Persistent circulation of a fluoroquinolone-resistant Salmonella enterica Typhi clone in the Indian subcontinent
| Autor: | Ashish Bosco, Savitha Nagaraj, Sanju Jose, Zoe A. Dyson, Kathryn E. Holt, Andrew J. Pollard, Carl Britto, Sitarah Mathias, Gordon Dougan |
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| Jazyk: | angličtina |
| Rok vydání: | 2020 |
| Předmět: |
0301 basic medicine
Microbiology (medical) 030106 microbiology India Microbial Sensitivity Tests Drug resistance Salmonella typhi Typhoid fever 03 medical and health sciences Antibiotic resistance Drug Resistance Bacterial Humans Medicine Pharmacology (medical) Blood culture Typhoid Fever Original Research Pharmacology Whole Genome Sequencing medicine.diagnostic_test biology business.industry Transmission (medicine) biology.organism_classification medicine.disease Virology Anti-Bacterial Agents Vaccination 030104 developmental biology Infectious Diseases Salmonella enterica business Fluoroquinolones |
| Zdroj: | Journal of Antimicrobial Chemotherapy |
| ISSN: | 0305-7453 |
| Popis: | Background The molecular structure of circulating enteric fever pathogens was studied using hospital-based genomic surveillance in a tertiary care referral centre in South India as a first genomic surveillance study, to our knowledge, of blood culture-confirmed enteric fever in the region. Methods Blood culture surveillance was conducted at St John’s Medical College Hospital, Bengaluru, between July 2016 and June 2017. The bacterial isolates collected were linked to demographic variables of patients and subjected to WGS. The resulting pathogen genomic data were also globally contextualized to gauge possible phylogeographical patterns. Results Hospital-based genomic surveillance for enteric fever in Bengaluru, India, identified 101 Salmonella enterica Typhi and 14 S. Paratyphi A in a 1 year period. Ninety-six percent of isolates displayed non-susceptibility to fluoroquinolones. WGS showed the dominant pathogen was S. Typhi genotype 4.3.1.2 (H58 lineage II). A fluoroquinolone-resistant triple-mutant clone of S. Typhi 4.3.1.2 previously associated with gatifloxacin treatment failure in Nepal was implicated in 18% of enteric fever cases, indicating ongoing inter-regional circulation. Conclusions Enteric fever in South India continues to be a major public health issue and is strongly associated with antimicrobial resistance. Robust microbiological surveillance is necessary to direct appropriate treatment and preventive strategies. Of particular concern is the emergence and expansion of the highly fluoroquinolone-resistant triple-mutant S. Typhi clone and its ongoing inter- and intra-country transmission in South Asia, which highlights the need for regional coordination of intervention strategies, including vaccination and longer-term strategies such as improvements to support hygiene and sanitation. |
| Databáze: | OpenAIRE |
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