Department of Medicine, University of Cambridge, Hinxton, Cambridge, United Kingdom.
Wellcome Sanger Institute, Wellcome Genome Campus, Hinxton, Cambridge, United Kingdom.
Clin Infect Dis. 2019 Mar 7;68(Suppl 2):S165-S170. doi: 10.1093/cid/ciy1111.
Multiple drug (antibiotic) resistance (MDR) has become a major threat to the treatment of typhoid and other infectious diseases. Since the 1970s, this threat has increased in Salmonella enterica serovar Typhi, driven in part by the emergence of successful genetic clades, such as haplotype H58, associated with the MDR phenotype. H58 S. Typhi can express multiple antibiotic resistance determinants while retaining the ability to efficiently transmit and persist within the human population. The recent identification of extensively drug resistant S. Typhi only highlights the dangers of ignoring this threat. Here we discuss the evolution of the S. Typhi MDR phenotype and consider options for management.
多重药物（抗生素）耐药性（MDR）已成为伤寒和其他传染病治疗的主要威胁。自 20 世纪 70 年代以来，这种威胁在肠炎沙门氏菌血清型 Typhi 中有所增加，部分原因是成功的遗传进化枝的出现，例如与 MDR 表型相关的单倍型 H58。H58 S. Typhi 可以表达多种抗生素耐药决定因素，同时保持在人群中高效传播和持续存在的能力。最近鉴定出广泛耐药的 S. Typhi 仅突出了忽视这一威胁的危险。在这里，我们讨论了 S. Typhi MDR 表型的进化，并考虑了管理的选择。
