CASE REPORT article
Front. Antibiot.
Sec. Antibiotic Resistance
Volume 4 - 2025 | doi: 10.3389/frabi.2025.1639736
Single Case Study: Ceftriaxone-Resistant Non-Typhoidal Salmonella Bacteremia from India
Provisionally accepted
- All India Institute of Medical Sciences, New Delhi, India
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Enteric fever, encompassing both Typhoid and Paratyphoid fevers, poses a significant global health challenge due to Salmonella enterica serovars Typhi and Paratyphi causing acute infections. Notably, in low-middle-income countries (LMICs), antimicrobial resistance (AMR) in Salmonella species is rising, complicating treatment and increasing morbidity and mortality. This case study reports on an 18-year-old male from Uttar Pradesh, India, admitted to AIIMS New Delhi with ceftriaxone-resistant non-typhoidal Salmonella (NTS) bacteremia. Despite Intensive Care Unit (ICU) admission and treatment, the patient succumbed to sepsis within seven days. The organism identified using VITEK MS® (bioMérieux®, France) was typhoidal Salmonella enterica and further characterized as serotype E through conventional serotyping. Antimicrobial susceptibility testing revealed resistance to multiple drugs, including imipenem, meropenem, ceftriaxone, and ciprofloxacin, but sensitivity to chloramphenicol. Whole-genome sequencing (WGS) and subsequent analysis identified 16 AMR genes, virulence factors, and six plasmids, highlighting a concerning AMR profile and potential for widespread dissemination. This study underscores the pressing issue of ceftriaxone-resistant NTS, particularly in LMICs, and the challenges it poses for clinical management. Our findings emphasize the need for continuous surveillance and tailored antimicrobial strategies to combat the rising threat of multidrug-resistant Salmonella, especially in vulnerable populations. The presence of diverse AMR genes and virulence factors suggests a dual challenge of resistance propagation and increased pathogenicity, necessitating urgent public health interventions.
Keywords: ceftriaxone-resistant, Salmonella, Whole-genome sequencing, antimicrobial resistance, Sepsis
Received: 22 Jun 2025; Accepted: 08 Sep 2025.
Copyright: © 2025 Ahmed, Puraswani, Tluanpuii, Das, kirti, Gautam and Mathur. This is an open-access article distributed under the terms of the Creative Commons Attribution License (CC BY). The use, distribution or reproduction in other forums is permitted, provided the original author(s) or licensor are credited and that the original publication in this journal is cited, in accordance with accepted academic practice. No use, distribution or reproduction is permitted which does not comply with these terms.
* Correspondence: Purva Mathur, All India Institute of Medical Sciences, New Delhi, India
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