Multidrug-Resistant Salmonella enterica Serovar Typhi Isolates with High-Level

Typhoid fever due to multidrug-resistant Salmonella enterica serovar Typhi is a global public health problem, with an esti-mated 30 million cases and 600,000 deaths annually (7). Since the beginning of the 1990s, there has been an increasing prev-alence of multidrug resistance to the first-line antimicrobials, such as chloramphenicol, ampicillin, and co-trimoxazole, shift-ing the drug of choice for the treatment of typhoid fever to fluoroquinolones on the Indian subcontinent (4, 5). Several clinical failures due to infection with isolates of S. enterica serovar Typhi with decreased susceptibilities to fluoroquinolo-nes but resistance to nalidixic acid, and their emergence, inci-dence, and spread have been reported from other developing countries (2, 3). The purpose of this report was to investigate whether such isolates were present in Bangladesh during the period between January and December 2005 by retrospectiv