Current Antimicrobial Susceptibility Trends and Clinical Outcomes of Typhoidal <i>Salmonella</i> in a Large Health Authority in British Columbia, Canada
Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) <i>Salmonella</i> Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal <i>Salmonella</i> antimicrobial susceptibility trends (including multi-drug resistance phen...
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| Main Authors: | , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
MDPI AG
2025-04-01
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| Series: | Tropical Medicine and Infectious Disease |
| Subjects: | |
| Online Access: | https://www.mdpi.com/2414-6366/10/4/108 |
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| Summary: | Background: From 2018 to 2021, travel-related extensively drug-resistant (XDR) <i>Salmonella</i> Typhi was identified in Ontario, Canada. Opportunities remain to characterize typhoidal <i>Salmonella</i> antimicrobial susceptibility trends (including multi-drug resistance phenotypes; MDR) within a large health authority in British Columbia, Canada. Methods: This retrospective study included patients with <i>Salmonella</i> Typhi or Paratyphi A, B or C bacteremia identified at Fraser Health regional microbiology laboratory from 2018 to 2024. The primary outcome was the proportion of cases with MDR and XDR typhoidal <i>Salmonella</i>. Secondary outcomes included annual antimicrobial susceptibility for ampicillin, ceftriaxone, ciprofloxacin, trimethoprim-sulfamethoxazole, ertapenem, meropenem and azithromycin. Clinical outcomes included hospitalization length, and 30-day mortality, clinical cure and infection relapse. Results: Among 271 patients, most were previously healthy and recently travelled. There were extended spectrum beta-lactamase (1.1%) and MDR (1.5%) typhoidal <i>Salmonella</i>, with no XDR cases observed. In 2024, ciprofloxacin resistance was 96% while susceptibility rates were high for other studied antimicrobials. Within 30 days, no deaths were reported; however, six patients (3%) had infection relapse. Conclusions: Currently, in British Columbia, MDR typhoidal <i>Salmonella</i> remains rare. Empiric ciprofloxacin should be avoided due to persistently high resistance rates. With ongoing travel patterns, it is beneficial for institutions to continue typhoidal <i>Salmonella</i> antimicrobial susceptibility surveillance, and travelers should seek pre-travel health assessments. |
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| ISSN: | 2414-6366 |