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

Author:

Eshaghi Alireza1,Zittermann Sandra1,Bharat Amrita2,Mulvey Michael R.2,Allen Vanessa G.13,Patel Samir N.13

Affiliation:

1. Public Health Ontario Laboratory, Public Health Ontario, Toronto, Ontario, Canada

2. National Microbiology Laboratory, Public Health Agency of Canada, Winnipeg, Manitoba, Canada

3. Department of Laboratory Medicine and Pathobiology, University of Toronto, Toronto, Ontario, Canada

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.

Publisher

American Society for Microbiology

Subject

Infectious Diseases,Pharmacology (medical),Pharmacology

Reference13 articles.

1. Burden of typhoid fever in low-income and middle-income countries: a systematic, literature-based update with risk-factor adjustment

2. Government of Canada. 2019. Prevention of typhoid fever. https://www.canada.ca/en/public-health/services/diseases/typhoid-fever/prevention.html.

3. Multidrug resistant enteric fever in South Asia: unmet medical needs and opportunities

4. Emergence of an Extensively Drug-Resistant Salmonella enterica Serovar Typhi Clone Harboring a Promiscuous Plasmid Encoding Resistance to Fluoroquinolones and Third-Generation Cephalosporins

5. Disease outbreaks in eastern Mediterranean region (EMR);World Health Organization, WHO Regional Office for Eastern Mediterranean;Wkly Epidemiol Monit,2018

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