A Biohistorical Perspective of Typhoid and Antimicrobial Resistance.

Abstract

We combine methodology from history and genetics to reconstruct the biosocial history of antimicrobial resistance (AMR) in the bacterium Salmonella enterica serovar Typhi (S. Typhi). We show how evolutionary divergence in S. Typhi was driven by rising global antibiotic use and by the neglect of typhoid outside of high-income countries. Although high-income countries pioneered 1960s precautionary antibiotic regulations to prevent selection for multidrug resistance, new antibiotic classes, typhoid's cultural status as a supposedly ancient disease of "undeveloped" countries, limited international funding, and narrow biosecurity agendas helped fragment effective global collective action for typhoid control. Antibiotic-intensive compensation for weak water and healthcare systems subsequently fueled AMR selection in low- and middle-income countries but often remained invisible due to lacking surveillance capabilities. The recent rise of extensively drug-resistant typhoid bears the biosocial footprint of more than half a century of antibiotic-intensive international neglect.

• Authors: Claas Kirchhelle, Zoe Anne Dyson, Gordon Dougan
• Journal: Clinical infectious diseases : an official publication of the Infectious Diseases Society of America (Clin Infect Dis) Vol. 69 Issue Suppl 5 Pg. S388-S394 (10 15 2019) ISSN: 1537-6591 [Electronic] United States
• PMID: 31612939 (Publication Type: Historical Article, Journal Article, Research Support, Non-U.S. Gov't)
• Copyright: © The Author(s) 2019. Published by Oxford University Press for the Infectious Diseases Society of America.

Chemical References

• Anti-Bacterial Agents

Topics

• Anti-Bacterial Agents (pharmacology, therapeutic use)
• Antimicrobial Stewardship
• Drug Resistance, Multiple, Bacterial
• Evolution, Molecular
• Genotype
• Global Health
• History, 19th Century
• History, 20th Century
• Humans
• Microbial Sensitivity Tests
• Phylogeny
• Salmonella typhi (classification, drug effects, genetics)
• Typhoid Fever (drug therapy, history, microbiology)