International journal of clinical microbiology最新文献

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Fecal Shedding, Antimicrobial Resistance and In Vitro Biofilm formation on Simulated Gallstones by Salmonella Typhi Isolated from Typhoid Cases and Asymptomatic Carriers in Nairobi, Kenya. 肯尼亚内罗毕伤寒病例和无症状带菌者中分离出的伤寒沙门氏菌在模拟胆结石上的粪便脱落、抗菌药耐药性和体外生物膜形成。

International journal of clinical microbiology

Pub Date : 2024-01-01 Epub Date: 2024-04-24 DOI: 10.14302/issn.2690-4721.ijcm-24-5030

Peter Muturi, Peter Wachira, Maina Wagacha, Cecilia Mbae, Susan Kavai, Musa Muhammed, John S Gunn, Samuel Kariuki

Typhoid fever, caused by the human restricted pathogen Salmonella Typhi, remains a major global public health concern. Even after successful treatment, approximately 3-5% of patients with typhoid fail to clear the bacteria within one year and become chronic carriers. Most typhoid carriers have gallstones in their gallbladder, and biofilm formation on gallstones is highly correlated with chronic carriage. This study's goal was to identify asymptomatic typhoid carriers in an endemic setting in Kenya, and to compare acute versus chronic isolates. A cohort of typhoid fever patients identified through blood and/or stool culture, and their household contacts, were followed up after treatment to detect longitudinal S. Typhi stool shedding. An abdominal ultrasound scan was used to identify individuals with gallstones. A total of 32 index patients and 32 household contacts were successfully followed-up. Gallstones were detected in 4 cases and 1 household contact. The duration of S. Typhi shedding was significantly longer in individuals with gallstones compared to those without, P<0.001. Eighty-three (83) S. Typhi strains were tested for susceptibility to commonly used antimicrobials and examined by in vitro biofilm formation assays. Out of 37 infected individuals, 32.4% had infections caused by multidrug resistant (MDR) S. Typhi strains and only 18.9% were infected by susceptible strains. Non-MDR strains formed significantly better biofilms in vitro than the MDR strains (P<0.001). This study provides data on S. Typhi chronic carriage that will influence public health approaches aimed at reducing typhoid transmission and the burden of infection.

伤寒是由人类限制性病原体伤寒沙门氏菌引起的，它仍然是全球主要的公共卫生问题。即使经过成功治疗，约有 3-5% 的伤寒患者也无法在一年内清除细菌，成为慢性带菌者。大多数伤寒携带者的胆囊中都有胆结石，而胆结石上生物膜的形成与慢性携带高度相关。这项研究的目的是在肯尼亚地方病流行的环境中发现无症状的伤寒携带者，并对急性和慢性分离株进行比较。对通过血液和/或粪便培养确定的伤寒患者及其家庭接触者进行治疗后随访，以检测粪便中伤寒杆菌的纵向带菌情况。腹部超声波扫描用于识别胆结石患者。共成功随访了 32 名指标患者和 32 名家庭接触者。其中 4 例患者和 1 名家庭接触者被检测出患有胆结石。与无胆结石者相比，有胆结石者的伤寒杆菌脱落持续时间明显更长。检测了 Typhi 菌株对常用抗菌药物的敏感性，并通过体外生物膜形成试验进行了检验。在37名感染者中，32.4%的感染者是由耐多药（MDR）伤寒杆菌菌株引起的，只有18.9%的感染者是由易感菌株引起的。非 MDR 菌株在体外形成的生物膜明显优于 MDR 菌株（PS.Typhi 慢性携带者），这将影响旨在减少伤寒传播和感染负担的公共卫生方法。

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Genotypic Diversity among Salmonella Typhi Isolated from Children Living in Informal Settlements in Nairobi, Kenya. 从肯尼亚内罗毕非正规住区儿童身上分离出的伤寒沙门氏菌的基因型多样性。

