Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa

BACKGROUND: Non-typhoidal Salmonella are frequently food-borne zoonotic pathogens that may cause invasive disease in HIV-positive individuals. METHODOLOGY: Invasive isolates (n = 652) of Salmonella Typhimurium from human patients in Gauteng Province of South Africa were investigated for the years 20...

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Main Authors: Karen H. Keddy, Sarika Dwarika, Penny Crowther, Olga Perovic, Jeanette Wadula, Anwar Hoosen, Arvinda Sooka, Heather H. Crewe-Brown, Anthony M. Smith
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2009-09-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/549
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author Karen H. Keddy
Sarika Dwarika
Penny Crowther
Olga Perovic
Jeanette Wadula
Anwar Hoosen
Arvinda Sooka
Heather H. Crewe-Brown
Anthony M. Smith
author_facet Karen H. Keddy
Sarika Dwarika
Penny Crowther
Olga Perovic
Jeanette Wadula
Anwar Hoosen
Arvinda Sooka
Heather H. Crewe-Brown
Anthony M. Smith
author_sort Karen H. Keddy
collection DOAJ
description BACKGROUND: Non-typhoidal Salmonella are frequently food-borne zoonotic pathogens that may cause invasive disease in HIV-positive individuals. METHODOLOGY: Invasive isolates (n = 652) of Salmonella Typhimurium from human patients in Gauteng Province of South Africa were investigated for the years 2006 and 2007. Bacteria were identified using standard microbiological techniques and serotyping was performed using commercially available antisera. Susceptibility testing to antimicrobial agents was determined by the E-test. Genotypic relatedness of isolates was investigated by pulsed-field gel electrophoresis analysis of digested genomic DNA. RESULTS: Forty-five clusters of isolates were identified, of which four (clusters 3, 5, 6 and 11) were major clusters. Most isolates originated from hospital H2 and most were isolated from patients in the age range of 15 to 64 years. Ninety-three percent (213/230) of patients with a known HIV status were HIV-positive. Most isolates showed resistance to multiple antibiotics. The most commonly expressed antibiotic resistance profiles were ACSSuNa (14%; 75/555) and ACSSuTNa (13%; 72/555). Some evidence was found for nosocomial acquisition of isolates. Of the isolates from the major clusters 3, 5, 6, and 11, 33% (8/24), 6% (7/117), 4% (1/26) and 6% (3/52) were of nosocomial origin, respectively. CONCLUSIONS: In South Africa, Salmonella Typhimurium remains a major opportunistic infection of predominantly HIV-positive patients. Clonally diverse strains that are resistant to multiple antibiotics may circulate in patients aged between 15 and 64 years over prolonged periods within the hospital environment, adding to the health care burden.
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spelling doaj-art-822d74af1585494bb4e4cf3e9c9904f62025-08-20T03:48:58ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802009-09-0130810.3855/jidc.549Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South AfricaKaren H. Keddy0Sarika Dwarika1Penny Crowther2Olga Perovic3Jeanette Wadula4Anwar Hoosen5Arvinda Sooka6Heather H. Crewe-Brown7Anthony M. Smith8Enteric Diseases Reference Unit, National Institute for Communicable Diseases, JohannesburgEnteric Diseases Reference Unit, National Institute for Communicable Diseases, JohannesburgNational Microbiology Surveillance Unit, National Institute for Communicable Diseases, JohannesburgDepartment of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service, University of Witwatersrand, JohannesburgDepartment of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service, University of Witwatersrand, JohannesburgDepartment of Medical Microbiology, University of Pretoria and National Health Laboratory Service Tshwane Academic Division, PretoriaEnteric Diseases Reference Unit, National Institute for Communicable Diseases, JohannesburgDepartment of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service, University of Witwatersrand, JohannesburgDepartment of Clinical Microbiology and Infectious Diseases, National Health Laboratory Service, University of Witwatersrand, JohannesburgBACKGROUND: Non-typhoidal Salmonella are frequently food-borne zoonotic pathogens that may cause invasive disease in HIV-positive individuals. METHODOLOGY: Invasive isolates (n = 652) of Salmonella Typhimurium from human patients in Gauteng Province of South Africa were investigated for the years 2006 and 2007. Bacteria were identified using standard microbiological techniques and serotyping was performed using commercially available antisera. Susceptibility testing to antimicrobial agents was determined by the E-test. Genotypic relatedness of isolates was investigated by pulsed-field gel electrophoresis analysis of digested genomic DNA. RESULTS: Forty-five clusters of isolates were identified, of which four (clusters 3, 5, 6 and 11) were major clusters. Most isolates originated from hospital H2 and most were isolated from patients in the age range of 15 to 64 years. Ninety-three percent (213/230) of patients with a known HIV status were HIV-positive. Most isolates showed resistance to multiple antibiotics. The most commonly expressed antibiotic resistance profiles were ACSSuNa (14%; 75/555) and ACSSuTNa (13%; 72/555). Some evidence was found for nosocomial acquisition of isolates. Of the isolates from the major clusters 3, 5, 6, and 11, 33% (8/24), 6% (7/117), 4% (1/26) and 6% (3/52) were of nosocomial origin, respectively. CONCLUSIONS: In South Africa, Salmonella Typhimurium remains a major opportunistic infection of predominantly HIV-positive patients. Clonally diverse strains that are resistant to multiple antibiotics may circulate in patients aged between 15 and 64 years over prolonged periods within the hospital environment, adding to the health care burden.https://jidc.org/index.php/journal/article/view/549Salmonella TyphimuriumHIVinvasivenosocomialSouth Africa
spellingShingle Karen H. Keddy
Sarika Dwarika
Penny Crowther
Olga Perovic
Jeanette Wadula
Anwar Hoosen
Arvinda Sooka
Heather H. Crewe-Brown
Anthony M. Smith
Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
Journal of Infection in Developing Countries
Salmonella Typhimurium
HIV
invasive
nosocomial
South Africa
title Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
title_full Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
title_fullStr Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
title_full_unstemmed Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
title_short Genotypic and demographic characterization of invasive isolates of Salmonella Typhimurium in HIV co-infected patients in South Africa
title_sort genotypic and demographic characterization of invasive isolates of salmonella typhimurium in hiv co infected patients in south africa
topic Salmonella Typhimurium
HIV
invasive
nosocomial
South Africa
url https://jidc.org/index.php/journal/article/view/549
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