat typhoid infection among which chloramphenicol was the first drug, later ampicillin and combination of trimethoprim and sulfamethoxazole (co-trimoxazole) was found to be effective for treating typhoid. Those drugs were known to be the first-line anti-microbial drugs. Emergence of resistance showed by the strains of Salmonella species against the first-line anti-microbial agents made this infection a serious concern in Pakistan. Such strains of pathogens are termed as MDR (multi-drug resistant). Recent cases of XDR (extensively drug resistant) strains of typhoid are also reported, in which pathogens have developed resistance not only against the first-line of therapy but also against second line antibiotics i.e. fluoroquinolones, and third-generation cephalosporin. This review study was conducted as an awareness move on the prevalence of MDR and XDR typhoid cases reported in Pakistan and data was collected through literature search from different sources by selecting relevant keywords. This study would help us in understanding the real picture of emergence and propagation of MDR and XDR typhoid in our population.