MDR and XDR typhoid fever-a threat for the current decade?

Abstract

Salmonella typhi is a gram-negative, flagellated, rod-shaped bacterium that is responsible for typhoid fever. Salmonella typhi infections are found only in humans and are spread by polluted water sources and poor hygiene practices, such as fecal contamination of edibles, insufficient hand washing, and so on. Despite significant advancements in health care delivery and medicine, millions of people around the world are at risk of contracting typhoid and paratyphoid fever as a result of exposure to the causative organism, which can result in disabilities and even death [1]. The African continent has had the world's highest case fatality rate and the longest median period of typhoid fever [2]. The World Health Organization in 2010 projected that the global burden of foodborne diseases was 33 million disability-adjusted life years (DALYs). Further to that, Africa has the largest incidence of food-borne diseases per household [3]. Inadequate sanitary practices have also contributed to an uptick in typhoid outbreaks following the COVID-19 pandemic. Previously, the discovery of new drugs to treat typhoid fever saved millions of lives all over the world. Unfortunately, decades of antibiotic use have resulted in the development of multidrug-resistant and extensively drug-resistant Salmonella typhi strains. In the case of typhoid fever, multidrug resistance (MDR) stands for resistance to Ampicillin, Trimethoprim-Sulfamethoxazole, and Chloramphenicol, whereas Extensive drug resistance (XDR) stands for Chloramphenicol, Ampicillin, Trimethoprim-Sulfamethoxazole, Fluoroquinolones, and third-generation Cephalosporin resistance.