Vanessa K. WongKathryn E. HoltChinyere OkoroStephen BakerDerek J. PickardFlorian MarksAndrew J. PageGrace OlanipekunHuda MunirRoxanne AlterPaul D. FeyNicholas A. FeaseyFrançois Xavier WeillSimon Le HelloPeter J. HartSamuel KariukiRobert F. BreimanMelita A. GordonRobert S. HeydermanJan JacobsOctavie LunguyaChisomo MsefulaCalman A. MacLennanKaren H. KeddyAnthony M. SmithRobert S. OnsareElizabeth De PinnaSatheesh NairBen AmosGordon DouganStephen ObaroJulian ParkhillRobert A. KingsleyNicholas R. ThomsonJacqueline A. KeaneJane HawkeyDavid J. EdwardsZoe A. DysonSimon R. HarrisAmy K. CainJames HadfieldElizabeth J. KlemmConall H. WatsonW. John EdmundsNga Tran Vu ThieuMike KamaKylie JenkinsShanta DuttaJosefina CamposCorinne ThompsonChristiane DolecekChristopher M. ParryAbhilasha KarkeyE. Kim MulhollandJames I. CampbellSabina DongolBuddha BasnyatAmit ArjyalMuriel DufourDon BandaranayakeTake N. ToleafoaShalini Pravin SinghMochammad HattaLupeoletalalelei IsaiaWellcome Trust Sanger InstituteAddenbrooke's HospitalBio21 Molecular Science and Biotechnology InstituteUniversity of MelbourneUCLNuffield Department of Clinical MedicineLondon School of Hygiene & Tropical MedicineInternational Vaccine Institute, SeoulInternational Foundation Against Infectious Diseases in Nigeria (IFAIN)Aminu Kano Teaching HospitalUniversity of Nebraska Medical CenterLiverpool School of Tropical MedicineInstitut Pasteur, ParisUniversity of BirminghamSt George's University of LondonKenya Medical Research InstituteCenters for Disease Control and PreventionEmory Global Health InstituteUniversity of LiverpoolUniversity of Malawi College of MedicinePrins Leopold Instituut voor Tropische GeneeskundeKU LeuvenNational Institute for Biomedical ResearchUniversity Hospital of KinshasaUniversity of WitwatersrandPublic Health EnglandSt Augustine's HospitalUniversity of AbujaBingham UniversityQuadram Institute BioscienceUniversidad de la Republica Instituto de HigieneMinistry of HealthFiji Health Sector Support ProgramNational Institute of Cholera and Enteric Diseases IndiaANLIS-Carlos G Malbran InstituteNagasaki UniversityOxford University Clinical Research UnitMurdoch Children's Research InstituteInstitute of Environmental Science and Research Limited (ESR)ESR - Kenepuru Science CentreSamoa Ministry of HealthOrganisation Mondiale de la SanteHasanuddin UniversityTupua Tamasese Meaole HospitalMahidol UniversityAngkor Hospital for ChildrenUniversity of OtagoCardiff UniversityBarts and The London NHS TrustUniversity of Cambridge2018-12-112019-03-142018-12-112019-03-142016-09-22PLoS Neglected Tropical Diseases. Vol.10, No.9 (2016)19352735193527272-s2.0-84992386056https://repository.li.mahidol.ac.th/handle/20.500.14594/41138© 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.Mahidol UniversityMedicineArticleSCOPUS10.1371/journal.pntd.0004781