The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa
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Date
2018
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Springer Nature
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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This article is published by Springer Nature and is also available at https://doi.org/10.1038/s41467-018-07370-z
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Park, S.E., Pham, D.T., Boinett, C. et al. The phylogeography and incidence of multi-drug resistant typhoid fever in sub-Saharan Africa. Nat Commun 9, 5094 (2018). https://doi.org/10.1038/s41467-018-07370-z