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

Published version
Peer-reviewed

Type

Article

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Authors

Pham, Duy Thanh 
Boinett, Christine 
Wong, Vanessa K 
Pak, Gi Deok 

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.

Description

Keywords

Africa South of the Sahara, Anti-Bacterial Agents, Drug Resistance, Multiple, Bacterial, Genetic Variation, Genotype, Humans, Incidence, Phylogeny, Phylogeography, Salmonella Infections, Salmonella typhi, Typhoid Fever

Journal Title

Nat Commun

Conference Name

Journal ISSN

2041-1723
2041-1723

Volume Title

9

Publisher

Springer Science and Business Media LLC
Sponsorship
Wellcome Trust (106158/Z/14/Z)