TY - JOUR
T1 - Genomic epidemiology and antimicrobial resistance mechanisms of imported typhoid in australia
AU - Ingle, Danielle J.
AU - Andersson, Patiyan
AU - Valcanis, Mary
AU - Wilmot, Mathilda
AU - Easton, Marion
AU - Lane, Courtney
AU - Barden, Jessica
AU - Da Silva, Anders Gonçalves
AU - Seemann, Torsten
AU - Horan, Kristy
AU - Ballard, Susan A.
AU - Sherry, Norelle L.
AU - Williamson, Deborah A.
AU - Howden, Benjamin P.
N1 - The Microbiological Diagnostic Unit Public Health Laboratory is funded by the Victorian Government. D.J.I. was supported by a National Health and Medical Research Council (NHMRC) Emerging Leadership Fellowship (GNT1195210). B.P.H. was supported by NHMRC Leadership Fellowship (GNT1196103). D.A.W. is supported by an NHMRC Emerging Leadership Fellowship (GNT1174555).
PY - 2021/11/17
Y1 - 2021/11/17
N2 - Typhoid fever is an invasive bacterial disease of humans that disproportionately affects low- and middle-income countries. Antimicrobial resistance (AMR) has been increasingly prevalent in recent decades in Salmonella enterica serovar Typhi (S. Typhi), the causative agent of typhoid fever, limiting treatment options. In Australia, most cases of typhoid fever are imported due to travel to regions where typhoid fever is endemic. Here, all 116 isolates of S. Typhi isolated in Victoria, Australia, between 1 July 2018 and 30 June 2020, underwent whole-genome sequencing and antimicrobial susceptibility testing. Genomic data were linked to international travel data collected from routine case interviews. Travel to South Asia accounted for most cases, with 92.2% imported from seven primary countries (the top two were India, n = 87, and Pakistan, n = 12). A total of 17 S. Typhi genotypes were detected in the 2-year cohort, with 48.2% genotyped as part of global AMR lineages. Ciprofloxacin resistance was detected in two lineages, 3.3 and 4.3.1.2, all from cases with reported travel to India. Nearly all multidrug and extensively drug resistant isolates (90%) were from cases with reported travel to Pakistan in genotypes 4.3.1.1 and 4.3.1.1.P1. Extended spectrum beta-lactamases, blaCTX-M-15 and blaSHV-12, were detected in cases with travel to Pakistan and India, respectively. Linking epidemiological data with genomic studies of S. Typhi provides an opportunity to improve understanding of the emergence, spread and risk of drug-resistant S. Typhi infections and to better inform empirical treatment guidelines in returned travelers.
AB - Typhoid fever is an invasive bacterial disease of humans that disproportionately affects low- and middle-income countries. Antimicrobial resistance (AMR) has been increasingly prevalent in recent decades in Salmonella enterica serovar Typhi (S. Typhi), the causative agent of typhoid fever, limiting treatment options. In Australia, most cases of typhoid fever are imported due to travel to regions where typhoid fever is endemic. Here, all 116 isolates of S. Typhi isolated in Victoria, Australia, between 1 July 2018 and 30 June 2020, underwent whole-genome sequencing and antimicrobial susceptibility testing. Genomic data were linked to international travel data collected from routine case interviews. Travel to South Asia accounted for most cases, with 92.2% imported from seven primary countries (the top two were India, n = 87, and Pakistan, n = 12). A total of 17 S. Typhi genotypes were detected in the 2-year cohort, with 48.2% genotyped as part of global AMR lineages. Ciprofloxacin resistance was detected in two lineages, 3.3 and 4.3.1.2, all from cases with reported travel to India. Nearly all multidrug and extensively drug resistant isolates (90%) were from cases with reported travel to Pakistan in genotypes 4.3.1.1 and 4.3.1.1.P1. Extended spectrum beta-lactamases, blaCTX-M-15 and blaSHV-12, were detected in cases with travel to Pakistan and India, respectively. Linking epidemiological data with genomic studies of S. Typhi provides an opportunity to improve understanding of the emergence, spread and risk of drug-resistant S. Typhi infections and to better inform empirical treatment guidelines in returned travelers.
KW - Antimicrobial resistance
KW - Genomics
KW - Typhoid
U2 - 10.1128/AAC.01200-21
DO - 10.1128/AAC.01200-21
M3 - Article
C2 - 34543095
AN - SCOPUS:85119434903
SN - 0066-4804
VL - 65
JO - Antimicrobial Agents and Chemotherapy
JF - Antimicrobial Agents and Chemotherapy
IS - 12
M1 - e01200-21
ER -
