New Variant of Multidrug-Resistant Salmonella enterica Serovar Typhimurium Associated with Invasive Disease in Immunocompromised Patients in Vietnam.
New Variant of Multidrug-Resistant Salmonella enterica Serovar Typhimurium Associated with Invasive Disease in Immunocompromised Patients in Vietnam.
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DOI：
10.1128/mbio.01056-18
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发表时间：
2018-09-04
期刊：
影响因子：
6.4
通讯作者：
Baker S
中科院分区：
文献类型：
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作者：
Mather AE;Phuong TLT;Gao Y;Clare S;Mukhopadhyay S;Goulding DA;Hoang NTD;Tuyen HT;Lan NPH;Thompson CN;Trang NHT;Carrique-Mas J;Tue NT;Campbell JI;Rabaa MA;Thanh DP;Harcourt K;Hoa NT;Trung NV;Schultsz C;Perron GG;Coia JE;Brown DJ;Okoro C;Parkhill J;Thomson NR;Chau NVV;Thwaites GE;Maskell DJ;Dougan G;Kenney LJ;Baker S
鼠伤寒沙门氏菌（Salmonella Typhimurium）是一种主要的肠道病原体，与易感人群中的侵袭性非伤寒沙门氏菌（iNTS）疾病相关。我们提出了在东南亚的iNTS生物体的第一个特征，并描述了不同的进化轨迹，从生物体引起的iNTS在撒哈拉以南非洲。在越南，全球分布的鼠伤寒沙门氏菌的双相变异体，血清型I：4，[5]，12：i：− ST 34克隆，已经重新获得了2期鞭毛，并获得了与HIV感染患者的iNTS疾病相关的多药耐药质粒。我们记录不同的社区S。鼠伤寒和I：4，[5]，12：i：−在越南的动物和人类中，尽管这些宿主种群在这里有更大的混合。这些数据强调了在一个健康环境中全基因组测序监测在了解耐药细菌感染的演变和传播方面的重要性。非伤寒沙门氏菌（NTS），特别是鼠伤寒沙门氏菌，是全球细菌性小肠结肠炎的主要病原体之一，也是撒哈拉以南非洲地区侵袭性疾病（iNTS）的主要原因。相比之下，鼠伤寒沙门氏菌在东南亚的定义不明确，东南亚是已知的人畜共患病热点，最近描述了iNTS疾病的负担。在此，我们旨在深入了解越南与iNTS和小肠结肠炎相关的鼠伤寒沙门氏菌中人畜共患病转移和抗菌素耐药性（AMR）的流行病学和潜在影响。我们对越南分离的85株人类（小肠结肠炎、携带和iNTS）和113株动物鼠伤寒沙门氏菌分离株进行了全基因组测序和系统发育重建。我们发现鼠伤寒沙门氏菌人畜共患传播的证据有限。然而，我们描述了一系列事件，其中鼠伤寒沙门氏菌的流行性双相变异体（血清型I：4，[5]，12：i：−序列类型34 [ST 34]）已被引入越南，重新获得2期鞭毛，并获得IncHI 2多药耐药质粒。值得注意的是，这些新型双相ST34鼠伤寒沙门氏菌变体与越南HIV感染患者的iNTS显著相关。我们的研究代表了撒哈拉以南非洲以外地区分离的新型iNTS生物的首次表征，并概述了替代沙门氏菌变体进入易感人群的新途径。
Salmonella Typhimurium is a major diarrheal pathogen and associated with invasive nontyphoid Salmonella (iNTS) disease in vulnerable populations. We present the first characterization of iNTS organisms in Southeast Asia and describe a different evolutionary trajectory from that of organisms causing iNTS in sub-Saharan Africa. In Vietnam, the globally distributed monophasic variant of Salmonella Typhimurium, the serovar I:4,[5],12:i:− ST34 clone, has reacquired a phase 2 flagellum and gained a multidrug-resistant plasmid to become associated with iNTS disease in HIV-infected patients. We document distinct communities of S. Typhimurium and I:4,[5],12:i:− in animals and humans in Vietnam, despite the greater mixing of these host populations here. These data highlight the importance of whole-genome sequencing surveillance in a One Health context in understanding the evolution and spread of resistant bacterial infections. Nontyphoidal Salmonella (NTS), particularly Salmonella enterica serovar Typhimurium, is among the leading etiologic agents of bacterial enterocolitis globally and a well-characterized cause of invasive disease (iNTS) in sub-Saharan Africa. In contrast, S. Typhimurium is poorly defined in Southeast Asia, a known hot spot for zoonotic disease with a recently described burden of iNTS disease. Here, we aimed to add insight into the epidemiology and potential impact of zoonotic transfer and antimicrobial resistance (AMR) in S. Typhimurium associated with iNTS and enterocolitis in Vietnam. We performed whole-genome sequencing and phylogenetic reconstruction on 85 human (enterocolitis, carriage, and iNTS) and 113 animal S. Typhimurium isolates isolated in Vietnam. We found limited evidence for the zoonotic transmission of S. Typhimurium. However, we describe a chain of events where a pandemic monophasic variant of S. Typhimurium (serovar I:4,[5],12:i:− sequence type 34 [ST34]) has been introduced into Vietnam, reacquired a phase 2 flagellum, and acquired an IncHI2 multidrug-resistant plasmid. Notably, these novel biphasic ST34 S. Typhimurium variants were significantly associated with iNTS in Vietnamese HIV-infected patients. Our study represents the first characterization of novel iNTS organisms isolated outside sub-Saharan Africa and outlines a new pathway for the emergence of alternative Salmonella variants into susceptible human populations.