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Updated: Dec 20, 2025
Isolation and Identification of Waterborne Antibiotic-Resistant Bacteria and Molecular Characterization of their Antibiotic Resistance Genes
Published on: March 3, 2023
Cephalosporin-resistant typhoid
Noella Maria Delia Pereira1, Ira Shah1
1Department of Paediatrics, Bai Jerbai Wadia Hospital for Children, Mumbai, India.
Abstract:
Typhoid fever is endemic in developing countries like India. An increasing prevalence of resistance to cephalosporins and fluoroquinolones by Salmonella isolates is seen. We present an 8-month-old boy with invasive Salmonella typhi disease. Blood culture showed S. typhi sensitive to ampicillin-sulbactam and cotrimoxazole but resistant to fluoroquinolones and third-generation cephalosporins. Cerebrospinal fluid examination revealed an aseptic meningitic picture. He was treated with intravenous meropenem and azithromycin following which his condition improved. This case highlights the need for improvement in environment sanitation and hygiene combined with early vaccination against typhoid fever and antimicrobial stewardship to help reduce the emerging resistance to cephalosporins and fluoroquinolones.
Insights
An 8-month-old boy with invasive Salmonella typhi disease resistant to common antibiotics highlights the growing threat of antimicrobial resistance. Early vaccination and improved sanitation are crucial to combat this public health challenge.
Area of Science:
- Pediatrics
- Infectious Diseases
- Microbiology
Background:
- Typhoid fever is a significant public health concern in developing nations, particularly India.
- Emerging antimicrobial resistance in Salmonella isolates, especially to fluoroquinolones and cephalosporins, poses a therapeutic challenge.
Observation:
- An 8-month-old boy presented with invasive Salmonella typhi disease.
- Blood cultures revealed Salmonella typhi resistant to fluoroquinolones and third-generation cephalosporins but sensitive to ampicillin-sulbactam and cotrimoxazole.
- Cerebrospinal fluid analysis indicated an aseptic meningitis.
Findings:
- The patient was successfully treated with intravenous meropenem and azithromycin.
- This case demonstrates a Salmonella typhi strain with reduced susceptibility to commonly used antibiotics.
Implications:
- Highlights the urgent need for enhanced environmental sanitation and hygiene practices.
- Emphasizes the importance of early typhoid fever vaccination and robust antimicrobial stewardship programs.
- Underscores the critical need to monitor and combat rising antimicrobial resistance in Salmonella typhi infections.
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