Typhoid is endemic in many countries in South Asia and sub-Saharan Africa. The high burden of this age-old, preventable disease exacerbates constraints on the health systems of these countries. Currently, most patients are treated effectively in the community or outpatient departments, but with rising antimicrobial resistance and the dearth of novel antimicrobials in the horizon, we risk losing our primary defense against typhoid. Extensively drug-resistant Salmonella Typhi is spreading, and azithromycin is the last oral drug to continue treating typhoid in the community. With increasing azithromycin resistance, emergence of pan-oral drug resistant Salmonella Typhi is imminent. The high burden of typhoid is also an underlying cause of the unnecessary use of antimicrobials. In addition to implementing water sanitation and hygiene interventions to prevent typhoid, it is imperative to rapidly roll out typhoid conjugate vaccines in endemic countries. This will not only reduce the burden of typhoid but will also help interrupt the trend of increasing antimicrobial resistance.

中文翻译：

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伤寒结合疫苗：对抗伤寒和解决抗菌素耐药性的紧急工具

伤寒在南亚和撒哈拉以南非洲的许多国家流行。这种古老的、可预防的疾病的沉重负担加剧了对这些国家卫生系统的限制。目前，大多数患者在社区或门诊部得到有效治疗，但随着抗菌素耐药性的上升和新型抗菌剂的缺乏，我们有可能失去对伤寒的主要防御。广泛耐药的伤寒沙门氏菌正在蔓延，阿奇霉素是社区中最后一种继续治疗伤寒的口服药物。随着阿奇霉素耐药性的增加，泛口服耐药伤寒沙门氏菌的出现迫在眉睫。伤寒的高负担也是不必要使用抗菌药物的根本原因。除了实施水环境卫生和个人卫生干预措施以预防伤寒外，还必须在流行国家迅速推出伤寒结合疫苗。这不仅将减轻伤寒的负担，还将有助于中断抗菌素耐药性增加的趋势。