Salmonella Typhi infection in a patient in Pakistan initially responded to standard treatment but failed to respond to subsequent treatment. The first strain was susceptible to carbapenems and azithromycin; subsequent strains harbored the NDM-5 gene. Treatment with a combination of intravenous meropenem and colistin was successful. Carbapenem-resistant Salmonella Typhi emergence will hinder treatment.
Keywords: Pakistan; Salmonella Typhi; Salmonella enteria serovar Typhi; antimicrobial resistance; bacteria; carbapenem resistance; diagnosis; therapy; typhoid fever.