Ancient Killer That Doctors Can No Longer Stop Is Spreading Worldwide: Study

A recent study warns that typhoid fever, an ancient disease that has plagued humanity for millennia, is rapidly evolving dangerous resistance to available antibiotics. While often overlooked in developed nations, this persistent threat remains a significant danger, particularly in our modern interconnected world.

Research published in 2022 indicates that Salmonella enterica serovar Typhi (S Typhi), the bacterium responsible for typhoid, is developing extensive drug resistance. This concerning trend sees highly resistant strains quickly replacing those that can still be treated with existing medications.
Currently, antibiotics are the sole effective treatment for typhoid. However, over the past three decades, S. Typhi's resistance to commonly used oral antibiotics has steadily increased and spread.

The study, which analyzed the genetic makeup of 3,489 S. Typhi strains collected between 2014 and 2019 from Nepal, Bangladesh, Pakistan, and India, revealed a significant rise in extensively drug-resistant (XDR) Typhi. These XDR strains are not only immune to older, frontline antibiotics such as ampicillin, chloramphenicol, and trimethoprim/sulfamethoxazole but are also showing increasing resistance to newer, critical antibiotics like fluoroquinolones and third-generation cephalosporins.

Compounding the problem, these highly resistant strains are spreading globally at an alarming pace. While the majority of XDR Typhi cases originate from South Asia, researchers have documented nearly 200 instances of international dissemination since 1990. The spread has primarily extended to Southeast Asia, as well as East and Southern Africa, with some typhoid "superbugs" also detected in Western countries including the United Kingdom, the United States, and Canada. This global spread underscores the urgent need for heightened surveillance and new treatment strategies.

Lead author, Dr Jason Andrews, Stanford University (USA), says: "The speed at which highly-resistant strains of S. Typhi have emerged and spread in recent years is a real cause for concern, and highlights the need to urgently expand prevention measures, particularly in countries at greatest risk. At the same time, the fact resistant strains of S. Typhi have spread internationally so many times also underscores the need to view typhoid control, and antibiotic resistance more generally, as a global rather than local problem."