The first Italian case of XDR Salmonella Typhi in a traveler returning from Pakistan, 2019: An alert for increased surveillance also in European countries?

Chirico, Claudia; Tomasoni, Lina Rachele; Corbellini, Silvia; Francesco, Maria Antonia De; Caruso, Arnaldo; Scaltriti, Erika; Buccino, Silvia; Gregori, Natalia; Caligaris, Silvio; Castelli, Francesco

doi:10.1016/j.tmaid.2020.101610

Cited by 12 publications

(6 citation statements)

References 4 publications

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“…Salmonella Typhi transfer from human to human via faecal-oral route and by contaminated water. Typhoid fever is a severe public health concern specially in under-developed countries with 128 000-161 000 deaths each year (Crump et al 2004;Chirico et al 2020). During 2016-2017, more than 300 cases of extensively drug-resistant (XDR) S. Typhi strain were reported in Pakistan (Klemm et al 2018).…”

Section: Introductionmentioning

confidence: 99%

Antibiotyping and genotyping of extensively drug‐resistant (XDR) Salmonella sp. isolated from clinical samples of Lahore, Pakistan

Zahid

Sarwar

Hussain

et al. 2021

J of Applied Microbiology

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Aims Antibiotic resistance is a major problem in Salmonella enterica serovar Typhi. The objective of this study was to evaluate the prevalence of XDR Salmonella among local population of Lahore and genotyping of isolates for antibiotic‐resistant genes. Methods and Results A total of 200 blood samples from suspected typhoid fever patients were collected. One hundred and fifty‐seven bacterial samples were confirmed as Salmonella Typhi and 23 samples were confirmed as Salmonella Paratyphi after biochemical, serological and PCR based molecular characterization. Antibiogram analysis classified 121 (67·2%) Salmonella isolates as MDR and 62 isolates (34·4%) as XDR. The predominant resistance gene was ampC with 47·7% prevalence, followed by gyrA, catA1, tet(A), aac (3)‐la, qnrS, blaNDM‐1 and blaCTX‐M‐15 genes in 45·5, 40, 21·6, 18·3, 11·6, 2·2 and 0·5% isolates respectively. Sequence analysis showed the presence of sul1 and dfrA7 gene cassette arrays in 12 class 1 integron integrase positive isolates. Conclusion Large number of clinical XDR S. Typhi‐resistant against third generation cephalosporins have been reported. Significance and Impact of the Study The current study highlights the possible emergence of clinical XDR S. Typhi cases in Lahore, Pakistan. Potential attribution of phenotypic and genotypic XDR cases may help to contribute targeted therapy.

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Section: Introductionmentioning

confidence: 99%

Antibiotyping and genotyping of extensively drug‐resistant (XDR) Salmonella sp. isolated from clinical samples of Lahore, Pakistan

Zahid

Sarwar

Hussain

et al. 2021

J of Applied Microbiology

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“…Recent reports from the WHO documented the first major outbreak of XDR typhoid infection, with 5274 cases from 8188 patients contracting typhoid fever in Hyderabad, Sindh, Pakistan, from November 2016 to December 2018 (WHO, 2018). Between late 2018 and early 2019, international transmission of XDR-related typhoid infections occurred in the United States, the United Kingdom and Canada from Pakistan (Akram et al, 2020;Chirico et al, 2020;Godbole et al, 2018;Wong, Rawahi, et al, 2019). As an alarming decline in the anti-Salmonella activity of azithromycin has been noticed recently, clinicians have been prescribing tigecycline, carbapenems and azithromycin (the newest line of antibiotics) to treat the critical infections caused by XDR S. Typhi since 2019 (Capoor et al, 2009;Kleine et al, 2017;Tang et al, 2016).…”

Section: His Tory Of Antimicrob Ial Re S Is Tan Ce In Salmon Ell a T ...mentioning

confidence: 99%

Defying the odds: Determinants of the antimicrobial response of Salmonella Typhi and their interplay

Chowdhury,

Mukherjee,

Chatterjee

et al. 2023

Molecular Microbiology

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Salmonella Typhi, the invasive serovar of S. enterica subspecies enterica, causes typhoid fever in healthy human hosts. The emergence of antibiotic‐resistant strains has consistently challenged the successful treatment of typhoid fever with conventional antibiotics. Antimicrobial resistance (AMR) in Salmonella is acquired either by mutations in the genomic DNA or by acquiring extrachromosomal DNA via horizontal gene transfer. In addition, Salmonella can form a subpopulation of antibiotic persistent (AP) cells that can survive at high concentrations of antibiotics. These have reduced the effectiveness of the first and second lines of antibiotics used to treat Salmonella infection. The recurrent and chronic carriage of S. Typhi in human hosts further complicates the treatment process, as a remarkable shift in the immune response from pro‐inflammatory Th1 to anti‐inflammatory Th2 is observed. Recent studies have also highlighted the overlap between AP, persistent infection (PI) and AMR. These incidents have revealed several areas of research. In this review, we have put forward a timeline for the evolution of antibiotic resistance in Salmonella and discussed the different mechanisms of the same availed by the pathogen at the genotypic and phenotypic levels. Further, we have presented a detailed discussion on Salmonella antibiotic persistence (AP), PI, the host and bacterial virulence factors that can influence PI, and how both AP and PI can lead to AMR.

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“…A study reported in 2018 that S. Typhi infections were also on a higher rate in Pakistan among all the south East Asian countries (Watkins et al 2020). As in Sindh province first large-scale outbreak, 493.5 cases were reported among 100,000 population (Klemm et al 2018;Fatima et al 2021), while in Punjab reports were similar (Saeed et al 2020;Kim et al 2021;Nizamuddin et al 2021) as well as among international travellers (Godbole et al 2018;Chirico et al 2020;Watkins et al 2020). Outbreaks of a new subvariant of extensively drug resistance (XDR) S. typhi emerged in Pakistan in the province Sindh (WHO 2019).…”

Section: Salmonella Outbreaksmentioning

confidence: 99%

Salmonella Resistance in Broiler Chicken: Risk to Human Health

2023

IJAB

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Salmonella is the most common zoonotic foodborne pathogen of economic status in animals and humans. The natural habitat of Salmonella is the gastrointestinal tract (GIT) of domestic and wild animals, part of diverse foodstuffs of both animal and plant origin, that become infected directly or indirectly with Salmonella. Most domestic and wild animals are infected with Salmonella spp. with no signs of illness. Due to increasing antibiotic resistance of Salmonella, poultry food and feedstuff became the main source of infection for humans. Appropriate risk analysis and effective control measures could reduce the prevalence of Salmonellosis at production and processing sites, that eventually, improves human health and be beneficial for mankind.

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The first Italian case of XDR Salmonella Typhi in a traveler returning from Pakistan, 2019: An alert for increased surveillance also in European countries?

Cited by 12 publications

References 4 publications

Antibiotyping and genotyping of extensively drug‐resistant (XDR) Salmonella sp. isolated from clinical samples of Lahore, Pakistan

Antibiotyping and genotyping of extensively drug‐resistant (XDR) Salmonella sp. isolated from clinical samples of Lahore, Pakistan

Defying the odds: Determinants of the antimicrobial response of Salmonella Typhi and their interplay

Salmonella Resistance in Broiler Chicken: Risk to Human Health

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