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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.

Original publication

DOI

10.1038/s41467-018-07370-z

Type

Journal article

Journal

Nature Communications

Publication Date

30/11/2018

Volume

9

Addresses

International Vaccine Institute, SNU Research Park, 1 Gwanak-ro, 1 Gwanak-gu, Seoul, 08826, Republic of Korea.

Keywords

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