International journal of clinical microbiology

Pub Date : 2024-01-01 Epub Date: 2024-09-16 DOI: 10.14302/issn.2690-4721.ijcm-24-5195

Susan Mutile Kavai, Julius Oyugi, Cecilia Mbae, Celestine Wairimu, Kelvin Kering, Collins Kebenei, Peter Muturi, Sylvia Omulo, Samuel Kariuki

The persistence of multidrug-resistant (MDR) Salmonella Typhi (S. Typhi) is a challenge especially in regions where typhoid is endemic. Surveillance of circulating genotypes of MDR S. Typhi is crucial in typhoid acute cases and carriers. This study aimed to investigate genotypic diversity of S. Typhi from symptomatic and asymptomatic children in endemic settings in Nairobi, Kenya. Symptomatic and asymptomatic individuals' ≤ 16 years were recruited at four health facilities and tested for typhoid through stool cultures. The S. Typhi isolates were subjected to antibiotic susceptibility testing to investigate multidrug resistance. The MDR S. Typhi isolates' DNA was extracted and illumina sequenced. Raw reads were de novo assembled and analyzed by pathogen-watch. From the 90 sequenced isolates, 60 (67%) were confirmed to be S. Typhi (sequence Type 1 and genotype 4.3.1). Out of the 60 S. Typhi strains; 39 (65%) had plasmids, from these 38 (97%) had IncHI1 plasmids alone. Out of the 60, 59 (98%) S. Typhi isolates had bla _TEM-1D . Point mutations conferring reduced susceptibility to quinolones were detected in 42 (70%) of S. Typhi isolates, from these; 14 (33%) had gyrA S83Y, and 28 (67%) gyrB S464F genes, respectively. This study reports 4.3.1 (H58) as the most dominant S. Typhi genotype responsible for spread of MDR phenotypes carried on IncHI1 plasmids. Presence of MDR S. Typhi with resistance genes such as bla _TEM-1D and reduced susceptibility to ciprofloxacin especially among asymptomatic individuals, reiterates the need for use of typhoid conjugate vaccine among vulnerable children as a control and prevention measure against typhoid.

耐多药（MDR）伤寒沙门氏菌（S. Typhi）的持续存在是一项挑战，尤其是在伤寒流行的地区。对伤寒急性病例和带菌者进行耐多药伤寒沙门氏菌循环基因型监测至关重要。本研究旨在调查肯尼亚内罗毕地方病流行地区有症状和无症状儿童的伤寒杆菌基因型多样性。研究人员在四家医疗机构招募了年龄小于16岁的有症状和无症状儿童，并通过粪便培养进行伤寒检测。对分离出的伤寒杆菌进行抗生素药敏试验，以调查多重耐药性。对多重耐药性伤寒杆菌分离株的DNA进行提取和illumina测序。通过病原体观察（pathogen-watch）对原始读数进行重新组装和分析。在90个测序分离物中，有60个（67%）被确认为伤寒杆菌（序列类型1和基因型4.3.1）。在 60 株伤寒杆菌中，39 株（65%）带有质粒，其中 38 株（97%）仅带有 IncHI1 质粒。在 60 株伤寒杆菌中，有 59 株（98%）分离出 bla TEM-1D。在 42 个（70%）伤寒杆菌分离株中检测到了对喹诺酮类药物敏感性降低的点突变，其中 14 个（33%）分离株的 gyrA 基因为 S83Y，28 个（67%）分离株的 gyrB 基因为 S464F。本研究报告指出，4.3.1（H58）是导致以 IncHI1 质粒为载体的 MDR 表型传播的最主要伤寒杆菌基因型。带有耐药基因（如 bla TEM-1D）的 MDR 伤寒杆菌的存在以及对环丙沙星敏感性的降低（尤其是在无症状的个体中），重申了在易感儿童中使用伤寒结合疫苗作为伤寒防控措施的必要性。

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