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Background <p>Carbapenem resistance in <i>Enterobacterales</i> is a growing public health concern, primarily driven by carbapenemase enzymes such as OXA-48, VIM, NDM, and IMP. Among these, <i>New Delhi Metallo-β-lactamase</i> (NDM) has disseminated widely across various <i>Enterobacterales</i> species, including <i>Salmonella</i> Typhi, though reports remain rare.</p> Case presentation <p>We report an 11-year-old boy from Bangalore with a 10-day history of high-grade fever, chills, rigors, and cough. Laboratory investigations revealed elevated CRP, normal CBC, and microcytic hypochromic anemia. A respiratory panel detected <i>Human Rhinovirus/ Enterovirus</i>. Blood cultures grew non-lactose fermenting gram-negative bacilli, identified as <i>Salmonella</i> spp. via Vitek ID/AST. The isolate exhibited resistance to ampicillin, ciprofloxacin, ceftriaxone, tetracycline, and meropenem but remained susceptible to azithromycin, chloramphenicol, and Co-trimoxazole. Serotyping confirmed the serotype as <i>Salmonella</i> Typhi. Whole-genome sequencing (Illumina) revealed <i>blaNDM-5</i> and <i>aac(6’)-Ia</i>, <i>InCX3</i> plasmid, and the fluoroquinolone resistance-associated <i>gyrA</i>S83Y mutation. Phylogenetic analysis placed the isolate (IOB-SWH-01) within a cluster of recently sequenced <i>S. Typhi</i> strains from India belonging to the H58 haplotype.</p> Discussion and conclusion <p>To date, NDM-producing <i>S. Typhi</i> has been reported only once, from Pakistan. This is the first documented case in India. The presence of <i>blaNDM-5</i> in <i>S.</i> Typhi poses a serious clinical and public health threat, given its multidrug-resistant nature and potential for interspecies transmission. Continued genomic surveillance is crucial to monitor its spread and guide treatment strategies.</p>

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Genomic perspectives on NDM Salmonella Typhi, and a case report from India

  • 期刊论文

  • 发表日期：

    2025年5月12日

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  • Shruthi Vasanthaiah,
  • Pritibala Takey,
  • Prasanna Kumar Selvam,
  • Supraja Mohan,
  • Ravi Kiran,
  • Shabnam Roohi,
  • Karthick Vasudevan

摘要

Background

Carbapenem resistance in Enterobacterales is a growing public health concern, primarily driven by carbapenemase enzymes such as OXA-48, VIM, NDM, and IMP. Among these, New Delhi Metallo-β-lactamase (NDM) has disseminated widely across various Enterobacterales species, including Salmonella Typhi, though reports remain rare.

Case presentation

We report an 11-year-old boy from Bangalore with a 10-day history of high-grade fever, chills, rigors, and cough. Laboratory investigations revealed elevated CRP, normal CBC, and microcytic hypochromic anemia. A respiratory panel detected Human Rhinovirus/ Enterovirus. Blood cultures grew non-lactose fermenting gram-negative bacilli, identified as Salmonella spp. via Vitek ID/AST. The isolate exhibited resistance to ampicillin, ciprofloxacin, ceftriaxone, tetracycline, and meropenem but remained susceptible to azithromycin, chloramphenicol, and Co-trimoxazole. Serotyping confirmed the serotype as Salmonella Typhi. Whole-genome sequencing (Illumina) revealed blaNDM-5 and aac(6’)-Ia, InCX3 plasmid, and the fluoroquinolone resistance-associated gyrAS83Y mutation. Phylogenetic analysis placed the isolate (IOB-SWH-01) within a cluster of recently sequenced S. Typhi strains from India belonging to the H58 haplotype.

Discussion and conclusion

To date, NDM-producing S. Typhi has been reported only once, from Pakistan. This is the first documented case in India. The presence of blaNDM-5 in S. Typhi poses a serious clinical and public health threat, given its multidrug-resistant nature and potential for interspecies transmission. Continued genomic surveillance is crucial to monitor its spread and guide treatment strategies.