Estimating the subnational prevalence of antimicrobial resistant Salmonella enterica serovars Typhi and Paratyphi A infections in 75 endemic countries, 1990–2019: a modelling study

This study examines the prevalence of antimicrobial resistance (AMR) in Salmonella enterica serovars Typhi and Paratyphi A infections in 75 endemic countries from 1990 to 2019. The research used a Bayesian spatiotemporal modelling framework to estimate the percentage of MDR, FQNS, and third-generation cephalosporin resistance in these infections. The results showed a decline in MDR in south Asia and southeast Asia, but an increase in FQNS in sub-Saharan Africa. The prevalence of third-generation cephalosporin-resistant S Typhi remained low across the endemic area, except for Pakistan. For S Paratyphi A, the study estimated low prevalence of MDR and third-generation cephalosporin resistance in all endemic countries, but a drastic increase in FQNS. The analysis highlights the increasing levels of AMR in this preventable infection and serves as a resource for urgent public health interventions.