Ceftriaxone-resistant Salmonella enterica serotype Typhi in a pregnant traveller returning from Karachi, Pakistan to Denmark, 2019

Euro Surveill. 2019 May;24(21):1900289. doi: 10.2807/1560-7917.ES.2019.24.21.1900289.

Abstract

We describe a ceftriaxone-resistant Salmonella Typhi bacteraemia in a pregnant woman returning from a family visit in Pakistan. Whole genome sequencing confirmed similarity to a Pakistani outbreak clone. Pregnancy and unawareness of this outbreak delayed appropriate antibiotic therapy. Concurrently, we detected faecal carriage of a carbapenemase-producing Escherichia coli. Awareness of the ongoing outbreak should affect empiric treatment of typhoid fever and hygiene precautions in travellers returning from Pakistan. Meropenem may be warranted in severe cases.

Keywords: XDR; azithromycin; carbapenemase-producing; meropenem; pregnancy; typhoid fever.

Publication types

  • Case Reports

MeSH terms

  • Abdominal Pain / etiology
  • Adult
  • Agglutination Tests
  • Anti-Bacterial Agents / pharmacology
  • Anti-Bacterial Agents / therapeutic use*
  • Azithromycin / therapeutic use*
  • Bacteremia / drug therapy
  • Carbapenem-Resistant Enterobacteriaceae
  • Ceftriaxone / pharmacology*
  • Ceftriaxone / therapeutic use
  • Denmark
  • Drug Resistance
  • Escherichia coli / genetics
  • Escherichia coli / isolation & purification
  • Female
  • Fever / etiology
  • Humans
  • Meropenem / therapeutic use*
  • Microbial Sensitivity Tests
  • Pakistan
  • Plasmids / analysis
  • Polymerase Chain Reaction
  • Pregnancy
  • Salmonella typhi / drug effects
  • Salmonella typhi / genetics*
  • Salmonella typhi / isolation & purification*
  • Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization
  • Travel
  • Typhoid Fever / diagnosis*
  • Typhoid Fever / drug therapy*
  • Typhoid Fever / microbiology
  • Whole Genome Sequencing

Substances

  • Anti-Bacterial Agents
  • Ceftriaxone
  • Azithromycin
  • Meropenem