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Abstract

We describe a ceftriaxone-resistant Typhi bacteraemia in a pregnant woman returning from a family visit in Pakistan. Whole genome sequencing confirmed similarity to a Pakistani outbreak clone. Pregnancy and unawareness of this outbreak delayed appropriate antibiotic therapy. Concurrently, we detected faecal carriage of a carbapenemase-producing Awareness of the ongoing outbreak should affect empiric treatment of typhoid fever and hygiene precautions in travellers returning from Pakistan. Meropenem may be warranted in severe cases.

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/content/10.2807/1560-7917.ES.2019.24.21.1900289
2019-05-23
2024-04-23
http://instance.metastore.ingenta.com/content/10.2807/1560-7917.ES.2019.24.21.1900289
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References

  1. World Health Organization (WHO). Typhoid. Geneva: WHO. [Accessed: 6 May 2019]. Available from: https://www.who.int/immunization/diseases/typhoid/en/
  2. Qamar FN, Yousafzai MT, Khalid M, Kazi AM, Lohana H, Karim S, et al. Outbreak investigation of ceftriaxone-resistant Salmonella enterica serotype Typhi and its risk factors among the general population in Hyderabad, Pakistan: a matched case-control study. Lancet Infect Dis. 2018;18(12):1368-76.  https://doi.org/10.1016/S1473-3099(18)30483-3  PMID: 30507460 
  3. European Committee on Antimicrobial Susceptibility Testing (EUCAST). Clinical Breakpoints – bacteria (version 9.0). Basel: European Society of Clinical Microbiology and Infectious Diseases. [Accessed: 21 May 2019]. Available from: http://www.eucast.org/clinical_breakpoints/
  4. Klemm EJ, Shakoor S, Page AJ, Qamar FN, Judge K, Saeed DK, et al. Emergence of an extensively drug-resistant Salmonella enterica serovar Typhi clone harboring a promiscuous plasmid encoding resistance to fluoroquinolones and third-generation cephalosporins. MBio. 2018;9(1):e00105-18.  https://doi.org/10.1128/mBio.00105-18  PMID: 29463654 
  5. Sahl JW, Lemmer D, Travis J, Schupp JM, Gillece JD, Aziz M, et al. NASP: an accurate, rapid method for the identification of SNPs in WGS datasets that supports flexible input and output formats. Microb Genom. 2016;2(8):e000074.  https://doi.org/10.1099/mgen.0.000074  PMID: 28348869 
  6. Parkhill J, Dougan G, James KD, Thomson NR, Pickard D, Wain J, et al. Complete genome sequence of a multiple drug resistant Salmonella enterica serovar Typhi CT18. Nature. 2001;413(6858):848-52.  https://doi.org/10.1038/35101607  PMID: 11677608 
  7. The World Health Organization Regional Office for the Eastern Mediterranean (WHO Eastern Mediterranean Region). Current outbreaks in the WHO Eastern Mediterranean Region. Cairo: WHO Eastern Mediterranean Region. [Accessed: 6 May 2019]. Available from: http://www.emro.who.int/pandemic-epidemic-diseases/outbreaks/index.html
  8. Cohen J. ‘Frightening’ typhoid fever outbreak spreads in Pakistan. Science. 2018;361(6399):214.  https://doi.org/10.1126/science.361.6399.214  PMID: 30026207 
  9. Chatham-Stephens K, Medalla F, Hughes M, Appiah GD, Aubert RD, Caidi H, et al. Emergence of extensively drug-resistant Salmonella Typhi infections among travelers to or from Pakistan - United States, 2016-2018. MMWR Morb Mortal Wkly Rep. 2019;68(1):11-3.  https://doi.org/10.15585/mmwr.mm6801a3  PMID: 30629573 
  10. Thwaites GE, Day NP. Approach to fever in the returning traveler. N Engl J Med. 2017;376(6):548-60.  https://doi.org/10.1056/NEJMra1508435  PMID: 28177860 
  11. Fallon RJ, Mandal BK, Mayon-White RT, Scott AC. Assessment of antimicrobial treatment of acute typhoid and paratyphoid fevers in Britain and The Netherlands 1971-1980. J Infect. 1988;16(2):129-34.  https://doi.org/10.1016/S0163-4453(88)93872-8  PMID: 3127475 
  12. Jones DA, Kudlac H, Edwards IR. Pivmecillinam and relapse of typhoid fever. J Infect Dis. 1982;145(5):773.  https://doi.org/10.1093/infdis/145.2.773  PMID: 6281342 
  13. Mandal BK, Ironside AG, Brennand J. Mecillinam in enteric fever. BMJ. 1979;1(6163):586-7.  https://doi.org/10.1136/bmj.1.6163.586  PMID: 218670 
  14. Effa EE, Lassi ZS, Critchley JA, Garner P, Sinclair D, Olliaro PL, et al. Fluoroquinolones for treating typhoid and paratyphoid fever (enteric fever). Cochrane Database Syst Rev. 2011; (10):CD004530.  https://doi.org/10.1002/14651858.CD004530.pub4  PMID: 21975746 
  15. Harris PNA, Tambyah PA, Lye DC, Mo Y, Lee TH, Yilmaz M, et al. Effect of piperacillin-tazobactam vs meropenem on 30-day mortality for patients with E coli or Klebsiella pneumoniae bloodstream infection and ceftriaxone resistance: a randomized clinical trial. JAMA. 2018;320(10):984-94.  https://doi.org/10.1001/jama.2018.12163  PMID: 30208454 
  16. Sulaiman K, Sarwari AR. Culture-confirmed typhoid fever and pregnancy. Int J Infect Dis. 2007;11(4):337-41.  https://doi.org/10.1016/j.ijid.2006.09.007  PMID: 17321180 
  17. Nordahl Petersen T, Rasmussen S, Hasman H, Carøe C, Bælum J, Schultz AC, et al. Meta-genomic analysis of toilet waste from long distance flights; a step towards global surveillance of infectious diseases and antimicrobial resistance. Sci Rep. 2015;5(1):11444.  https://doi.org/10.1038/srep11444  PMID: 26161690 
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