{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,27]],"date-time":"2026-10-27T15:27:09Z","timestamp":1793114829680,"version":"4.5.0"},"reference-count":42,"publisher":"SAGE Publications","license":[{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"},{"start":{"date-parts":[[2026,1,1]],"date-time":"2026-01-01T00:00:00Z","timestamp":1767225600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/journals.sagepub.com\/page\/policies\/text-and-data-mining-license"}],"content-domain":{"domain":["journals.sagepub.com"],"crossmark-restriction":true},"short-container-title":["Sage Open Pediatrics"],"published-print":{"date-parts":[[2026,1]]},"abstract":"<jats:sec>\n                    <jats:title>Objectives:<\/jats:title>\n                    <jats:p>\n                      To describe the demographics, clinical characteristics, antimicrobial resistance profiles, and treatment responses of pediatric XDR\n                      <jats:italic toggle=\"yes\">Salmonella Typhi<\/jats:italic>\n                      in Northern Punjab, Pakistan, and assess their association with disease severity.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Introduction:<\/jats:title>\n                    <jats:p>\n                      XDR\n                      <jats:italic toggle=\"yes\">Salmonella enterica serovar Typhi<\/jats:italic>\n                      poses a major pediatric health challenge in Pakistan due to limited treatment options, relapse risk, and contaminated water exposure.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods:<\/jats:title>\n                    <jats:p>\n                      A prospective cohort study was conducted at POF Hospital, Northern Punjab (January 2024-January 2025), enrolling 65 children (1-12\u2009years) with culture-confirmed XDR\n                      <jats:italic toggle=\"yes\">S. Typhi<\/jats:italic>\n                      . Clinical, laboratory, and treatment data were analyzed using Chi-square tests.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results:<\/jats:title>\n                    <jats:p>\n                      Most patients (60%) were aged 5 to 10\u2009years; vomiting (69.2%) and headache (47.7%) were frequent. All isolates were resistant to ceftriaxone, ciprofloxacin, and first-line agents; meropenem and azithromycin remained 100% and 96.9% susceptible. Severe disease was associated with delayed fever clearance (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.001) and longer hospitalization (\n                      <jats:italic toggle=\"yes\">P<\/jats:italic>\n                      \u2009&lt;\u2009.05).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion:<\/jats:title>\n                    <jats:p>XDR typhoid demands strengthened stewardship, vaccination, and water safety.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1177\/30502225251408603","type":"journal-article","created":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T08:09:14Z","timestamp":1768550954000},"update-policy":"https:\/\/doi.org\/10.1177\/sage-journals-update-policy","source":"Crossref","is-referenced-by-count":4,"title":["Clinical Characteristics and Resistance Patterns of Extensively Drug-Resistant\n                    <i>Salmonella Typhi<\/i>\n                    in the Pediatric Population of Pakistan: A Prospective Study"],"prefix":"10.1177","volume":"13","author":[{"ORCID":"https:\/\/orcid.org\/0009-0005-5414-1356","authenticated-orcid":false,"given":"Hamna","family":"Khalid","sequence":"first","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0009-0001-3317-5662","authenticated-orcid":false,"given":"Zoha","family":"Rehman","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Malik","family":"Muhammad Kabir","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Noshaba","family":"Razaq","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kanza","family":"Riaz","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zavata","family":"Afnan","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Muhammad","family":"Dawood Nazir","sequence":"additional","affiliation":[{"name":"Wah Medical College, Wah Cantt, Pakistan"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7391-4709","authenticated-orcid":false,"given":"Noof K.","family":"Binashikhbubkr","sequence":"additional","affiliation":[{"name":"Hadhramout University, Mukalla, Yemen"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"179","published-online":{"date-parts":[[2026,1,16]]},"reference":[{"key":"e_1_3_3_2_2","doi-asserted-by":"publisher","DOI":"10.48036\/apims.v20i1.964"},{"key":"e_1_3_3_3_2","doi-asserted-by":"publisher","DOI":"10.3855\/jidc.1405"},{"key":"e_1_3_3_4_2","doi-asserted-by":"publisher","DOI":"10.19184\/geosi.v8i2.39584"},{"key":"e_1_3_3_5_2","doi-asserted-by":"publisher","DOI":"10.3343\/alm.2024.0378"},{"key":"e_1_3_3_6_2","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0321879"},{"key":"e_1_3_3_7_2","doi-asserted-by":"publisher","DOI":"10.53350\/pjmhs2023175162"},{"key":"e_1_3_3_8_2","doi-asserted-by":"publisher","DOI":"10.62019\/a1v2gq57"},{"key":"e_1_3_3_9_2","unstructured":"World Health Organization. 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