Emergence of ceftriaxone resistant Salmonella enterica serovar Typhi in Eastern India

Samajpati, Sriparna; Pragasam, Agila Kumari; Mandal, Subhranshu; Veeraraghavan, Balaji

doi:10.1016/j.meegid.2021.105093

Cited by 14 publications

(9 citation statements)

References 22 publications

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“…Cephalosporins and azithromycin are currently the first-line treatment for enteric fever in the majority of South Asian settings (12). Recent reports have established the emergence of third-generation cephalosporin resistant S. Typhi in India (12,36,37). In our study ceftriaxone resistance was linked to the acquisition of a IncX3 plasmid carrying the ESBL gene bla SHV-12.…”

Section: Discussionmentioning

confidence: 57%

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Population structure and antimicrobial resistance patterns ofSalmonellaTyphi and Paratyphi A amid a phased municipal vaccination campaign in Navi Mumbai, India

Silva

Date

Hirani

et al. 2023

Preprint

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We performed whole genome sequencing of 174 Salmonella Typhi and 54 Salmonella Paratyphi A isolates collected through prospective and retrospective surveillance in the context of a phased typhoid conjugate vaccine introduction in Navi Mumbai, India. We investigate the temporal and geographical patters of emergence and spread of antimicrobial resistance. Additionally, we evaluated the relationship between the spatial distance between households and genetic clustering of isolates using hierarchical Bayesian models. Most isolates were non-susceptible to fluoroquinolones, with nearly 20% containing ≥3 mutations in the quinolone resistance determining region, conferring high-level resistance. Two H58 isolates carried an IncX3 resistance plasmid containing blaSHV-12, associated with ceftriaxone resistance, suggesting that the ceftriaxone-resistant S. Typhi isolates from India have evolved independently on multiple occasions. Among S. Typhi isolates, we identified two main clades circulating in Navi Mumbai (2.2 and 4.3.1 [H58]); 2.2 isolates were closely related following a single introduction around 2007, whereas H58 isolates had been introduced multiple times to the city. Increasing geographic distance between isolates was strongly associated with genetic clustering (OR 0.72 per km; 95% CrI: 0.66-0.79). This effect was seen for distances up to 5 km (OR 0.65 per km; 95% CrI: 0.59-0.73) but was not seen for distances beyond 5 km (OR 1.02 per km; 95% CrI: 0.83-1.26). Our findings indicate that S. Typhi was repeatedly introduced into Navi Mumbai and then spread locally, with strong evidence of spatial-genetic clustering. In addition to vaccination, local interventions to improve water and sanitation will be critical to interrupt transmission.

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Section: Discussionmentioning

confidence: 57%

“…Recent reports have established the emergence of third-generation cephalosporin resistant S . Typhi in India (12,36,37). In our study ceftriaxone resistance was linked to the acquisition of a IncX3 plasmid carrying the ESBL gene bla SHV-12.…”

Section: Discussionmentioning

confidence: 99%

Population structure and antimicrobial resistance patterns ofSalmonellaTyphi and Paratyphi A amid a phased municipal vaccination campaign in Navi Mumbai, India

Silva

Date

Hirani

et al. 2023

Preprint

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“…Typhi infection in controlled trials and public health programs, and S . Typhi surveillance [1, 5, 6, 9, 13–15, 17, 18].…”

Section: Discussionmentioning

confidence: 99%

“…Unfortunately, antimicrobial-resistant S. Typhi is on the rise, especially in Asia [5,6], and is associated with increased severity of disease [7][8][9].…”

Section: Introductionmentioning

confidence: 99%

Programmatic Effectiveness of a Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India

