GRAM study reveals rising antimicrobial resistance in enteric fever across 75 countries, affecting millions

A study in Lancet Global Health, ‘Estimating the subnational prevalence of antimicrobial resistant Salmonella enterica serovars Typhi and Paratyphi A infections in 75 endemic countries, 1990–2019: a modelling study’, highlights the escalating prevalence of antimicrobial resistance (AMR) in these pathogens. The study, conducted by the GRAM Typhoid Collaborators, used a Bayesian spatiotemporal modelling framework to estimate the percentage of multidrug resistance (MDR), fluoroquinolone non-susceptibility (FQNS), and third-generation cephalosporin resistance in Salmonella Typhi and Paratyphi A infections in 75 endemic countries from 1990 to 2019. Key findings include a decline in MDR Salmonella Typhi in South Asia and Southeast Asia, a concerning increase in sub-Saharan Africa, and a rapid escalation of FQNS Salmonella Typhi in South Asia, resulting in 74% million infections in endemic countries. The study underscores the urgent need for comprehensive public health strategies to combat AMR and reduce the number of enteric fever infections.