{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,31]],"date-time":"2026-10-31T06:04:19Z","timestamp":1793426659490,"version":"4.5.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0012558","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2024,10,16]],"date-time":"2024-10-16T00:00:00Z","timestamp":1729036800000}}],"reference-count":58,"publisher":"Public Library of Science (PLoS)","issue":"10","license":[{"start":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T00:00:00Z","timestamp":1728000000000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/100001125","name":"GAVI Alliance","doi-asserted-by":"publisher","award":["201588766, 201233523, 201022732, 200749550"],"award-info":[{"award-number":["201588766, 201233523, 201022732, 200749550"]}],"id":[{"id":"10.13039\/100001125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100001125","name":"GAVI Alliance","doi-asserted-by":"publisher","award":["Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP) - No Award Number is available"],"award-info":[{"award-number":["Pneumococcal Vaccines Accelerated Development and Introduction Plan (PneumoADIP) - No Award Number is available"]}],"id":[{"id":"10.13039\/100001125","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100000865","name":"Bill and Melinda Gates Foundation","doi-asserted-by":"publisher","award":["INV-008335"],"award-info":[{"award-number":["INV-008335"]}],"id":[{"id":"10.13039\/100000865","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["www.plosntds.org"],"crossmark-restriction":false},"short-container-title":["PLoS Negl Trop Dis"],"abstract":"<jats:sec id=\"sec001\">\n<jats:title>Background<\/jats:title>\n<jats:p>Rising antimicrobial resistance (AMR) in <jats:italic>Salmonella<\/jats:italic> Typhi restricts typhoid treatment options, heightening concerns for pan-oral drug-resistant outbreaks. However, lack of long-term temporal surveillance data on AMR in countries with high burden like Bangladesh is scarce. Our study explores the AMR trends of <jats:italic>Salmonella<\/jats:italic> Typhi isolates from Bangladesh, drawing comparisons with antibiotic consumption to optimize antibiotic stewardship strategies for the country.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec002\">\n<jats:title>Methodology\/Principal findings<\/jats:title>\n<jats:p>The typhoid fever surveillance from 1999 to 2022 included two pediatric hospitals and three private clinics in Dhaka, Bangladesh. Blood cultures were performed at treating physicians\u2019 discretion; cases were confirmed by microbiological, serological, and biochemical tests. Antibiotic susceptibility was determined following CLSI guidelines. National antibiotic consumption data for cotrimoxazole, ciprofloxacin, and azithromycin was obtained from IQVIA-MIDAS database for comparison.<\/jats:p>\n<jats:p>Over the 24 years of surveillance, we recorded 12,435 culture-confirmed typhoid cases and observed declining resistance to first-line drugs (amoxicillin, chloramphenicol, and cotrimoxazole); multidrug resistance (MDR) decreased from 38% in 1999 to 17% in 2022. Cotrimoxazole consumption dropped from 0.8 to 0.1 Daily defined doses (DDD)\/1000\/day (1999\u20132020). Ciprofloxacin non-susceptibility persisted at &gt;90% with unchanged consumption (1.1\u20131.3 DDD\/1000\/day, 2002\u20132020). Low ceftriaxone resistance (&lt;1%) was observed, with slightly rising MIC (0.03 to 0.12 mg\/L, 1999\u20132019). Azithromycin consumption increased (0.1 to 3.8 DDD\/1000\/day, 1999\u20132020), but resistance remained \u22644%.<\/jats:p>\n<\/jats:sec>\n<jats:sec id=\"sec003\">\n<jats:title>Conclusion<\/jats:title>\n<jats:p>Our study highlights declining MDR amongst <jats:italic>Salmonella<\/jats:italic> Typhi in Bangladesh; first-line antimicrobials could be reintroduced as empirical treatment options for typhoid fever if MDR rates further drops below 5%. The analysis also provides baseline data for monitoring the impact of future interventions like typhoid conjugate vaccines on typhoid burden and associated AMR.<\/jats:p>\n<\/jats:sec>","DOI":"10.1371\/journal.pntd.0012558","type":"journal-article","created":{"date-parts":[[2024,10,4]],"date-time":"2024-10-04T17:33:09Z","timestamp":1728063189000},"page":"e0012558","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":16,"title":["Trends in antimicrobial resistance amongst Salmonella Typhi in Bangladesh: A 24-year retrospective observational study (1999\u20132022)"],"prefix":"10.1371","volume":"18","author":[{"given":"Arif Mohammad","family":"Tanmoy","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Yogesh","family":"Hooda","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohammad Saiful Islam","family":"Sajib","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hafizur","family":"Rahman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anik","family":"Sarkar","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dipu","family":"Das","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nazrul","family":"Islam","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Naito","family":"Kanon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Md. 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