التفاصيل البيبلوغرافية
| العنوان: |
Predominance of multidrug-resistant Salmonella Typhi genotype 4.3.1 with low-level ciprofloxacin resistance in Zanzibar. |
| المؤلفون: |
Onken, Annette1,2,3 (AUTHOR) annetteonken@yahoo.com, Moyo, Sabrina1,4 (AUTHOR), Miraji, Mohammed Khamis5 (AUTHOR), Bohlin, Jon6,7 (AUTHOR), Marijani, Msafiri8 (AUTHOR), Manyahi, Joel9 (AUTHOR), Kibwana, Kibwana Omar9 (AUTHOR), Müller, Fredrik10,11 (AUTHOR), Jenum, Pål A.3,11 (AUTHOR), Abeid, Khamis Ali12 (AUTHOR), Reimers, Marianne13 (AUTHOR), Langeland, Nina1,2 (AUTHOR), Mørch, Kristine1,2 (AUTHOR), Blomberg, Bjørn1,2 (AUTHOR) |
| المصدر: |
PLoS Neglected Tropical Diseases. 4/17/2024, Vol. 18 Issue 4, p1-17. 17p. |
| مصطلحات موضوعية: |
*SALMONELLA typhi, *TYPHOID fever, *CIPROFLOXACIN, *WHOLE genome sequencing, *MICROBIAL sensitivity tests, *GENOTYPES |
| مصطلحات جغرافية: |
ZANZIBAR, SOUTHEAST Asia |
| مستخلص: |
Background: Typhoid fever is a common cause of febrile illness in low- and middle-income countries. While multidrug-resistant (MDR) Salmonella Typhi (S. Typhi) has spread globally, fluoroquinolone resistance has mainly affected Asia. Methods: Consecutively, 1038 blood cultures were obtained from patients of all age groups with fever and/or suspicion of serious systemic infection admitted at Mnazi Mmoja Hospital, Zanzibar in 2015–2016. S. Typhi were analyzed with antimicrobial susceptibility testing and with short read (61 strains) and long read (9 strains) whole genome sequencing, including three S. Typhi strains isolated in a pilot study 2012–2013. Results: Sixty-three S. Typhi isolates (98%) were MDR carrying blaTEM-1B, sul1 and sul2, dfrA7 and catA1 genes. Low-level ciprofloxacin resistance was detected in 69% (43/62), with a single gyrase mutation gyrA-D87G in 41 strains, and a single gyrA-S83F mutation in the non-MDR strain. All isolates were susceptible to ceftriaxone and azithromycin. All MDR isolates belonged to genotype 4.3.1 lineage I (4.3.1.1), with the antimicrobial resistance determinants located on a composite transposon integrated into the chromosome. Phylogenetically, the MDR subgroup with ciprofloxacin resistance clusters together with two external isolates. Conclusions: We report a high rate of MDR and low-level ciprofloxacin resistant S. Typhi circulating in Zanzibar, belonging to genotype 4.3.1.1, which is widespread in Southeast Asia and African countries and associated with low-level ciprofloxacin resistance. Few therapeutic options are available for treatment of typhoid fever in the study setting. Surveillance of the prevalence, spread and antimicrobial susceptibility of S. Typhi can guide treatment and control efforts. Author summary: Salmonella Typhi causes typhoid fever. Multi-drug resistant (MDR) S. Typhi is spreading globally. Local and regional surveillance of MDR S. Typhi populations using both blood culture and whole genome sequencing can uncover outbreaks and help mapping the spread of S. Typhi and resistance mechanisms, which, in turn, can guide both control and prevention efforts and clinical management. Data regarding the distribution of MDR S. Typhi genotypes and resistance mechanisms is scarce in Zanzibar, Tanzania, as in many other African countries. In this study we characterize S. Typhi phenotypically and genotypically. This study shows high rate of MDR S. Typhi, hence few therapeutic options are available for treatment of typhoid fever in the study setting. Our findings contribute to the knowledge base on typhoid fever in the region and to guide correct treatment of individual patients and control of the disease. [ABSTRACT FROM AUTHOR] |
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