First Case of Azithromycin Resistance in Salmonella Typhi, Isolated in a Patient with Prosthetic Valve Replacement

Salmonella enterica serovar Typhi (S. Typhi) is one of the typhoidal Salmonellae that causes typhoid fever. We report the first case of an XDR S. Typhi in a suspected case of Endocarditis with Aortic Valve Replacement and deranged INR. The identification was carried out by an automated system. The antibiogram was performed according to CLSI recommendations. The XDR S. Typhi isolates were found resistant to Azithromycin. Although XDR S. Typhi has been reported in our country and elsewhere, however, till to date no complete resistant isolate of S. Typhi to Azithromycin has been reported in Pakistan. The patient had a smooth recovery on intravenous meropenem. The case highlights the importance of the acquisition of resistance to the last line antibiotics in S. Typhi in our country and is of concern to infectious disease specialists to ensure infection control to avoid its spread. J Microbiol Infect Dis 2021; 11(1):32-35.