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Temporal fluctuation of multidrug resistant Salmonella Typhi haplotypes in the Mekong River delta region of Vietnam

Abstract:

Background: Typhoid fever remains a public health problem in Vietnam, with a significant burden in the Mekong River delta region. Typhoid fever is caused by the bacterial pathogen Salmonella enterica serovar Typhi (S.Typhi), which is frequently multidrug resistant with reduced susceptibility to fluoroquinolone-based drugs, the first choice for the treatment of typhoid fever. We used a GoldenGate (Illumina) assay to type 1,500 single nucleotide polymorphisms (SNPs) and analyse the genetic variation of S. Typhi isolated from 267 typhoid fever patients in the Mekong delta region participating in a randomized trial conducted between 2004 and 2005.

Principal findings: The population of S. Typhi circulating during the study was highly clonal, with 91% of isolates belonging to a single clonal complex of the S. Typhi H58 haplogroup. The patterns of disease were consistent with the presence of an endemic haplotype H58-C and a localised outbreak of S. Typhi haplotype H58-E2 in 2004. H58-E2-associated typhoid fever cases exhibited evidence of significant geo-spatial clustering along the Sông Hậu branch of the Mekong River. Multidrug resistance was common in the established clone H58-C but not in the outbreak clone H58-E2, however all H58 S. Typhi were nalidixic acid resistant and carried a Ser83Phe amino acide substitution in the gyrA gene.

Significance: The H58 haplogroup dominates S. Typhi populations in other endemic areas, but the population described here was more homogenous than previously examined populations, and the dominant clonal complex (H58-C, -E1, -E2) observed in this study has not been detected outside Vietnam. IncHI1 plasmid-bearing S. Typhi H58-C was endemic during the study period whilst H58-E2, which rarely carried the plasmid, was only transient, suggesting a selective advantage for the plasmid. These data add insight into the outbreak dynamics and local molecular epidemiology of S. Typhi in southern Vietnam.

Publication status:
Published
Peer review status:
Peer reviewed

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Publisher copy:
10.1371/journal.pntd.0000929

Authors

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Institution:
"Wellcome Trust Sanger Institute, Wellcome Trust Genome Campus, Hinxton, Cambridge, UK", "University of Melbourne, Australia"
Department:
Department of Microbiology and Immunology
Role:
Author
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Institution:
"Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam", "University of Oxford", "London School of Hygiene and Tropical Medicine, London, UK"
Department:
Medical Sciences Division - Clinical Vaccinology and Tropical Medicine,Centre for (CCVTM)
Role:
Author
More by this author
Institution:
Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
Role:
Author
More by this author
Institution:
Hospital for Tropical Diseases, Wellcome Trust Major Overseas Programme, Oxford University Clinical Research Unit, Ho Chi Minh City, Vietnam
Role:
Author
More by this author
Institution:
An Giang Provincial Hospital, My Binh, Long Xuyen, An Giang, Vietnam
Role:
Author


Publisher:
Public Library of Science
Journal:
PLoS Neglected Tropical Diseases More from this journal
Volume:
5
Issue:
1
Article number:
e929
Publication date:
2011-01-01
Edition:
Publisher's version
DOI:
EISSN:
1935-2735


Language:
English
Keywords:
Subjects:
UUID:
uuid:172c5102-52a8-41f5-b1a4-df396ac6151b
Local pid:
ora:5221
Deposit date:
2011-04-06
ARK identifier:

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