当前位置： SCI文献检索 > PLoS Neglected Tropical Diseases期刊下所有文献 > Rapid emergence of multidrug resistant, H58-lineage Salmonella typhi in Blantyre, Malawi.

Rapid emergence of multidrug resistant, H58-lineage Salmonella typhi in Blantyre, Malawi.

Abstract：

INTRODUCTION:Between 1998 and 2010, S. Typhi was an uncommon cause of bloodstream infection (BSI) in Blantyre, Malawi and it was usually susceptible to first-line antimicrobial therapy. In 2011 an increase in a multidrug resistant (MDR) strain was detected through routine bacteriological surveillance conducted at Queen Elizabeth Central Hospital (QECH). METHODS:Longitudinal trends in culture-confirmed Typhoid admissions at QECH were described between 1998-2014. A retrospective review of patient cases notes was conducted, focusing on clinical presentation, prevalence of HIV and case-fatality. Isolates of S. Typhi were sequenced and the phylogeny of Typhoid in Blantyre was reconstructed and placed in a global context. RESULTS:Between 1998-2010, there were a mean of 14 microbiological diagnoses of Typhoid/year at QECH, of which 6.8% were MDR. This increased to 67 in 2011 and 782 in 2014 at which time 97% were MDR. The disease predominantly affected children and young adults (median age 11 [IQR 6-21] in 2014). The prevalence of HIV in adult patients was 16.7% [8/48], similar to that of the general population (17.8%). Overall, the case fatality rate was 2.5% (3/94). Complications included anaemia, myocarditis, pneumonia and intestinal perforation. 112 isolates were sequenced and the phylogeny demonstrated the introduction and clonal expansion of the H58 lineage of S. Typhi. CONCLUSIONS:Since 2011, there has been a rapid increase in the incidence of multidrug resistant, H58-lineage Typhoid in Blantyre. This is one of a number of reports of the re-emergence of Typhoid in Southern and Eastern Africa. There is an urgent need to understand the reservoirs and transmission of disease and how to arrest this regional increase.

journal_name

PLoS Negl Trop Dis

journal_title

PLoS neglected tropical diseases

authors

Feasey NA,Gaskell K,Wong V,Msefula C,Selemani G,Kumwenda S,Allain TJ,Mallewa J,Kennedy N,Bennett A,Nyirongo JO,Nyondo PA,Zulu MD,Parkhill J,Dougan G,Gordon MA,Heyderman RS

doi

10.1371/journal.pntd.0003748

subject

Has Abstract

pub_date

2015-04-24 00:00:00

pages

e0003748

issue

eissn

1935-2727

issn

1935-2735

pii

PNTD-D-15-00131

journal_volume

pub_type

杂志文章

在线工具

Rapid emergence of multidrug resistant, H58-lineage Salmonella typhi in Blantyre, Malawi.