We report an outbreak of ceftriaxone-resistant Salmonella Typhi in Bangladesh, with 47 cases identified from April-September 2024. Isolates belong to genotype 4.3.1.2 and harbor the blaCTX-M-15 gene on the pCROB1 plasmid. This unique genotype-plasmid lineage represents a recent introduction, necessitating enhanced surveillance, antimicrobial stewardship, and consideration of vaccination strategies.

The authors have declared no competing interest.

The study was funded by the Bill and Melinda Gates Foundation grant to SS (INV-051975).

I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained.

Yes

The details of the IRB/oversight body that provided approval or exemption for the research described are given below:

Ethical approval for this study was obtained from the Ethics Review Boards of the Child Health Research Foundation (CHRF) and the Bangladesh Shishu Hospital and Institute.

I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals.

Yes

I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance).

Yes

I have followed all appropriate research reporting guidelines, such as any relevant EQUATOR Network research reporting checklist(s) and other pertinent material, if applicable.

Yes

All data in the present study are contained in the manuscript.