Muhammad Ahmed Abdullah, Babar Tasneem Shaikh, Maryam Ashraf, Shahzad Ali Khan
{"title":"巴基斯坦的广泛耐药伤寒:对全球卫生安全的威胁和对抗菌药物管理的警钟。","authors":"Muhammad Ahmed Abdullah, Babar Tasneem Shaikh, Maryam Ashraf, Shahzad Ali Khan","doi":"10.1371/journal.pntd.0013067","DOIUrl":null,"url":null,"abstract":"<p><p>Extensively drug-resistant (XDR) typhoid, caused by Salmonella enterica serotype Typhi, has emerged as a critical global health security threat, with Pakistan, particularly Sindh province, at its epicenter. The misuse of antibiotics, inadequate diagnostic tools, and poor water and sanitation infrastructure have created ideal conditions for the rise of antimicrobial resistance (AMR). XDR typhoid strains resistant to multiple first-line antibiotics have been linked to environmental contamination, with urban areas like Karachi demonstrating high rates of waterborne transmission. International travel has amplified this threat, exporting cases to countries including the United States, the United Kingdom, and Canada, thus highlighting its global implications. This commentary examines the historical context of typhoid treatment, the drivers of AMR in Pakistan, and the critical role of antimicrobial stewardship in combating XDR typhoid. It advocates for an integrated approach that would encompass improvements in water quality, expanded vaccination coverage with typhoid conjugate vaccines (TCVs), and stringent audit of antibiotic prescription practices. Immediate local and global action is needed to contain this public health crisis and prevent the resurgence of typhoid as a largely untreatable disease. This situation underscores the urgency of addressing AMR to safeguard global health security.</p>","PeriodicalId":49000,"journal":{"name":"PLoS Neglected Tropical Diseases","volume":"19 5","pages":"e0013067"},"PeriodicalIF":3.4000,"publicationDate":"2025-05-12","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068562/pdf/","citationCount":"0","resultStr":"{\"title\":\"XDR typhoid in Pakistan: A threat to global health security and a wake-up call for antimicrobial stewardship.\",\"authors\":\"Muhammad Ahmed Abdullah, Babar Tasneem Shaikh, Maryam Ashraf, Shahzad Ali Khan\",\"doi\":\"10.1371/journal.pntd.0013067\",\"DOIUrl\":null,\"url\":null,\"abstract\":\"<p><p>Extensively drug-resistant (XDR) typhoid, caused by Salmonella enterica serotype Typhi, has emerged as a critical global health security threat, with Pakistan, particularly Sindh province, at its epicenter. The misuse of antibiotics, inadequate diagnostic tools, and poor water and sanitation infrastructure have created ideal conditions for the rise of antimicrobial resistance (AMR). XDR typhoid strains resistant to multiple first-line antibiotics have been linked to environmental contamination, with urban areas like Karachi demonstrating high rates of waterborne transmission. International travel has amplified this threat, exporting cases to countries including the United States, the United Kingdom, and Canada, thus highlighting its global implications. This commentary examines the historical context of typhoid treatment, the drivers of AMR in Pakistan, and the critical role of antimicrobial stewardship in combating XDR typhoid. It advocates for an integrated approach that would encompass improvements in water quality, expanded vaccination coverage with typhoid conjugate vaccines (TCVs), and stringent audit of antibiotic prescription practices. Immediate local and global action is needed to contain this public health crisis and prevent the resurgence of typhoid as a largely untreatable disease. This situation underscores the urgency of addressing AMR to safeguard global health security.</p>\",\"PeriodicalId\":49000,\"journal\":{\"name\":\"PLoS Neglected Tropical Diseases\",\"volume\":\"19 5\",\"pages\":\"e0013067\"},\"PeriodicalIF\":3.4000,\"publicationDate\":\"2025-05-12\",\"publicationTypes\":\"Journal Article\",\"fieldsOfStudy\":null,\"isOpenAccess\":false,\"openAccessPdf\":\"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12068562/pdf/\",\"citationCount\":\"0\",\"resultStr\":null,\"platform\":\"Semanticscholar\",\"paperid\":null,\"PeriodicalName\":\"PLoS Neglected Tropical Diseases\",\"FirstCategoryId\":\"3\",\"ListUrlMain\":\"https://doi.org/10.1371/journal.pntd.0013067\",\"RegionNum\":2,\"RegionCategory\":\"医学\",\"ArticlePicture\":[],\"TitleCN\":null,\"AbstractTextCN\":null,\"PMCID\":null,\"EPubDate\":\"2025/5/1 0:00:00\",\"PubModel\":\"eCollection\",\"JCR\":\"Q1\",\"JCRName\":\"PARASITOLOGY\",\"Score\":null,\"Total\":0}","platform":"Semanticscholar","paperid":null,"PeriodicalName":"PLoS Neglected Tropical Diseases","FirstCategoryId":"3","ListUrlMain":"https://doi.org/10.1371/journal.pntd.0013067","RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":null,"EPubDate":"2025/5/1 0:00:00","PubModel":"eCollection","JCR":"Q1","JCRName":"PARASITOLOGY","Score":null,"Total":0}
XDR typhoid in Pakistan: A threat to global health security and a wake-up call for antimicrobial stewardship.
Extensively drug-resistant (XDR) typhoid, caused by Salmonella enterica serotype Typhi, has emerged as a critical global health security threat, with Pakistan, particularly Sindh province, at its epicenter. The misuse of antibiotics, inadequate diagnostic tools, and poor water and sanitation infrastructure have created ideal conditions for the rise of antimicrobial resistance (AMR). XDR typhoid strains resistant to multiple first-line antibiotics have been linked to environmental contamination, with urban areas like Karachi demonstrating high rates of waterborne transmission. International travel has amplified this threat, exporting cases to countries including the United States, the United Kingdom, and Canada, thus highlighting its global implications. This commentary examines the historical context of typhoid treatment, the drivers of AMR in Pakistan, and the critical role of antimicrobial stewardship in combating XDR typhoid. It advocates for an integrated approach that would encompass improvements in water quality, expanded vaccination coverage with typhoid conjugate vaccines (TCVs), and stringent audit of antibiotic prescription practices. Immediate local and global action is needed to contain this public health crisis and prevent the resurgence of typhoid as a largely untreatable disease. This situation underscores the urgency of addressing AMR to safeguard global health security.
期刊介绍:
PLOS Neglected Tropical Diseases publishes research devoted to the pathology, epidemiology, prevention, treatment and control of the neglected tropical diseases (NTDs), as well as relevant public policy.
The NTDs are defined as a group of poverty-promoting chronic infectious diseases, which primarily occur in rural areas and poor urban areas of low-income and middle-income countries. Their impact on child health and development, pregnancy, and worker productivity, as well as their stigmatizing features limit economic stability.
All aspects of these diseases are considered, including:
Pathogenesis
Clinical features
Pharmacology and treatment
Diagnosis
Epidemiology
Vector biology
Vaccinology and prevention
Demographic, ecological and social determinants
Public health and policy aspects (including cost-effectiveness analyses).