A new study has raised serious concerns about rising antibiotic resistance in Salmonella Typhi—the bacteria that causes typhoid fever. Conducted by scientists from the Gujarat Biotechnology Research Centre (GBRC) and partnering institutions, the study shows resistance levels reaching as high as 90% for several commonly used antibiotics. This alarming trend could severely limit treatment options for typhoid patients in India.
High Resistance Detected in Typhoid Strains
Researchers collected S. Typhi samples from patients in Ahmedabad and Vadodara, testing them against 28 antibiotics commonly prescribed for typhoid. Disturbingly, several antibiotics—including ceftriaxone, ciprofloxacin, ampicillin, and gentamicin—showed resistance levels exceeding 90%.
As reported by TOI, the study, titled “Comprehensive Analysis of Extensive Drug-Resistant Salmonella Typhi in Gujarat Region, India: Genomic Findings and Prospective Alternative Therapy,” appeared in the journal Microbiology Spectrum, published by the American Society for Microbiology. The research team included scientists from GBRC, MS University of Baroda, BJ Medical College, the Commissionerate of Health (Gujarat), and Toprani Labs, Vadodara.
Genome Analysis Points to Resistance Genes
Through genomic sequencing, the researchers identified specific plasmids—genetic elements that carry antibiotic resistance genes. These plasmids are helping S. Typhi evade even third-generation cephalosporins and fluoroquinolones (FQs), two key antibiotic classes that were once highly effective.
Importantly, the team found that combination therapy involving β-lactam antibiotics and β-lactam inhibitors (BLIs) improved treatment outcomes. This strategy offers a potential alternative for managing extensively drug-resistant (XDR) typhoid cases.
Typhoid Remains a Seasonal Threat
Typhoid fever, caused by ingestion of contaminated food or water, remains a widespread illness across Asia, Africa, and Latin America. In Ahmedabad, the number of cases spikes during the monsoon, with doctors reporting up to 200 cases per month.
Symptoms include fever, abdominal pain, rashes, fatigue, and in severe cases, intestinal bleeding. While antibiotics typically reduce the illness’s duration to 5–6 days, growing resistance is forcing a shift in treatment approaches.
Doctors Warn Against Overuse of Antibiotics
Local health experts have been witnessing the rise of drug-resistant typhoid for nearly a decade. Dr. Urvesh Shah, head of microbiology at GCS Medical College, explained that quinolones, once the first line of treatment, now show over 50% resistance.
“Third-generation cephalosporins remain the drug of choice, but we now see scattered resistance even to those,” said Dr. Shah. He emphasized that while azithromycin remains effective, it should be used only as a supplementary drug to avoid further resistance.
Medical Community Adapts to New Realities
Dr. RC Damani, an internal medicine specialist at KD Hospital, noted that compared to a decade ago, treatment protocols have significantly changed. “Today, doctors rely on better screening and diagnostic methods to confirm typhoid before prescribing antibiotics,” he said.
Accurate Diagnosis Is Critical
According to Dr. Pragnesh Vachcharajani, secretary of the Federation of Family Physicians’ Association of India, blood culture remains the gold standard for confirming typhoid. Sonography is also useful to detect internal signs like swollen lymph nodes. He warned that treating patients based only on symptoms can lead to the misuse of antibiotics, further worsening antimicrobial resistance (AMR).
“Typhoid has not only become more resistant but also more prolonged,” said Dr. Vachcharajani. “The duration now extends up to seven days, and in serious cases, treatment shifts from oral drugs to intravenous (IV) therapy.”
Urgent Need for Responsible Antibiotic Use
This study underscores the urgent need for responsible antibiotic usage, accurate diagnosis, and development of alternative therapies. Without immediate action, drug-resistant typhoid could escalate into a major public health crisis.