Importation of Extensively Drug-Resistant Salmonella enterica Serovar Typhi Cases in Ontario, Canada

Antimicrob Agents Chemother. 2020 Apr 21;64(5):e02581-19. doi: 10.1128/AAC.02581-19. Print 2020 Apr 21.

Abstract

A strain of extensively drug-resistant (XDR) Salmonella enterica serovar Typhi has caused a large ongoing outbreak in Pakistan since 2016. In Ontario, Canada, 10 cases of mainly bloodstream infections (n = 9) were identified in patients who traveled to Pakistan. Whole-genome sequencing showed that Canadian cases were genetically related to the Pakistan outbreak strain. The appearance of XDR typhoid cases in Ontario prompted a provincial wide alert to physicians to recommend treatment with carbapenems or azithromycin in suspected typhoid cases with travel history to Pakistan.

Keywords: XDR; antibiotic resistance; ceftriaxone; extensively drug resistant; typhoid fever; whole genome.

Publication types

  • Research Support, Non-U.S. Gov't

MeSH terms

  • Anti-Bacterial Agents / therapeutic use
  • Azithromycin / therapeutic use
  • Carbapenems / therapeutic use
  • Drug Resistance, Multiple, Bacterial*
  • Humans
  • Microbial Sensitivity Tests
  • Ontario / epidemiology
  • Pakistan
  • Salmonella enterica / drug effects*
  • Salmonella enterica / genetics
  • Travel
  • Typhoid Fever / drug therapy
  • Typhoid Fever / epidemiology*
  • Typhoid Fever / microbiology*
  • Whole Genome Sequencing

Substances

  • Anti-Bacterial Agents
  • Carbapenems
  • Azithromycin