The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa

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    Author
    Park, SE; Duy, TP; Boinett, C; Wong, VK; Pak, GD; Panzner, U; Espinoza, LMC; von Kalckreuth, V; Im, J; Schuett-Gerowitt, H; ...
    Date
    2018-11-30
    Source Title
    Nature Communications
    Publisher
    NATURE PUBLISHING GROUP
    University of Melbourne Author/s
    Holt, Kathryn; Dougan, Gordon; Dyson, Zoe; Duchene Garzon, Sebastian
    Affiliation
    Biochemistry and Molecular Biology
    Microbiology and Immunology
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    Document Type
    Journal Article
    Citations
    Park, S. E., Duy, T. P., Boinett, C., Wong, V. K., Pak, G. D., Panzner, U., Espinoza, L. M. C., von Kalckreuth, V., Im, J., Schuett-Gerowitt, H., Crump, J. A., Breiman, R. F., Adu-Sarkodie, Y., Owusu-Dabo, E., Rakotozandrindrainy, R., Soura, A. B., Aseffa, A., Gasmelseed, N., Keddy, K. H. ,... Baker, S. (2018). The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa. NATURE COMMUNICATIONS, 9 (1), https://doi.org/10.1038/s41467-018-07370-z.
    Access Status
    Open Access
    URI
    http://hdl.handle.net/11343/253310
    DOI
    10.1038/s41467-018-07370-z
    Abstract
    There is paucity of data regarding the geographical distribution, incidence, and phylogenetics of multi-drug resistant (MDR) Salmonella Typhi in sub-Saharan Africa. Here we present a phylogenetic reconstruction of whole genome sequenced 249 contemporaneous S. Typhi isolated between 2008-2015 in 11 sub-Saharan African countries, in context of the 2,057 global S. Typhi genomic framework. Despite the broad genetic diversity, the majority of organisms (225/249; 90%) belong to only three genotypes, 4.3.1 (H58) (99/249; 40%), 3.1.1 (97/249; 39%), and 2.3.2 (29/249; 12%). Genotypes 4.3.1 and 3.1.1 are confined within East and West Africa, respectively. MDR phenotype is found in over 50% of organisms restricted within these dominant genotypes. High incidences of MDR S. Typhi are calculated in locations with a high burden of typhoid, specifically in children aged <15 years. Antimicrobial stewardship, MDR surveillance, and the introduction of typhoid conjugate vaccines will be critical for the control of MDR typhoid in Africa.

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