Surveillance of Salmonella enterica serovar Typhi in Colombia, 2012-2015
Surveillance of Salmonella enterica serovar Typhi in Colombia, 2012-2015
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DOI：
10.1371/journal.pntd.0008040
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发表时间：
2020-03-01
影响因子：
3.8
通讯作者：
Baker, Stephen
中科院分区：
文献类型：
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作者：
Diaz-Guevara, Paula;Angeline Montano, Lucy;Baker, Stephen
伤寒沙门氏菌（S.伤寒（Typhi）是伤寒的病原体;伤寒是一种全身性疾病，每年影响全球约2000万人。关于伤寒在拉丁美洲的当代流行病学资料很少。因此，我们的目的是使用2012年至2015年期间向国家公共卫生监测系统（Sivigila）报告的病例来描述哥伦比亚伤寒的一些最新流行病学方面。在四年报告期内，哥伦比亚有836例伤寒培养确诊病例，其中大多数（676/836; 80.1%）报告病例仅来自七个省。我们进一步描述了402 S。通过抗菌药物敏感性测试和分子亚型分析，从哥伦比亚各部门回收伤寒菌株及可用的相应数据。这些伤寒病例中的大多数（235/402; 58.5%）发生在男性中，最常见于10至29岁之间的人群（218/402; 54.2%）;据报道有3人（0.74%）死亡。以S.伤寒对所有测试的抗菌剂敏感。微生物表现出不敏感性的最常见抗菌剂是氨苄青霉素（30/402; 7.5%），其次是萘啶酸（23/402，5.7%）。分子分型确定了大量的遗传多样性，分布在全国各地。尽管S.伤寒基因型，我们确定了各种地理热点的疾病与当地的优势基因型。值得注意的是，我们发现哥伦比亚基因型与其他拉丁美洲国家报告的生物体重叠有限。我们的工作突出了哥伦比亚伤寒的巨大负担，其特点是在一些地区持续传播，在其他省份流行有限。该疾病在全国广泛分布，并与似乎仅限于哥伦比亚的多种抗生素敏感基因型有关。这项研究提供了一个当前的角度来看，伤寒在拉丁美洲，并强调病原体特异性监测的重要性，以增加洞察有限的流行病学伤寒在这一地区。
Salmonella Typhi (S. Typhi) is the causative agent of typhoid fever; a systemic disease affecting similar to 20 million people per year globally. There are little data regarding the contemporary epidemiology of typhoid in Latin America. Consequently, we aimed to describe some recent epidemiological aspects of typhoid in Colombia using cases reported to the National Public Health Surveillance System (Sivigila) between 2012 and 2015. Over the four-year reporting period there were 836 culture confirmed cases of typhoid in Colombia, with the majority (676/836; 80.1%) of reported cases originated from only seven departments. We further characterized 402 S. Typhi isolates with available corresponding data recovered from various departments of Colombia through antimicrobial susceptibility testing and molecular subtyping. The majority (235/402; 58.5%) of these typhoid cases occurred in males and were most commonly reported in those aged between 10 and 29 years (218/402; 54.2%); there were three (0.74%) reported fatalities. The overwhelming preponderance (339/402; 84.3%) of S. Typhi were susceptible to all tested antimicrobials. The most common antimicrobial to which the organisms exhibited non-susceptibility was ampicillin (30/402;7.5%), followed by nalidixic acid (23/402, 5.7%). Molecular subtyping identified substantial genetic diversity, which was well distributed across the country. Despite the diffuse pattern of S. Typhi genotypes, we identified various geographical hotspots of disease associated with local dominant genotypes. Notably, we found limited overlap of Colombian genotypes with organisms reported in other Latin American countries. Our work highlights a substantial burden of typhoid in Colombia, characterized by sustained transmission in some regions and limited epidemics in other departments. The disease is widely distributed across the country and associated with multiple antimicrobial susceptible genotypes that appear to be restricted to Colombia. This study provides a current perspective for typhoid in Latin America and highlights the importance of pathogen-specific surveillance to add insight into the limited epidemiology of typhoid in this region.