XDR outbreak of Typhoid Fever in Hayatabad, Peshawar Pakistan

Extended Drug Resistant  (XDR) outbreak of Typhoid Fever in Hayatabad, Peshawar Pakistan

The title of my presentation in the Annual Conference was “Extensively drug resistant (XDR) outbreak of Typhoid Fever in Hayatabad, Peshawar”
Typhoid fever is a life-threatening & highly infectious illness affecting more than 21 million people with up to 161,000 deaths annually. Typhoid fever is endemic in South Asia and the most common bacteraemic illness in children in Pakistan. An outbreak of Extensively Drug-Resistant (XDR) typhoid fever reported in Hyderabad in November 2016, which Spread & affected > 5,200 people in Sindh by December 2018. This was the world’s first outbreak of Ceftriaxone resistant S. Typhi,  a standard treatment of typhoid fever. It was found to be resistant to five classes of antibiotics. Globally, XDR is increasingly reported in S. Typhi and S. Paratyphi from Asia and Africa. XDR in S. Typhi is a critical challenge in high disease burden countries such as Pakistan with limited therapeutic options such as oral Azithromycin. Expensive IV antibiotics are needed to treat typhoid fever.

NWGH Microbiology laboratory observed an outbreak of XDR S. Typhi in Hayatabad through antimicrobial resistance surveillance. Laboratory based surveillance data of local XDR outbreak was Collected from January 1, 2021 to August 31, 2022 and compared with retrospective data from 2012 – 2020.  Typhoid is a notifiable diseases in Pakistan, hence all new cases of typhoid fever were notified to the DG Health to identify the risk factor and institute control measures