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Title: Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa
Authors: Vanessa K. Wong
Kathryn E. Holt
Chinyere Okoro
Stephen Baker
Derek J. Pickard
Florian Marks
Andrew J. Page
Grace Olanipekun
Huda Munir
Roxanne Alter
Paul D. Fey
Nicholas A. Feasey
François Xavier Weill
Simon Le Hello
Peter J. Hart
Samuel Kariuki
Robert F. Breiman
Melita A. Gordon
Robert S. Heyderman
Jan Jacobs
Octavie Lunguya
Chisomo Msefula
Calman A. MacLennan
Karen H. Keddy
Anthony M. Smith
Robert S. Onsare
Elizabeth De Pinna
Satheesh Nair
Ben Amos
Gordon Dougan
Stephen Obaro
Julian Parkhill
Robert A. Kingsley
Nicholas R. Thomson
Jacqueline A. Keane
Jane Hawkey
David J. Edwards
Zoe A. Dyson
Simon R. Harris
Amy K. Cain
James Hadfield
Elizabeth J. Klemm
Conall H. Watson
W. John Edmunds
Nga Tran Vu Thieu
Mike Kama
Kylie Jenkins
Shanta Dutta
Josefina Campos
Corinne Thompson
Christiane Dolecek
Christopher M. Parry
Abhilasha Karkey
E. Kim Mulholland
James I. Campbell
Sabina Dongol
Buddha Basnyat
Amit Arjyal
Muriel Dufour
Don Bandaranayake
Take N. Toleafoa
Shalini Pravin Singh
Mochammad Hatta
Lupeoletalalelei Isaia
Wellcome Trust Sanger Institute
Addenbrooke's Hospital
Bio21 Molecular Science and Biotechnology Institute
University of Melbourne
Nuffield Department of Clinical Medicine
London School of Hygiene & Tropical Medicine
International Vaccine Institute, Seoul
International Foundation Against Infectious Diseases in Nigeria (IFAIN)
Aminu Kano Teaching Hospital
University of Nebraska Medical Center
Liverpool School of Tropical Medicine
Institut Pasteur, Paris
University of Birmingham
St George's University of London
Kenya Medical Research Institute
Centers for Disease Control and Prevention
Emory Global Health Institute
University of Liverpool
University of Malawi College of Medicine
Prins Leopold Instituut voor Tropische Geneeskunde
KU Leuven
National Institute for Biomedical Research
University Hospital of Kinshasa
University of Witwatersrand
Public Health England
St Augustine's Hospital
University of Abuja
Bingham University
Quadram Institute Bioscience
Universidad de la Republica Instituto de Higiene
Ministry of Health
Fiji Health Sector Support Program
National Institute of Cholera and Enteric Diseases India
ANLIS-Carlos G Malbran Institute
Nagasaki University
Oxford University Clinical Research Unit
Murdoch Children's Research Institute
Institute of Environmental Science and Research Limited (ESR)
ESR - Kenepuru Science Centre
Samoa Ministry of Health
Organisation Mondiale de la Sante
Hasanuddin University
Tupua Tamasese Meaole Hospital
Mahidol University
Angkor Hospital for Children
University of Otago
Cardiff University
Barts and The London NHS Trust
University of Cambridge
Keywords: Medicine
Issue Date: 22-Sep-2016
Citation: PLoS Neglected Tropical Diseases. Vol.10, No.9 (2016)
Abstract: © 2016 Public Library of Science. All rights reserved. Background: The burden of typhoid in sub-Saharan African (SSA) countries has been difficult to estimate, in part, due to suboptimal laboratory diagnostics. However, surveillance blood cultures at two sites in Nigeria have identified typhoid associated with Salmonella enterica serovar Typhi (S. Typhi) as an important cause of bacteremia in children. Methods: A total of 128 S. Typhi isolates from these studies in Nigeria were whole-genome sequenced, and the resulting data was used to place these Nigerian isolates into a worldwide context based on their phylogeny and carriage of molecular determinants of antibiotic resistance. Results: Several distinct S. Typhi genotypes were identified in Nigeria that were related to other clusters of S. Typhi isolates from north, west and central regions of Africa. The rapidly expanding S. Typhi clade 4.3.1 (H58) previously associated with multiple antimicrobial resistances in Asia and in east, central and southern Africa, was not detected in this study. However, antimicrobial resistance was common amongst the Nigerian isolates and was associated with several plasmids, including the IncHI1 plasmid commonly associated with S. Typhi. Conclusions: These data indicate that typhoid in Nigeria was established through multiple independent introductions into the country, with evidence of regional spread. MDR typhoid appears to be evolving independently of the haplotype H58 found in other typhoid endemic countries. This study highlights an urgent need for routine surveillance to monitor the epidemiology of typhoid and evolution of antimicrobial resistance within the bacterial population as a means to facilitate public health interventions to reduce the substantial morbidity and mortality of typhoid.
ISSN: 19352735
Appears in Collections:Scopus 2016-2017

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