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Non-typhoidal Salmonella bloodstream infections in Kisantu, DR Congo: emergence of O5-negative Salmonella Typhimurium and extensive drug resistance. / Tack, Bieke; Phoba, Marie-France; Barbé, Barbara; Kalonji, Lisette M; Hardy, Liselotte; Van Puyvelde, Sandra; Ingelbeen, Brecht; Falay, Dadi; Ngbonda, Dauly; van der Sande, Marianne A B; Deborggraeve, Stijn; Jacobs, Jan; Lunguya, Octavie.

In: PLoS Neglected Tropical Diseases, Vol. 14, Nr. 4, e0008121, 2020.

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@article{0ff52c18f31e4abba55f26a33ffa5d20,
title = "Non-typhoidal Salmonella bloodstream infections in Kisantu, DR Congo: emergence of O5-negative Salmonella Typhimurium and extensive drug resistance",
abstract = "BACKGROUND: Non-typhoidal Salmonella (NTS) are a major cause of bloodstream infection (BSI) in sub-Saharan Africa. This study aimed to assess its longitudinal evolution as cause of BSI, its serotype distribution and its antibiotic resistance pattern in Kisantu, DR Congo.METHODS: As part of a national surveillance network, blood cultures were sampled in patients with suspected BSI admitted to Kisantu referral hospital from 2015-2017. Blood cultures were worked-up according to international standards. Results were compared to similar data from 2007 onwards.RESULTS: In 2015-2017, NTS (n = 896) represented the primary cause of BSI. NTS were isolated from 7.6{\%} of 11,764 suspected and 65.4{\%} of 1371 confirmed BSI. In children <5 years, NTS accounted for 9.6{\%} of suspected BSI. These data were in line with data from previous surveillance periods, except for the proportion of confirmed BSI, which was lower in previous surveillance periods. Salmonella Typhimurium accounted for 63.1{\%} of NTS BSI and Salmonella Enteritidis for 36.4{\%}. Of all Salmonella Typhimurium, 36.9{\%} did not express the O5-antigen (i.e. variant Copenhagen). O5-negative Salmonella Typhimurium were rare before 2013, but increased gradually from then onwards. Multidrug resistance was observed in 87.4{\%} of 864 NTS isolates, decreased ciprofloxacin susceptibility in 7.3{\%}, ceftriaxone resistance in 15.7{\%} and azithromycin resistance in 14.9{\%}. A total of 14.2{\%} of NTS isolates, that were all Salmonella Typhimurium, were multidrug resistant and ceftriaxone and azithromycin co-resistant. These Salmonella isolates were called extensively drug resistant. Compared to previous surveillance periods, proportions of NTS isolates with resistance to ceftriaxone and azithromycin and decreased ciprofloxacin susceptibility increased.CONCLUSION: As in previous surveillance periods, NTS ranked first as the cause of BSI in children. The emergence of O5-negative Salmonella Typhimurium needs to be considered in the light of vaccine development. The high proportions of antibiotic resistance are worrisome.",
author = "Bieke Tack and Marie-France Phoba and Barbara Barb{\'e} and Kalonji, {Lisette M} and Liselotte Hardy and {Van Puyvelde}, Sandra and Brecht Ingelbeen and Dadi Falay and Dauly Ngbonda and {van der Sande}, {Marianne A B} and Stijn Deborggraeve and Jan Jacobs and Octavie Lunguya",
note = "CPDF",
year = "2020",
doi = "10.1371/journal.pntd.0008121",
language = "English",
volume = "14",
journal = "PLoS Neglected Tropical Diseases",
issn = "1935-2727",
publisher = "Public Library of Science",
number = "4",

}

RIS

TY - JOUR

T1 - Non-typhoidal Salmonella bloodstream infections in Kisantu, DR Congo: emergence of O5-negative Salmonella Typhimurium and extensive drug resistance

