A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi with Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa

Hassan M. Al-Emran, Daniel Eibach, Ralf Krumkamp, Mohammad Ali, Stephen Baker, Holly M. Biggs, Morten Bjerregaard-Andersen, Robert F. Breiman, John D. Clemens, John A. Crump, Ligia Maria Cruz Espinoza, Jessica Deerin, Denise Myriam Dekker, Amy Gassama Sow, Julian T. Hertz, Justin Im, Samuel Ibrango, Vera Von Kalckreuth, Leon Parfait Kabore, Frank KoningsSandra Valborg Løfberg, Christian G. Meyer, Eric D. Mintz, Joel M. Montgomery, Beatrice Olack, Gi Deok Pak, Ursula Panzner, Se Eun Park, Jean Luco Tsiriniaina Razafindrabe, Henintsoa Rabezanahary, Jean Philibert Rakotondrainiarivelo, Raphaël Rakotozandrindrainy, Tiana Mirana Raminosoa, Heidi Schütt-Gerowitt, Emmanuel Sampo, Abdramane Bassiahi Soura, Adama Tall, Michelle Warren, Thomas F. Wierzba, Jürgen May, Florian Marks

Research output: Contribution to journalArticle

Abstract

Background. Salmonella enterica serovar Typhi is a predominant cause of bloodstream infections in sub-Saharan Africa (SSA). Increasing numbers of S. Typhi with resistance to ciprofloxacin have been reported from different parts of the world. However, data from SSA are limited. In this study, we aimed to measure the ciprofloxacin susceptibility of S. Typhi isolated from patients with febrile illness in SSA. Methods. Febrile patients from 9 sites within 6 countries in SSA with a body temperature of ≥38.0°C were enrolled in this study. Blood samples were obtained for bacterial culture, and Salmonella isolates were identified biochemically and confirmed by multiplex polymerase chain reaction (PCR). Antimicrobial susceptibility of all Salmonella isolates was performed by disk diffusion test, and minimum inhibitory concentrations (MICs) against ciprofloxacin were measured by Etest. All Salmonella isolates with reduced susceptibility to ciprofloxacin (MIC > 0.06 μg/mL) were screened for mutations in quinolone resistance-determining regions in target genes, and the presence of plasmid-mediated quinolone resistance (PMQR) genes was assessed by PCR. Results. A total of 8161 blood cultures were performed, and 100 (1.2%) S. Typhi, 2 (

Original languageEnglish (US)
Pages (from-to)s42-s46
JournalClinical Infectious Diseases
Volume62
DOIs
StatePublished - Mar 15 2016

Fingerprint

Salmonella typhi
Africa South of the Sahara
Ciprofloxacin
Salmonella
Quinolones
Microbial Sensitivity Tests
Fever
Disk Diffusion Antimicrobial Tests
Multiplex Polymerase Chain Reaction
Body Temperature
Genes
Plasmids
Polymerase Chain Reaction
Mutation
Infection

Keywords

  • ciprofloxacin
  • S. Typhi
  • sub-Saharan Africa
  • susceptible

ASJC Scopus subject areas

  • Infectious Diseases
  • Microbiology (medical)

Cite this

A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi with Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa. / Al-Emran, Hassan M.; Eibach, Daniel; Krumkamp, Ralf; Ali, Mohammad; Baker, Stephen; Biggs, Holly M.; Bjerregaard-Andersen, Morten; Breiman, Robert F.; Clemens, John D.; Crump, John A.; Cruz Espinoza, Ligia Maria; Deerin, Jessica; Dekker, Denise Myriam; Gassama Sow, Amy; Hertz, Julian T.; Im, Justin; Ibrango, Samuel; Von Kalckreuth, Vera; Kabore, Leon Parfait; Konings, Frank; Løfberg, Sandra Valborg; Meyer, Christian G.; Mintz, Eric D.; Montgomery, Joel M.; Olack, Beatrice; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Razafindrabe, Jean Luco Tsiriniaina; Rabezanahary, Henintsoa; Rakotondrainiarivelo, Jean Philibert; Rakotozandrindrainy, Raphaël; Raminosoa, Tiana Mirana; Schütt-Gerowitt, Heidi; Sampo, Emmanuel; Soura, Abdramane Bassiahi; Tall, Adama; Warren, Michelle; Wierzba, Thomas F.; May, Jürgen; Marks, Florian.

In: Clinical Infectious Diseases, Vol. 62, 15.03.2016, p. s42-s46.

