Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa

International Typhoid Consortium

Research output: Contribution to journalArticle

16 Citations (Scopus)

Abstract

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.

Original languageEnglish (US)
Article numbere0004781
JournalPLoS neglected tropical diseases
Volume10
Issue number9
DOIs
StatePublished - Sep 22 2016

Fingerprint

Western Africa
Typhoid Fever
Nigeria
Central Africa
Plasmids
Southern Africa
Eastern Africa
Salmonella typhi
Phylogeny
Microbial Drug Resistance
Bacteremia
Haplotypes
Epidemiology
Public Health
Genotype
Serogroup
Genome
Morbidity
Mortality
Population

ASJC Scopus subject areas

  • Public Health, Environmental and Occupational Health
  • Infectious Diseases

Cite this

Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa. / International Typhoid Consortium.

In: PLoS neglected tropical diseases, Vol. 10, No. 9, e0004781, 22.09.2016.

Research output: Contribution to journalArticle

@article{67f7cfa2cd6d4e8eb09188fd7334b89d,
title = "Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa",
abstract = "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.",
author = "{International Typhoid Consortium} and Wong, {Vanessa K.} and Holt, {Kathryn E.} and Chinyere Okoro and Stephen Baker and Pickard, {Derek J.} and Florian Marks and Page, {Andrew J.} and Grace Olanipekun and Huda Munir and Roxanne Alter and Fey, {Paul D.} and Fey, {Paul D} and Weill, {Francois Xavier} and {Le Hello}, Simon and Hart, {Peter J.} and Samuel Kariuki and Breiman, {Robert F.} and Gordon, {Melita A.} and Heyderman, {Robert S.} and Jan Jacobs and Octavie Lunguya and Chisomo Msefula and MacLennan, {Calman A.} and Keddy, {Karen H.} and Smith, {Anthony M.} and Onsare, {Robert S.} and {De Pinna}, Elizabeth and Satheesh Nair and Ben Amos and Gordon Dougan and Stephen Obaro and Obaro, {Stephen K} and Julian Parkhill and Page, {Andrew J.} and Kingsley, {Robert A.} and Thomson, {Nicholas R.} and Keane, {Jacqueline A.} and Weill, {Fran{\cc}ois Xavier} and Jane Hawkey and Edwards, {David J.} and Dyson, {Zoe A.} and Harris, {Simon R.} and Cain, {Amy K.} and James Hadfield and {Vu Thieu}, {Nga Tran} and Klemm, {Elizabeth J.} and Watson, {Conall H.} and {John Edmunds}, W. and Chabalgoity, {Jose A.} and Mike Kama",
year = "2016",
month = "9",
day = "22",
doi = "10.1371/journal.pntd.0004781",
language = "English (US)",
volume = "10",
journal = "PLoS Neglected Tropical Diseases",
issn = "1935-2727",
publisher = "Public Library of Science",
number = "9",

}

TY - JOUR

T1 - Molecular Surveillance Identifies Multiple Transmissions of Typhoid in West Africa

AU - International Typhoid Consortium

AU - Wong, Vanessa K.

AU - Holt, Kathryn E.

AU - Okoro, Chinyere

AU - Baker, Stephen

AU - Pickard, Derek J.

AU - Marks, Florian

AU - Page, Andrew J.

AU - Olanipekun, Grace

AU - Munir, Huda

AU - Alter, Roxanne

AU - Fey, Paul D.

AU - Fey, Paul D

AU - Weill, Francois Xavier

AU - Le Hello, Simon

AU - Hart, Peter J.

AU - Kariuki, Samuel

AU - Breiman, Robert F.

AU - Gordon, Melita A.

AU - Heyderman, Robert S.

AU - Jacobs, Jan

AU - Lunguya, Octavie

AU - Msefula, Chisomo

AU - MacLennan, Calman A.

AU - Keddy, Karen H.

AU - Smith, Anthony M.

AU - Onsare, Robert S.

AU - De Pinna, Elizabeth

AU - Nair, Satheesh

AU - Amos, Ben

AU - Dougan, Gordon

AU - Obaro, Stephen

AU - Obaro, Stephen K

AU - Parkhill, Julian

AU - Page, Andrew J.

AU - Kingsley, Robert A.

AU - Thomson, Nicholas R.

AU - Keane, Jacqueline A.

AU - Weill, François Xavier

AU - Hawkey, Jane

AU - Edwards, David J.

AU - Dyson, Zoe A.

AU - Harris, Simon R.

AU - Cain, Amy K.

AU - Hadfield, James

AU - Vu Thieu, Nga Tran

AU - Klemm, Elizabeth J.

AU - Watson, Conall H.

AU - John Edmunds, W.

AU - Chabalgoity, Jose A.

AU - Kama, Mike

PY - 2016/9/22

Y1 - 2016/9/22

N2 - 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.

AB - 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.

UR - http://www.scopus.com/inward/record.url?scp=84992386056&partnerID=8YFLogxK

UR - http://www.scopus.com/inward/citedby.url?scp=84992386056&partnerID=8YFLogxK

U2 - 10.1371/journal.pntd.0004781

DO - 10.1371/journal.pntd.0004781

M3 - Article

C2 - 27657909

AN - SCOPUS:84992386056

VL - 10

JO - PLoS Neglected Tropical Diseases

JF - PLoS Neglected Tropical Diseases

SN - 1935-2727

IS - 9

M1 - e0004781

ER -