Abstract
There have been several outbreaks of antimicrobial resistant (AMR) strains of Salmonella enterica serovar Typhi that cause extensively drug resistant (XDR) typhoid fever in Pakistan. It has been observed that many clinicians use serological diagnostic tests such as Widal agglutination, and TyphiDOT that detects IgM and IgG antibodies against the outer membrane protein of S. Typhi. However, it has been confirmed by many scientists that these test may lead to misdiagnosis against XDR S. Typhi. Due to lack of implementation strategies health authorities are unable to hamper Widal or TyphiDOT tests which are still practiced in many rural and urban areas.
Highlights
In Pakistan, since 2016 there have been several outbreaks of antimicrobial resistant (AMR) strains of Salmonella enterica serovar Typhi
Typhi are not recommended for diagnosis of typhoid fever [4,5]
There has been excessive usage of azithromycin during COVID-19 pandemic which may turn into havoc if azithromycin resistance strain appeared in near future [6]
Summary
In Pakistan, since 2016 there have been several outbreaks of antimicrobial resistant (AMR) strains of Salmonella enterica serovar Typhi Typhi) belonging to the H58 haplotype, that cause extensively drug resistant (XDR) typhoid fever [1]. Some of the H58 strains are resistant to chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole antibiotics [2]. Fluoroquinolones and ceftriaxone have shown resistance to S.
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