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The case involved an NDM-5–producing strain associated with progressive gastrointestinal symptoms that worsened after a short ciprofloxacin course, culminating in fever and severe headache. Molecular testing detected Salmonella and Shigella signals, while culture confirmed Salmonella. Antimicrobial susceptibility testing identified carbapenem resistance and additional multidrug-resistant phenotypes, with the isolate subtyped as Salmonella Typhi and analyzed alongside relevant genomes.",{"@graph":69,"@context":122},[70,84,105],{"@type":71,"itemListElement":72},"BreadcrumbList",[73,77,79,82],{"item":74,"name":75,"@type":76,"position":8},"https://docshare.wps.com","Home","ListItem",{"item":78,"name":9,"@type":76,"position":14},"https://docshare.wps.com/document/",{"item":80,"name":35,"@type":76,"position":81},"https://docshare.wps.com/document/healthcare/",3,{"item":83,"name":65,"@type":76,"position":19},"https://docshare.wps.com/document/carbapenem-resistant-salmonella-typhi-infection-in-traveler-returning-to-germany-from-india-2024/458870/",{"url":83,"name":65,"@type":85,"image":86,"author":91,"headline":65,"publisher":94,"fileFormat":97,"inLanguage":63,"description":67,"dateModified":98,"datePublished":99,"encodingFormat":97,"isAccessibleForFree":100,"interactionStatistic":101},"DigitalDocument",{"url":87,"@type":88,"width":89,"height":90},"https://docshare.wps.com/thumbnails/carbapenem-resistant-salmonella-typhi-infection-in-traveler-returning-to-germany-from-india-2024/458870.png","ImageObject",300,407,{"name":92,"@type":93},"pop out","Person",{"url":74,"name":95,"@type":96},"DocShare","Organization","application/pdf","2026-11-08","2026-09-30",true,{"@type":102,"interactionType":103,"userInteractionCount":19},"InteractionCounter",{"@type":104},"ViewAction",{"@type":106,"mainEntity":107},"FAQPage",[108,114,118],{"name":109,"@type":110,"acceptedAnswer":111},"What type of Salmonella Typhi strain was reported in the traveler returning to Germany from India in 2024?","Question",{"text":112,"@type":113},"The report describes an NDM-5–producing Salmonella Typhi strain with carbapenem resistance and multidrug-resistant features.","Answer",{"name":115,"@type":110,"acceptedAnswer":116},"How did the patient’s symptoms and testing progress after travel?",{"text":117,"@type":113},"After a return to Germany, mild gastrointestinal symptoms gradually worsened over about two weeks. Stool and blood sampling were performed; PCR signals were positive for Salmonella and Shigella spp., and stool culture grew Salmonella spp.",{"name":119,"@type":110,"acceptedAnswer":120},"Why is carbapenem resistance highlighted as a concern for typhoid treatment?",{"text":121,"@type":113},"Because recently emerged extensively drug-resistant Salmonella Typhi strains may further expand resistance to carbapenems, seriously threatening available treatment options.","https://schema.org",{"og:url":83,"og:type":124,"og:title":65,"og:site_name":95,"og:description":67},"article",{"robots":126,"canonical":83},"index,follow",{"doc_id":128,"site_id":62},458870,1790754654,{"code":4,"msg":5,"data":131},{"doc_id":128,"user_id":132,"nickname":92,"user_avatar":133,"doc_module":4,"category_id":34,"category_name":35,"doc_title":65,"doc_description":67,"doc_content":134,"file_id":135,"file_url":136,"file_type":137,"file_size":138,"view_count":19,"is_deleted":4,"is_public":8,"is_downloadable":8,"audit_status":8,"page_count":19,"language":139,"language_code":63,"site_id":62,"html_lang":63,"table_of_contents":140,"faqs":141,"seo_title":142,"seo_description":67,"update_tm":129,"read_time":52,"preview_page_count":4},962090760408,"https://ap-avatar.wpscdn.com/davatar_085a072bc5b1113ac321206ff7593b45","RESEARCH LETTERS  \n(OROV) infections: systematic review and meta-analysis of observational studies. Viruses. 2024;16:1498 .  \n7. Gauci PJ, McAllister J, Mitchell IR, Weir RP, Melville LF, Gubala AJ. Genomic characterisation of Trubanaman and Gan Gan viruses, two bunyaviruses with potential significance to public health in Australia. Virol Rep. 2016;6:1–10 .  \n8. Boughton CR, Hawkes RA, Naim HM. Arbovirus infection in humans in NSW: seroprevalence and pathogenicity of certain Australian bunyaviruses. Aust N Z J Med. 1990;20:51–5 .  \n9. Johansen CA, Mackenzie JS, Smith DW, Lindsay MDA.  \nPrevalence of neutralising antibodies to Barmah Forest, Sindbis and Trubanaman viruses in animals and humans in the south-west of Western Australia. Aust J Zool.  \n2005;53:51–8 .  \n10. Chiu CY, Godasi RR, Hughes HR, Servellita V, Foresythe K, Tubati A, et al. Two human cases of fatal meningoencephalitis associated with Potosi and Lone Star virus infections, United States, 2020–2023. Emerg Infect Dis. 2025;31:215–21 .  \nAddress for correspondence: Krispin Hajkowicz, School of Medical Sciences, University of Sydney, Biomedical Bldg C81, Central Avenue, Everleigh, NSW 2015, Australia; email:  \n[khaj2604@uni.sydney.edu.au](khaj2604@uni.sydney.edu.au)  \nCarbapenem-Resistant Salmonella Typhi Infection in Traveler Returning to Germany from India, 2024  \nSandra Simon, Eva Trost, Jan Lennings, Julia Enkelmann, Julia Kuhn, Michael Pietsch, Antje Flieger  \nAuthor affiliations: Robert Koch Institute, Wernigerode, Germany (S. Simon, E. Trost, M. Pietsch, A. Flieger); Public Health Department of Stuttgart, Stuttgart, Germany (J. Lennings); Robert Koch Institute, Berlin, Germany (J. Enkelmann); Ministry of Social Affairs, Health and Integration Baden-Wuerttemberg, Stuttgart (J. Kuhn)  \nDOI: [https://doi.org/10.3201/eid3112.251234](https://doi.org/10.3201/eid3112.251234)  \nWe report on a carbapenem- , extended spectrum β-lactam- , fluoroquinolone- , and tetracycline-resistant Salmonella enterica serovar Typhi strain in a patient returning to Germany from India. Considering the recent emergence of extensively drug-resistant Salmonella Typhi strains, further expansion of antibiotic resistance to carbapenems poses a serious threat for typhoid fever treatment.  \nExtcaesnsiverovy drugr Typhi-r,esbeilstantongin(XDRg to th) SeaHlmo58laplenterotypie-, was first identified in Sindh, Pakistan, in 2016 (1). Since then, those strains have been reported worldwide, mainly in association with travel to Pakistan. XDR Salmonella Typhi exhibit a multidrug-resistant (MDR) phenotype, including resistance to chloramphenicol, ampicillin, and sulfamethoxazole/trimethoprim, along with additional resistance to fluoroquinolonesand third-generation cephalosporins. Consequently, therapeutic options for treating infections caused by XDR strains are primarily limited to the macrolideazithromycin and carbapenems. Salmonella Typhi strains resistant to carbapenems, azithromycin, or both have been reported occasionally. Carbapenemresistant strains isolated in Pakistan harbored genes encoding VIM, GES, or NDM-5 carbapenemases (2,3) . The respective NDM-5–positive strain showed the XDR phenotype and was phylogenetically assigned to the H58 haplotype. Recently, another case study described a non–XDR NDM-5–producing Salmonella Typhi isolate from India, which revealed additional resistance to fluoroquinolones and third-generation cephalosporins but remained susceptible to chloramphenicol, sulfamethoxazole/trimethoprim, and azithromycin (4) .  \nWe report an NDM-5–producing Salmonella Typhi strain isolated from a patient from Germany after returning from India. The patient, an experienced traveler to India who was last vaccinated with the typhoid polysaccharide vaccine in June 2021, undertook a 4-week round trip through several states in southwest India in September and October 2024. Upon return to Germany, the patient had onset of mild gastrointestinal symptoms, including diarrhea and abdominal pain.","cbCailHyd8PWAAii","https://ap.wps.com/l/cbCailHyd8PWAAii","pdf",1524489,"English","# Case report summary\n## Clinical presentation and diagnostics\n## Antimicrobial resistance and genetic determinants\n## Comparative genomic context","[{\"question\":\"What type of Salmonella Typhi strain was reported in the traveler returning to Germany from India in 2024?\",\"answer\":\"The report describes an NDM-5–producing Salmonella Typhi strain with carbapenem resistance and multidrug-resistant features.\"},{\"question\":\"How did the patient’s symptoms and testing progress after travel?\",\"answer\":\"After a return to Germany, mild gastrointestinal symptoms gradually worsened over about two weeks. Stool and blood sampling were performed; PCR signals were positive for Salmonella and Shigella spp., and stool culture grew Salmonella spp.\"},{\"question\":\"Why is carbapenem resistance highlighted as a concern for typhoid treatment?\",\"answer\":\"Because recently emerged extensively drug-resistant Salmonella Typhi strains may further expand resistance to carbapenems, seriously threatening available treatment options.\"}]","Carbapenem-Resistant Salmonella Typhi Infection in Traveler Returning to Germany from India, 2024 | PDF"]