From 1 November 2016 through 9 December 2018, 5,274 cases of XDR typhoid out of 8,188 typhoid fever cases were reported by the Provincial Disease Surveillance and Response Unit in Sindh province, Pakistan.
Sixty-nine percent of cases were reported in Karachi (the capital city), 27% in Hyderabad district, and 4% in other districts in the province.
The circulating XDR strain of S. Typhi haplotype 58 was resistant to first and second-line antibiotics as well as third generation cephalosporins.