AU - Tack, Bieke

AU - Phoba, Marie-France

AU - Barbé, Barbara

AU - Kalonji, Lisette M

AU - Hardy, Liselotte

AU - Van Puyvelde, Sandra

AU - Ingelbeen, Brecht

AU - Falay, Dadi

AU - Ngbonda, Dauly

AU - van der Sande, Marianne A B

AU - Deborggraeve, Stijn

AU - Jacobs, Jan

AU - Lunguya, Octavie

N1 - CPDF

PY - 2020

Y1 - 2020

N2 - BACKGROUND: Non-typhoidal Salmonella (NTS) are a major cause of bloodstream infection (BSI) in sub-Saharan Africa. This study aimed to assess its longitudinal evolution as cause of BSI, its serotype distribution and its antibiotic resistance pattern in Kisantu, DR Congo.METHODS: As part of a national surveillance network, blood cultures were sampled in patients with suspected BSI admitted to Kisantu referral hospital from 2015-2017. Blood cultures were worked-up according to international standards. Results were compared to similar data from 2007 onwards.RESULTS: In 2015-2017, NTS (n = 896) represented the primary cause of BSI. NTS were isolated from 7.6% of 11,764 suspected and 65.4% of 1371 confirmed BSI. In children <5 years, NTS accounted for 9.6% of suspected BSI. These data were in line with data from previous surveillance periods, except for the proportion of confirmed BSI, which was lower in previous surveillance periods. Salmonella Typhimurium accounted for 63.1% of NTS BSI and Salmonella Enteritidis for 36.4%. Of all Salmonella Typhimurium, 36.9% did not express the O5-antigen (i.e. variant Copenhagen). O5-negative Salmonella Typhimurium were rare before 2013, but increased gradually from then onwards. Multidrug resistance was observed in 87.4% of 864 NTS isolates, decreased ciprofloxacin susceptibility in 7.3%, ceftriaxone resistance in 15.7% and azithromycin resistance in 14.9%. A total of 14.2% of NTS isolates, that were all Salmonella Typhimurium, were multidrug resistant and ceftriaxone and azithromycin co-resistant. These Salmonella isolates were called extensively drug resistant. Compared to previous surveillance periods, proportions of NTS isolates with resistance to ceftriaxone and azithromycin and decreased ciprofloxacin susceptibility increased.CONCLUSION: As in previous surveillance periods, NTS ranked first as the cause of BSI in children. The emergence of O5-negative Salmonella Typhimurium needs to be considered in the light of vaccine development. The high proportions of antibiotic resistance are worrisome.

AB - BACKGROUND: Non-typhoidal Salmonella (NTS) are a major cause of bloodstream infection (BSI) in sub-Saharan Africa. This study aimed to assess its longitudinal evolution as cause of BSI, its serotype distribution and its antibiotic resistance pattern in Kisantu, DR Congo.METHODS: As part of a national surveillance network, blood cultures were sampled in patients with suspected BSI admitted to Kisantu referral hospital from 2015-2017. Blood cultures were worked-up according to international standards. Results were compared to similar data from 2007 onwards.RESULTS: In 2015-2017, NTS (n = 896) represented the primary cause of BSI. NTS were isolated from 7.6% of 11,764 suspected and 65.4% of 1371 confirmed BSI. In children <5 years, NTS accounted for 9.6% of suspected BSI. These data were in line with data from previous surveillance periods, except for the proportion of confirmed BSI, which was lower in previous surveillance periods. Salmonella Typhimurium accounted for 63.1% of NTS BSI and Salmonella Enteritidis for 36.4%. Of all Salmonella Typhimurium, 36.9% did not express the O5-antigen (i.e. variant Copenhagen). O5-negative Salmonella Typhimurium were rare before 2013, but increased gradually from then onwards. Multidrug resistance was observed in 87.4% of 864 NTS isolates, decreased ciprofloxacin susceptibility in 7.3%, ceftriaxone resistance in 15.7% and azithromycin resistance in 14.9%. A total of 14.2% of NTS isolates, that were all Salmonella Typhimurium, were multidrug resistant and ceftriaxone and azithromycin co-resistant. These Salmonella isolates were called extensively drug resistant. Compared to previous surveillance periods, proportions of NTS isolates with resistance to ceftriaxone and azithromycin and decreased ciprofloxacin susceptibility increased.CONCLUSION: As in previous surveillance periods, NTS ranked first as the cause of BSI in children. The emergence of O5-negative Salmonella Typhimurium needs to be considered in the light of vaccine development. The high proportions of antibiotic resistance are worrisome.

U2 - 10.1371/journal.pntd.0008121

DO - 10.1371/journal.pntd.0008121

M3 - A1: Web of Science-article

C2 - 32240161

VL - 14

JO - PLoS Neglected Tropical Diseases

JF - PLoS Neglected Tropical Diseases

SN - 1935-2727

IS - 4

M1 - e0008121

ER -

ID: 3307658