Temporal fluctuation of multidrug resistant salmonella typhi haplotypes in the mekong river delta region of Vietnam.
Temporal fluctuation of multidrug resistant salmonella typhi haplotypes in the mekong river delta region of Vietnam.
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DOI：
10.1371/journal.pntd.0000929
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发表时间：
2011-01-04
影响因子：
3.8
通讯作者：
Baker S
中科院分区：
文献类型：
--
作者：
Holt KE;Dolecek C;Chau TT;Duy PT;La TT;Hoang NV;Nga TV;Campbell JI;Manh BH;Vinh Chau NV;Hien TT;Farrar J;Dougan G;Baker S
伤寒仍然是越南的一个公共卫生问题，对湄公河三角洲地区造成重大负担。伤寒是由伤寒沙门氏菌引起的。伤寒），这是经常多药耐药与氟喹诺酮类药物的敏感性降低，为治疗伤寒的首选。我们使用GoldenGate（Illumina）检测法对1,500个单核苷酸多态性（SNP）进行分型，并分析S.从2004年至2005年湄公河三角洲地区参与一项随机试验的267名伤寒患者中分离出的伤寒。S.在研究期间传播的伤寒是高度克隆的，91%的分离株属于单一的S。伤寒H58单倍群。疾病的模式与地方性单倍型H58-C的存在和局部爆发的S。伤寒单倍型H58-E2。H58-E2相关伤寒病例显示出沿湄公河分支颂湖沿着具有显著地理空间聚集性的证据。H58-E2的多药耐药率较低，而H58-C的耐药率较高，而H58-S的耐药率较高。伤寒杆菌对萘啶酸耐药，并在gyrA基因中携带Ser 83 Phe氨基酸取代。H58单倍型群占优势。伤寒人口在其他流行地区，但这里描述的人口比以前研究的人口更均匀，在这项研究中观察到的优势克隆复合体（H58-C，-E1，-E2）尚未检测到越南以外。含IncHI 1质粒的S.伤寒H58-C在研究期间流行，而H58-E2很少携带质粒，只是短暂的，这表明质粒的选择性优势。这些数据增加了对沙门氏菌爆发动力学和当地分子流行病学的了解。伤寒在越南南部。在越南的一些地区，包括湄公河三角洲地区，伤寒仍然是严重的公共卫生问题。伤寒是由伤寒沙门氏菌引起的，它经常具有多重耐药性，对氟喹诺酮类药物的敏感性降低。我们分析了S. 2004年至2005年，从湄公河三角洲267例伤寒患者中分离出伤寒菌，并鉴定出遗传上不同的S。伤寒菌株。我们还检测到这些菌株中存在赋予耐药性的基因或突变。我们发现绝大多数伤寒病例是由H58 S的两个亚群之一引起的。伤寒，称为H58-C和H58-E2。H58-E2群似乎在2004年引起了一次疫情，影响了居住在湄公河附近一个小区域的患者。另一组，H58-C，在整个研究期间都存在，影响了生活在湄公河三角洲更广泛地区的患者。大多数H58-C菌株对多种药物耐药，并携带编码多种耐药基因的质粒。然而，很少有H58-E2菌株具有多重耐药性，这可能解释了为什么该菌株在最初爆发后没有持续存在。
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. 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 H u 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 acid substitution in the gyrA gene. The H58 haplogroup dominates S. Typhi populations in other endemic areas, but the population described here was more homogeneous 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. Typhoid fever remains a serious public health issue in some parts of Vietnam, including the Mekong delta region. Typhoid is caused by the bacterium Salmonella Typhi, which is frequently multidrug resistant and shows reduced susceptibility to fluoroquinolone-based drugs. We assayed single nucleotide variation in the genomes of S. Typhi organisms isolated from 267 patients with typhoid fever in the Mekong delta between 2004 and 2005, and identified genetically distinct S. Typhi strains. We also detected the presence of genes or mutations that confer drug resistance in those strains. We found that the vast majority of typhoid cases were caused by one of two subgroups of H58 S. Typhi, referred to as H58-C and H58-E2. The H58-E2 group appeared to cause an outbreak in 2004, affecting patients living in a small zone near the Mekong River. The other group, H58-C, was present throughout the study period and affected patients living in a broader area of the Mekong River delta. Most of the H58-C strains were resistant to multiple drugs and carried a plasmid encoding multiple resistance genes. However very few H58-E2 strains were multidrug resistant, which may explain why the strain did not persist after the initial outbreak.
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影响因子：
30.8
作者：
Holt, Kathryn E.;Parkhill, Julian;Mazzoni, Camila J.;Roumagnac, Philippe;Weill, Francois-Xavier;Goodhead, Ian;Rance, Richard;Baker, Stephen;Maskell, Duncan J.;Wain, John;Dolecek, Christiane;Achtman, Mark;Dougan, Gordon
通讯作者：
Dougan, Gordon
影响因子：
4.9
作者：
Crump, John A.;Kretsinger, Katrina;Angulo, Frederick J.
通讯作者：
Angulo, Frederick J.
影响因子：
2.8
作者：
TAYLOR, DE;BROSE, EC
通讯作者：
BROSE, EC
DOI：
10.4269/ajtmh.2000.62.644
发表时间：
2000-05-01
影响因子：
3.3
作者：
Lin, FYC;Ho, VA;Robbins, JB
通讯作者：
Robbins, JB
影响因子：
9.4
作者：
Baker, Stephen;Holt, Kathryn;Dougan, Gordon
通讯作者：
Dougan, Gordon