Antimicrobial resistant strains of Salmonella typhi: The role of illicit antibiotics sales, misuse, and self-medication practices in Pakistan.

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  • Additional Information
    • Source:
      Publisher: Elsevier Country of Publication: England NLM ID: 101487384 Publication Model: Print-Electronic Cited Medium: Internet ISSN: 1876-035X (Electronic) Linking ISSN: 18760341 NLM ISO Abbreviation: J Infect Public Health Subsets: MEDLINE
    • Publication Information:
      Original Publication: Oxford : Elsevier, 2008-
    • Subject Terms:
      Salmonella typhi* ; Typhoid Fever*/drug therapy ; Typhoid Fever*/epidemiology; Humans ; Anti-Bacterial Agents/pharmacology ; Anti-Bacterial Agents/therapeutic use ; Pakistan/epidemiology ; Fluoroquinolones
    • Abstract:
      Typhoid fever, caused by the bacterium Salmonella typhi, is an often-fatal illness prevalent in Africa and South Asia. The illness has seen an alarming rise in multi-drug-resistant (MDR) and extensive drug-resistant (XDR) strains, particularly in Pakistan. The MDR strain links to the H58 haplotype, and its XDR variant exhibits fluoroquinolone resistance due to an IncY plasmid. The increasing prevalence of these resistant strains is concerning, given the global antimicrobial resistance (AMR) issue. Causes include misuse of antibiotics in self-limiting infections and an unregulated drug market. Pakistan's Sindh province first reported the XDR typhoid strain, highlighting the urgent need to investigate the relationship between AMR development and external factors. This narrative review intends to scrutinize the state of AMR in Pakistan, considering illicit drug sales, healthcare worker education gaps, and self-medication behaviors.
      Competing Interests: Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.
      (Copyright © 2023 The Author(s). Published by Elsevier Ltd.. All rights reserved.)
    • Contributed Indexing:
      Keywords: Antibiotics; Antimicrobial Resistance; Multi-drug resistant; Pakistan; Typhoid
    • Accession Number:
      0 (Anti-Bacterial Agents)
      0 (Fluoroquinolones)
    • Publication Date:
      Date Created: 20230812 Date Completed: 20230911 Latest Revision: 20230911
    • Publication Date:
      20230911
    • Accession Number:
      10.1016/j.jiph.2023.08.003
    • Accession Number:
      37572573