Research output: Contribution to journalArticle

Al-Emran, HM, Eibach, D, Krumkamp, R, Ali, M, Baker, S, Biggs, HM, Bjerregaard-Andersen, M, Breiman, RF, Clemens, JD, Crump, JA, Cruz Espinoza, LM, Deerin, J, Dekker, DM, Gassama Sow, A, Hertz, JT, Im, J, Ibrango, S, Von Kalckreuth, V, Kabore, LP, Konings, F, Løfberg, SV, Meyer, CG, Mintz, ED, Montgomery, JM, Olack, B, Pak, GD, Panzner, U, Park, SE, Razafindrabe, JLT, Rabezanahary, H, Rakotondrainiarivelo, JP, Rakotozandrindrainy, R, Raminosoa, TM, Schütt-Gerowitt, H, Sampo, E, Soura, AB, Tall, A, Warren, M, Wierzba, TF, May, J & Marks, F 2016, 'A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi with Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa', Clinical Infectious Diseases, vol. 62, pp. s42-s46. https://doi.org/10.1093/cid/civ788
Al-Emran, Hassan M. ; Eibach, Daniel ; Krumkamp, Ralf ; Ali, Mohammad ; Baker, Stephen ; Biggs, Holly M. ; Bjerregaard-Andersen, Morten ; Breiman, Robert F. ; Clemens, John D. ; Crump, John A. ; Cruz Espinoza, Ligia Maria ; Deerin, Jessica ; Dekker, Denise Myriam ; Gassama Sow, Amy ; Hertz, Julian T. ; Im, Justin ; Ibrango, Samuel ; Von Kalckreuth, Vera ; Kabore, Leon Parfait ; Konings, Frank ; Løfberg, Sandra Valborg ; Meyer, Christian G. ; Mintz, Eric D. ; Montgomery, Joel M. ; Olack, Beatrice ; Pak, Gi Deok ; Panzner, Ursula ; Park, Se Eun ; Razafindrabe, Jean Luco Tsiriniaina ; Rabezanahary, Henintsoa ; Rakotondrainiarivelo, Jean Philibert ; Rakotozandrindrainy, Raphaël ; Raminosoa, Tiana Mirana ; Schütt-Gerowitt, Heidi ; Sampo, Emmanuel ; Soura, Abdramane Bassiahi ; Tall, Adama ; Warren, Michelle ; Wierzba, Thomas F. ; May, Jürgen ; Marks, Florian. / A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi with Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa. In: Clinical Infectious Diseases. 2016 ; Vol. 62. pp. s42-s46.
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AU - Al-Emran, Hassan M.

AU - Eibach, Daniel

AU - Krumkamp, Ralf

AU - Ali, Mohammad

AU - Baker, Stephen

AU - Biggs, Holly M.

AU - Bjerregaard-Andersen, Morten

AU - Breiman, Robert F.

AU - Clemens, John D.

AU - Crump, John A.

AU - Cruz Espinoza, Ligia Maria

AU - Deerin, Jessica

AU - Dekker, Denise Myriam

AU - Gassama Sow, Amy

AU - Hertz, Julian T.

AU - Im, Justin

AU - Ibrango, Samuel

AU - Von Kalckreuth, Vera

AU - Kabore, Leon Parfait

AU - Konings, Frank

AU - Løfberg, Sandra Valborg

AU - Meyer, Christian G.

AU - Mintz, Eric D.

AU - Montgomery, Joel M.

AU - Olack, Beatrice

AU - Pak, Gi Deok

AU - Panzner, Ursula

AU - Park, Se Eun

AU - Razafindrabe, Jean Luco Tsiriniaina

AU - Rabezanahary, Henintsoa

AU - Rakotondrainiarivelo, Jean Philibert

AU - Rakotozandrindrainy, Raphaël

AU - Raminosoa, Tiana Mirana

AU - Schütt-Gerowitt, Heidi

AU - Sampo, Emmanuel

AU - Soura, Abdramane Bassiahi

AU - Tall, Adama

AU - Warren, Michelle

AU - Wierzba, Thomas F.

AU - May, Jürgen

AU - Marks, Florian

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N2 - Background. Salmonella enterica serovar Typhi is a predominant cause of bloodstream infections in sub-Saharan Africa (SSA). Increasing numbers of S. Typhi with resistance to ciprofloxacin have been reported from different parts of the world. However, data from SSA are limited. In this study, we aimed to measure the ciprofloxacin susceptibility of S. Typhi isolated from patients with febrile illness in SSA. Methods. Febrile patients from 9 sites within 6 countries in SSA with a body temperature of ≥38.0°C were enrolled in this study. Blood samples were obtained for bacterial culture, and Salmonella isolates were identified biochemically and confirmed by multiplex polymerase chain reaction (PCR). Antimicrobial susceptibility of all Salmonella isolates was performed by disk diffusion test, and minimum inhibitory concentrations (MICs) against ciprofloxacin were measured by Etest. All Salmonella isolates with reduced susceptibility to ciprofloxacin (MIC > 0.06 μg/mL) were screened for mutations in quinolone resistance-determining regions in target genes, and the presence of plasmid-mediated quinolone resistance (PMQR) genes was assessed by PCR. Results. A total of 8161 blood cultures were performed, and 100 (1.2%) S. Typhi, 2 (

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