{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T09:08:56Z","timestamp":1790932136282,"version":"4.1.0"},"update-to":[{"DOI":"10.1371\/journal.pntd.0014206","type":"new_version","label":"New version","source":"publisher","updated":{"date-parts":[[2026,4,24]],"date-time":"2026-04-24T00:00:00Z","timestamp":1776988800000}}],"reference-count":31,"publisher":"Public Library of Science (PLoS)","issue":"4","license":[{"start":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T00:00:00Z","timestamp":1776297600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"name":"World-leading Innovative & Smart Education","award":["no.672009"],"award-info":[{"award-number":["no.672009"]}]},{"DOI":"10.13039\/501100023693","name":"Vaccine Impact Modelling Consortium","doi-asserted-by":"publisher","award":["INV-034281"],"award-info":[{"award-number":["INV-034281"]}],"id":[{"id":"10.13039\/501100023693","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}],"id":[{"id":"10.13039\/100009619","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100009619","name":"Japan Agency for Medical Research and Development","doi-asserted-by":"publisher","award":["JP223fa627004"],"award-info":[{"award-number":["JP223fa627004"]}],"id":[{"id":"10.13039\/100009619","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>\n                      Antimicrobial-resistant (AMR)\n                      <jats:italic>Salmonella<\/jats:italic>\n                      Typhi (\n                      <jats:italic>S<\/jats:italic>\n                      . Typhi) is a persistent public health threat in India. We conducted a systematic review and meta-analysis to estimate the prevalence and temporal trends of AMR\n                      <jats:italic>S<\/jats:italic>\n                      . Typhi across Indian states to inform prevention and treatment strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec002\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We systematically reviewed antimicrobial resistance in\n                      <jats:italic>S.<\/jats:italic>\n                      Typhi isolates from India, including studies published up to March 31, 2025, with no start-date restriction. We screened eligible articles from PubMed-MEDLINE, EMBASE, Scopus, Web of Science, and AMR surveillance networks and excluded studies on chronic carriers and travellers. We assessed risk of bias using the Risk Of Bias In Non-randomised Studies \u2013 of Exposures (ROBINS-E) tool. We conducted meta-analysis using a random-effects model to estimate the prevalence of multidrug resistance (MDR; resistance to chloramphenicol, ampicillin, and co-trimoxazole) and resistance to fluoroquinolones, third-generation cephalosporins, and azithromycin across five-year periods, Indian states, and age groups (&lt;18 versus all ages).\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec003\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>We analysed data from 188 of 4,430 identified studies. MDR declined from 65% (95% CI 63\u201367) in 1990\u201394 to nearly 0% (95% CI 0\u20131) \u22652020. Fluoroquinolone resistance rose from 2% (95% CI 1\u20132) in 1990\u201394\u201385% (95% CI 84\u201386) in 2015\u201319, then declined slightly, with similar trends in children but marked variation across Indian states. Resistance to third-generation cephalosporins, azithromycin, and carbapenems remained below 5%, 8%, and 2%, respectively. Our meta-analysis of studies with samples collected from 2015 onwards showed a pooled summary resistance estimate of 82% (95% CI 74\u201387) for fluoroquinolones, 3% (95% CI 2\u20134) for third-generation cephalosporins, and 3% (95% CI 1\u20136) for azithromycin.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec id=\"sec004\">\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      Fluoroquinolone resistance in\n                      <jats:italic>S<\/jats:italic>\n                      . Typhi in India is high but is declining, while resistance to third-generation cephalosporins and azithromycin is low. As many isolates originated from major cities, caution is warranted when generalising nationally. Continued AMR surveillance is crucial to guide vaccination strategies and treatment decisions.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.1371\/journal.pntd.0014206","type":"journal-article","created":{"date-parts":[[2026,4,16]],"date-time":"2026-04-16T17:47:52Z","timestamp":1776361672000},"page":"e0014206","update-policy":"https:\/\/doi.org\/10.1371\/journal.pntd.corrections_policy","source":"Crossref","is-referenced-by-count":2,"title":["Burden of antimicrobial resistance in culture-confirmed Salmonella Typhi isolates in India from 1977 to 2024: A systematic review and meta-analysis"],"prefix":"10.1371","volume":"20","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-9564-8760","authenticated-orcid":true,"given":"Vijayalaxmi V.","family":"Mogasale","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Peixuan","family":"Zhang","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jacob","family":"John","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Habib Hasan","family":"Farooqui","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Arindam","family":"Ray","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vittal","family":"Mogasale","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christopher M.","family":"Parry","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Bhim Gopal","family":"Dhoubhadel","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"W. John","family":"Edmunds","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Andrew","family":"Clark","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kaja","family":"Abbas","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"340","published-online":{"date-parts":[[2026,4,16]]},"reference":[{"key":"pntd.0014206.ref001","unstructured":"WHO. Ten threats to global health in 2019. Geneva: World Health Organization; 2019 [cited 2025 Jan 24]. Available from: https:\/\/www.who.int\/news-room\/spotlight\/ten-threats-to-global-health-in-2019"},{"key":"pntd.0014206.ref002","unstructured":"World Health Organisation. Antimicrobial resistance. 2023 [cited 2024 Sept 2]. Available from: https:\/\/www.who.int\/news-room\/fact-sheets\/detail\/antimicrobial-resistance"},{"key":"pntd.0014206.ref003","unstructured":"WHO. 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