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Cited by 50Salmonella and Campylobacter epidemiologyAntibiotic Resistance in BacteriaBacterial Infections and Vaccines

The genomic epidemiology of multi-drug resistant invasive non-typhoidal Salmonella in selected sub-Saharan African countries

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Park, Se Eun, Pham, Duy Thanh, Pak, Gi Deok, Panzner, Ursula, Maria Cruz Espinoza, Ligia, von Kalckreuth, Vera, Im, Justin, Mogeni, Ondari D. +45 more·2021·BMJ Global Health
DOI 10.1136/bmjgh-2021-005659PMC PMC8330565
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Abstract

Background: Invasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant (MDR) iNTS serovars across the continent. Methods: A total of 166 iNTS isolates collected from a multi-centre surveillance in 10 African countries (2010–2014) and a fever study in Ghana (2007–2009) were genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes–genotypes. Phylogenetic analyses were conducted in the context of the existing genomic frameworks for various iNTS serovars. Population-based incidence of MDR-iNTS disease was estimated in each study site. Results: Salmonella Typhimurium sequence-type (ST) 313 and Salmonella Enteritidis ST11 were predominant, and both exhibited high frequencies of MDR; Salmonella Dublin ST10 was identified in West Africa only. Mutations in the gyrA gene (fluoroquinolone resistance) were identified in S. Enteritidis and S. Typhimurium in Ghana; an ST313 isolate carrying bla CTX-M-15 was found in Kenya. International transmission of MDR ST313 (lineage II) and MDR ST11 (West African clade) was observed between Ghana and neighbouring West African countries. The incidence of MDR-iNTS disease exceeded 100/100 000 person-years-of-observation in children aged <5 years in several West African countries. Conclusions: We identified the circulation of multiple MDR iNTS serovar STs in the sampled sub-Saharan African countries. Investment in the development and deployment of iNTS vaccines coupled with intensified antimicrobial resistance surveillance are essential to limit the impact of these pathogens in Africa.

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  • Invasive strains of multidrug-resistant non-typhoidal Salmonella circulating in sub-Saharan Africa are predominantly Salmonella Typhimurium ST313 and Salmonella Enteritidis ST11, although Salmonella Dublin ST10 has only been associated with resistance in West Africa.

    “Invasive strains of multidrug-resistant NTS circulating in SSA are predominantly S. Typhimurium ST313 and S. Enteritidis ST11, although S. Dublin ST10 has only been associated with resistance in West Africa.96,104”

    From Antimicrobial Resistance Rates and Surveillance in Sub-Saharan Africa: Where Are We Now? (2022) · cites this paper as [104]

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Authors
Park, S. E., Pham, D. T., Pak, G. D., Panzner, U., Maria Cruz Espinoza, L., von Kalckreuth, V., Im, J., Mogeni, O. D., Schütt-Gerowitt, H., Crump, J. A., Breiman, R. F., Adu-Sarkodie, Y., Owusu-Dabo, E., Rakotozandrindrainy, R., Bassiahi Soura, A., Aseffa, A., Gasmelseed, N., Sooka, A., Keddy, K. H., May, J., Aaby, P., Biggs, H. M., Hertz, J. T., Montgomery, J. M., Cosmas, L., Olack, B., Fields, B., Sarpong, N., Razafindrabe, T. J. L., Raminosoa, T. M., Kabore, L. P., Sampo, E., Teferi, M., Yeshitela, B., El Tayeb, M. A., Krumkamp, R., Dekker, D. M., Jaeger, A., Tall, A., Gassama, A., Niang, A., Bjerregaard-Andersen, M., Løfberg, S. V., Deerin, J. F., Park, J. K., Konings, F., Carey, M. E., Van Puyvelde, S., Ali, M., Clemens, J., Dougan, G., Baker, S., & Marks, F.
Affiliations
  • International Vaccine Institute (KR)
  • The Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
  • International Vaccine Institute, Seoul, Republic of Korea
  • Duke University (US)
  • Emory University (US)
  • Kwame Nkrumah University of Science and Technology, Kumasi, Ghana
  • University of Antananarivo (MG)
  • Institut Supérieur des Sciences de la Population, University of Ouagadougou, Ouagadougou, Burkina Faso
  • Armauer Hansen Research Institute (ET)
  • University of Hafr Al-Batin (SA)
  • National Institute for Communicable Diseases (ZA)
  • University of the Witwatersrand (ZA)
  • German Center for Infection Research (DE)
  • Statens Serum Institut (DK)
  • Duke Medical Center (US)
  • Kenya Medical Research Institute (KE)
  • Kwame Nkrumah University of Science and Technology (GH)
  • Schiphra Hospital, Ouagadougou, Burkina Faso
  • Faculty of Medicine, University of Gezira, Wad Medani, Sudan
  • Institut Pasteur de Dakar (SN)
  • Institute Pasteur de Dakar, Dakar, Senegal
  • University of Cambridge (GB)
  • Medicine, Cambridge University, Cambridge, UK
  • Department of Medicine, University of Cambridge, Cambridge, Cambridgeshire, UK
Corresponding author
Baker, Stephen
ORCID
Venue
BMJ Global Health
Publisher
BMJ
Published
2021-08
Volume
6
Issue
8
Pages
e005659
ISSN
2059-7908 (ISSN-L)
DOI
10.1136/bmjgh-2021-005659
PMC
PMC8330565
OpenAlex
W3188242408
Cited by
50
References
2
Citations by year
2026: 16 · 2025: 15 · 2024: 3 · 2023: 7 · 2022: 9
FWCI
2.84
Type
journal article
Language
en
Open access
Licence
Locations
  • BMJ Global Health (publishedVersion, cc-by-nc)
  • PubMed Central (publishedVersion, cc-by-nc)
  • PubMed (publishedVersion)
  • Kölner Universitäts PublikationsServer (Universität zu Köln) (publishedVersion)
  • LSHTM Research Online (London School of Hygiene and Tropical Medicine) (acceptedVersion)
  • Apollo (University of Cambridge) (submittedVersion, cc-by-nc)
  • Apollo (University of Cambridge) (submittedVersion, other-oa)
  • DOAJ (DOAJ: Directory of Open Access Journals) (submittedVersion)
  • YUHSpace (Yonsei University Medical Library) (submittedVersion, cc-by-nc-nd)
  • Apollo
Funders
  • Swedish International Development Cooperation Agency
  • Oak Foundation (215515/Z/19/Z, OCAY-15-547)
  • Biotechnology and Biological Sciences Research Council (BB/J010367)
  • Bill & Melinda Gates Foundation (OPPGH5231)
  • Government of Republic of Korea
  • US Centers for Disease Control and Prevention
  • National Institutes of Health (P30 AI064518, PA-03-018, R01TW009237, R24 TW007988, U01 AI062563, U01 AI067854, U01 AI069484)
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Medicine › Antibiotic Resistance in Bacteria
  • Life Sciences › Immunology and Microbiology › Microbiology › Bacterial Infections and Vaccines
Keywords
invasive non-typhoidal Salmonella, multidrug resistance, Salmonella Typhimurium ST313, population structure, phylogenetic analysis, gyrA mutations, fluoroquinolone resistance, blaCTX-M-15, international transmission, bacteremia, disease incidence, sub-Saharan Africa, antimicrobial resistance surveillance
MeSH terms
Child, Pharmaceutical Preparations, Humans, Kenya, Phylogeny, Salmonella typhimurium, Genomics

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