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Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers

Salmonella enterica serovar Typhi (S. Typhi) is the causative agent of typhoid fever, a systemic human infection with a burden exceeding 20 million cases each year that occurs disproportionately among children in low and middle income countries. Antimicrobial therapy is the mainstay for treatment, b...

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Autores principales: Ingle, Danielle J., Nair, Satheesh, Hartman, Hassan, Ashton, Philip M., Dyson, Zoe A., Day, Martin, Freedman, Joanne, Chattaway, Marie A., Holt, Kathryn E., Dallman, Timothy J.
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Public Library of Science 2019
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741848/
https://www.ncbi.nlm.nih.gov/pubmed/31513580
http://dx.doi.org/10.1371/journal.pntd.0007620
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author Ingle, Danielle J.
Nair, Satheesh
Hartman, Hassan
Ashton, Philip M.
Dyson, Zoe A.
Day, Martin
Freedman, Joanne
Chattaway, Marie A.
Holt, Kathryn E.
Dallman, Timothy J.
author_facet Ingle, Danielle J.
Nair, Satheesh
Hartman, Hassan
Ashton, Philip M.
Dyson, Zoe A.
Day, Martin
Freedman, Joanne
Chattaway, Marie A.
Holt, Kathryn E.
Dallman, Timothy J.
author_sort Ingle, Danielle J.
collection PubMed
description Salmonella enterica serovar Typhi (S. Typhi) is the causative agent of typhoid fever, a systemic human infection with a burden exceeding 20 million cases each year that occurs disproportionately among children in low and middle income countries. Antimicrobial therapy is the mainstay for treatment, but resistance to multiple agents is common. Here we report genotypes and antimicrobial resistance (AMR) determinants detected from routine whole-genome sequencing (WGS) of 533 S. Typhi isolates referred to Public Health England between April 2014 and March 2017, 488 (92%) of which had accompanying patient travel information obtained via an enhanced surveillance questionnaire. The majority of cases involved S. Typhi 4.3.1 (H58) linked with travel to South Asia (59%). Travel to East and West Africa were associated with genotypes 4.3.1 and 3.3.1, respectively. Point mutations in the quinolone resistance determining region (QRDR), associated with reduced susceptibility to fluoroquinolones, were very common (85% of all cases) but the frequency varied significantly by region of travel: 95% in South Asia, 43% in East Africa, 27% in West Africa. QRDR triple mutants, resistant to ciprofloxacin, were restricted to 4.3.1 lineage II and associated with travel to India, accounting for 23% of cases reporting travel to the country. Overall 24% of isolates were MDR, however the frequency varied significantly by region and country of travel: 27% in West Africa, 52% in East Africa, 55% in Pakistan, 24% in Bangladesh, 3% in India. MDR determinants were plasmid-borne (IncHI1 PST2 plasmids) in S. Typhi 3.1.1 linked to West Africa, but in all other regions MDR was chromosomally integrated in 4.3.1 lineage I. We propose that routine WGS data from travel-associated cases in industrialised countries could serve as informal sentinel AMR genomic surveillance data for countries where WGS is not available or routinely performed.
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spelling pubmed-67418482019-09-20 Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers Ingle, Danielle J. Nair, Satheesh Hartman, Hassan Ashton, Philip M. Dyson, Zoe A. Day, Martin Freedman, Joanne Chattaway, Marie A. Holt, Kathryn E. Dallman, Timothy J. PLoS Negl Trop Dis Research Article Salmonella enterica serovar Typhi (S. Typhi) is the causative agent of typhoid fever, a systemic human infection with a burden exceeding 20 million cases each year that occurs disproportionately among children in low and middle income countries. Antimicrobial therapy is the mainstay for treatment, but resistance to multiple agents is common. Here we report genotypes and antimicrobial resistance (AMR) determinants detected from routine whole-genome sequencing (WGS) of 533 S. Typhi isolates referred to Public Health England between April 2014 and March 2017, 488 (92%) of which had accompanying patient travel information obtained via an enhanced surveillance questionnaire. The majority of cases involved S. Typhi 4.3.1 (H58) linked with travel to South Asia (59%). Travel to East and West Africa were associated with genotypes 4.3.1 and 3.3.1, respectively. Point mutations in the quinolone resistance determining region (QRDR), associated with reduced susceptibility to fluoroquinolones, were very common (85% of all cases) but the frequency varied significantly by region of travel: 95% in South Asia, 43% in East Africa, 27% in West Africa. QRDR triple mutants, resistant to ciprofloxacin, were restricted to 4.3.1 lineage II and associated with travel to India, accounting for 23% of cases reporting travel to the country. Overall 24% of isolates were MDR, however the frequency varied significantly by region and country of travel: 27% in West Africa, 52% in East Africa, 55% in Pakistan, 24% in Bangladesh, 3% in India. MDR determinants were plasmid-borne (IncHI1 PST2 plasmids) in S. Typhi 3.1.1 linked to West Africa, but in all other regions MDR was chromosomally integrated in 4.3.1 lineage I. We propose that routine WGS data from travel-associated cases in industrialised countries could serve as informal sentinel AMR genomic surveillance data for countries where WGS is not available or routinely performed. Public Library of Science 2019-09-12 /pmc/articles/PMC6741848/ /pubmed/31513580 http://dx.doi.org/10.1371/journal.pntd.0007620 Text en © 2019 Ingle et al http://creativecommons.org/licenses/by/4.0/ This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.
spellingShingle Research Article
Ingle, Danielle J.
Nair, Satheesh
Hartman, Hassan
Ashton, Philip M.
Dyson, Zoe A.
Day, Martin
Freedman, Joanne
Chattaway, Marie A.
Holt, Kathryn E.
Dallman, Timothy J.
Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title_full Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title_fullStr Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title_full_unstemmed Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title_short Informal genomic surveillance of regional distribution of Salmonella Typhi genotypes and antimicrobial resistance via returning travellers
title_sort informal genomic surveillance of regional distribution of salmonella typhi genotypes and antimicrobial resistance via returning travellers
topic Research Article
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6741848/
https://www.ncbi.nlm.nih.gov/pubmed/31513580
http://dx.doi.org/10.1371/journal.pntd.0007620
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