Hoffman

LeBoa

Date

et al. 2022

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Background:The WHO recommends vaccines for prevention and control of typhoid fever, especially where antimicrobial-resistant typhoid circulates. In 2018 the Navi Mumbai Municipal Corporation (NMMC), implemented a TCV campaign. The campaign targeted all children aged 9-months through 14-years within NMMC boundaries (~320,000 children) over 2 vaccination phases. The phase 1 campaign occurred from July 14-August 25, 2018 (71% coverage, ~113,420 children). We evaluated the campaign's programmatic effectiveness in reducing typhoid cases at the community level.Methods:We established prospective, blood culture-based surveillance at 6 hospitals in Navi Mumbai, offering blood cultures to children presenting with fever for at least 3 days. We employed a cluster-randomized test-negative design to estimate the effectiveness of the vaccination campaign on pediatric typhoid cases. We matched culture-confirmed typhoid cases with up to 3 culture-negative controls by age and date of blood culture and assessed community vaccine campaign phase as an exposure using conditional logistic regression.Results:Between September 1, 2018-March 31, 2021, we identified 81 typhoid cases and matched these with 238 controls. Cases were 0.44 times as likely to live in vaccine campaign communities (campaign effectiveness, 56%, 95%CI: 25%-74%, p=0.002). Cases ≥ 5-years-old were 0.37 times as likely (95% CI: 0.19-0.70; p-value = 0.002) and cases during the first year of surveillance were 0.30 times as likely (95% CI: 0.14-0.64; p-value = 0.002) to live in vaccine campaign communities.Conclusions:Our findings support the use of TCV mass vaccination campaigns as effective population-based tools to combat typhoid fever.

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“…94,115 Unfortunately, we found only one study that sequenced the genome of a pathogen possibly acquired during the travel between two geo-climatic zones of India. 44 The patient, resident of the eastern zone, had a history of travel to the northern zone, but no clear link between the infection and travel could be established in the study. We found another handful of studies that sequenced isolates from the travellers that were visiting India/South Asia (Table 1 and Supplementary material 4).…”

Section: Genomic Sequencing Of the Pathogens From Travel-associated I...mentioning

confidence: 92%

Genomic sequencing should extend to diverse priority pathogens for effective study and surveillance of antimicrobial resistance: a systematic review of whole-genome sequencing studies from India

Gheewalla,

Jagannadham,

Kutum

et al. 2023

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BackgroundAntimicrobial resistance (AMR) is a public health emergency in many low and middle-income countries, including India. To effectively tackle AMR, we need rapid diagnostics, effective surveillance and new antimicrobial drugs. Whole-genome sequencing of pathogens is the first definite step towards achieving these goals.MethodsIn this work, we review all the studies published till date that report whole-genome sequences of select priority AMR pathogens from India. We searched PubMed and Web of Science databases for the studies that involved whole-genome sequencing of AMR priority pathogens from India. For the top two highly sequenced pathogens,S. typhiandK. pneumoniae, we performed phylogenetic analyses to understand the geo-climatic distribution of genetically diverse strains.ResultsOur search reveals 94 studies that report 2547 unique whole-genome sequences. We find that most sequences are limited to select priority pathogens isolated from a couple of geo-climatic zones of India. Our phylogenetic analyses show that available data does not indicate systematic differences between the genomes of isolates from different geo-climatic zones. Our search also reveals complete absence of travel-related studies tracking possible movement of AMR pathogens within country. Lastly, we find very few studies that sequence AMR pathogens isolated from food, soil or other environments.ConclusionTogether, these observations suggest that lndia should prioritize sequencing of diverse AMR pathogens from clinics as well as from environments and travellers rather than extending the geo-climatic range of already-sequenced pathogens. Our recommendations can be potentially valuable for other low and middle-income countries with limited resources, high prevalence of AMR and diverse geo-climatic conditions.

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Emergence of ceftriaxone resistant Salmonella enterica serovar Typhi in Eastern India

Cited by 14 publications

References 22 publications

Population structure and antimicrobial resistance patterns ofSalmonellaTyphi and Paratyphi A amid a phased municipal vaccination campaign in Navi Mumbai, India

Population structure and antimicrobial resistance patterns ofSalmonellaTyphi and Paratyphi A amid a phased municipal vaccination campaign in Navi Mumbai, India

Programmatic Effectiveness of a Pediatric Typhoid Conjugate Vaccine Campaign in Navi Mumbai, India

Genomic sequencing should extend to diverse priority pathogens for effective study and surveillance of antimicrobial resistance: a systematic review of whole-genome sequencing studies from India

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