The arms race between humanity and bacteria has a battle front that continues to worsen year after year. For decades, we have relied on antibiotics like our definitive shield in order to put an end to them and prevent them from continuing to generate diseases. The problem is that they are very smart and know how to evade the effect of antibiotics, and the latest major scientific warning focuses on an old acquaintance, the Salmonella typhimuriumthe bacteria that causes typhoid fever.
A new strain. We are not talking about a minor problem, and to understand it you have to travel to the province of Sindh, in Pakistan. There, as detailed in a study in 2008, all the alarms went off when a clone of this bacteria was detected that was named XDR and which has the characteristic of being very resistant to all medications that are available today.
In this way, we are not facing a bacteria that is a little tougher to peel, but rather it is a strain that carries within itself a great genetic superpower: simultaneous resistance to major antibiotics such as chloramphenicol, ampicillin, cotrimoxazole, fluoroquinolones and third generation cephalosporins. In this way, overnight, the entire basic medical arsenal had become obsolete to be able to fight this bacteria.
An expansion. What happens in Pakistan, in a hyperconnected world, does not stay in Pakistan. And this makes science be warning from the year 2022 where an international team sequenced 3,489 genomes of S. Typhi from Nepal, Bangladesh, Pakistan and India.
The result. Here you could clearly see the map of an enemy that is rapidly gaining ground. The research confirmed not only the increase in XDR strains, but also their international dispersion, crossing continental borders with astonishing ease. That is why imported cases of this highly resistant bacteria have begun to be detected in the United States, the United Kingdom and Canada, alerting the health systems of developed countries.
No weapons. As medicines that we can use to kill these bacteria, we have few left. For now, science suggests that these XDR strains can be treated with antibiotics called meropenem and azithromycin.
However, experts warn of the critical danger of this situation, since azithromycin has become the last viable oral antibiotic to treat these outpatient infections. The problem is that if we abuse this antibiotic, the bacteria will be able to create resistance against the drug, which would mean that all these infections would have to be treated in a hospital with intravenous medications and not oral ones. Simply because they would no longer exist.
The vaccine. At this point, the scientific community is clear that we cannot win this war just by creating new antibiotics, but we have to prevent people from getting sick in the first place. And this particular case is where they come into play. typhoid conjugate vaccines.
In this case, the WHO itself has prequalified four of these vaccines and the CDC also supports their use in vaccination programs in countries endemic to the disease. That is why the data suggests that an aggressive childhood vaccination campaign in urban areas of India could prevent approximately 36% of cases and deaths from typhoid fever. And it is great news, since preventing these deaths also prevents their widespread spread to other countries.
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