Department of Medicine, Ziauddin University, Karachi, Pakistan.
Department of Medicine, Liaquat National Hospital and Medical College, Karachi, Pakistan.
J Infect Public Health. 2023 Oct;16(10):1591-1597. doi: 10.1016/j.jiph.2023.08.003. Epub 2023 Aug 3.
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.
伤寒，由伤寒沙门氏菌引起，是一种常见于非洲和南亚的致命疾病。这种疾病的多药耐药（MDR）和广泛耐药（XDR）菌株数量惊人增加，尤其是在巴基斯坦。MDR 菌株与 H58 单倍型有关，其 XDR 变体由于 IncY 质粒而表现出氟喹诺酮耐药性。鉴于全球抗菌药物耐药性（AMR）问题，这些耐药菌株的流行令人担忧。造成这种情况的原因包括在自限性感染中滥用抗生素和不受监管的药品市场。巴基斯坦信德省首次报告了 XDR 伤寒菌株，这凸显了迫切需要调查 AMR 发展与外部因素之间的关系。本叙述性综述旨在审查巴基斯坦的 AMR 状况，考虑非法毒品销售、医疗保健工作者教育差距和自我用药行为。
