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

Keddy, Karen H.; Dwarika, Sarika; Crowther, Penny; Perovic, Olga; Wadula, Jeannette; Hoosen, Anwar A.; Sooka, Arvinda; Crewe-Brown, H. H.; Smith, Anthony M.

doi:10.3855/jidc.549

Cited by 24 publications

(20 citation statements)

References 18 publications

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“…In South Africa, the major contributing factor to invasive salmonellosis is HIV infection [20]: the introduction of ART is thus critical to preventing iNTS infections. We examined the incidence of iNTS in Gauteng Province, which has a predominantly urbanised population, and documented a significant decrease in the incidence of iNTS cases in a period of increased ART utilization which followed the introduction of ART in 2004.…”

Section: Discussionmentioning

confidence: 99%

An association between decreasing incidence of invasive non-typhoidal salmonellosis and increased use of antiretroviral therapy, Gauteng Province, South Africa, 2003–2013

Keddy

Takuva

Musekiwa³

et al. 2017

PLoS ONE

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BackgroundHIV-infected persons are at increased risk of opportunistic infections, including invasive nontyphoidal Salmonella (iNTS) infections; antiretroviral therapy (ART) reduces this risk. We explored changing iNTS incidence associated with increasing ART availability in South Africa.MethodsLaboratory-based surveillance for iNTS was conducted in Gauteng Province, South Africa, with verification using the National Health Laboratory Service’s Central Data Warehouse (CDW), between 2003 and 2013. Isolates were serotyped at the Centre for Enteric Diseases. CDW data on patient numbers obtaining HIV viral load measurements provided estimates of numbers of HIV-infected patients receiving ART. A Poisson regression model was used to measure the changing incidence of iNTS infection from 2003 to 2013. The correlation between the incidence of iNTS and ART use from 2004 to 2013 was determined using Pearson’s correlation coefficient.ResultsFrom 2003–2013, the incidence of iNTS per 100,000 population per year decreased from 5.0 to 2.2 (p < .001). From 2004 to 2013, the incidence per 100,000 population of HIV viral load testing increased from 75.2 to 3,620.3 (p < .001). The most common serotypes causing invasive disease were Salmonella enterica serovar Typhimurium (Salmonella Typhimurium), and Salmonella Enteritidis: 2,469 (55.4%) and 1,156 (25.9%) of 4,459 isolates serotyped, respectively. A strong negative correlation was observed between decreasing iNTS incidence and increasing ART use from 2004 to 2013 (r = -0.94, p < .001). Similarly, decreasing incidence of invasive Salmonella Typhimurium infection correlated with increasing ART use (r = -0.93, p < .001). Incidence of invasive Salmonella Enteritidis infection increased, however (r = 0.95, p < .001). Between 2003 and 2004, fewer adult men than women presented with iNTS (male-to-female rate ratio 0.73 and 0.89, respectively). This was reversed from 2005 through 2013 (ranging from 1.07 in 2005 to 1.44 in 2013). Adult men accessed ART less (male-to-female rate ratio ranging from 0.61 [2004] to 0.67 [2013]).ConclusionsThe incidence of iNTS infections including Salmonella Typhimurium decreased significantly in Gauteng Province in association with increased ART utilization. Adult men accessed ART programs less than women, translating into increasing iNTS incidence in this group. Monitoring iNTS incidence may assist in monitoring the ART program. Increasing incidence of invasive Salmonella Enteritidis infections needs further elucidation.

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Section: Discussionmentioning

confidence: 99%

An association between decreasing incidence of invasive non-typhoidal salmonellosis and increased use of antiretroviral therapy, Gauteng Province, South Africa, 2003–2013

Keddy

Takuva

Musekiwa³

et al. 2017

PLoS ONE

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“…primarily occurs via consumption of food and water that is contaminated with fecal pollution (animal and human) (Keddy et al, 2009). Salmonella spp.…”

Section: Introductionmentioning

confidence: 99%

Surface waters in northern Tanzania harbor fecal coliform and antibiotic resistant Salmonella spp. capable of horizontal gene transfer

lyimo¹,

Buza²,

Woutrina³

et al. 2016

Afr. J. Microbiol. Res.

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Some Salmonella spp. are important pathogenic bacteria that can be transmitted to people via food and water and that can cause disease characterized by mild to severe enteric and systemic illness. In developing countries, infections caused by pathogenic antibiotic resistant Salmonella spp. are a major health challenge, particularly in children. Through the use of membrane filtration and Environmental Protection Agency (EPA) 1200 methods, the presence of fecal coliforms and antibiotic resistant Salmonella spp. in surface water sources was investigated, some of which had shared access for animals and people. Out of 100 water samples, 76 were positive for fecal coliforms and 63% of the positive samples contained >100 CFU / 100 ml of water. We observed a significant positive correlation between the number of fecal coliforms and the presence of Salmonella spp. (r=0.46, n=100, P=0.01). Importantly, >26% of the samples were positive for Salmonella spp. and 88% of these samples harbored isolates resistant to ≥1 antibiotic. Moreover, we found that 26% of antibiotic resistant Salmonella spp. isolates were able to transfer their resistance traits to a recipient strain of Escherichia coli at the rate of 1-7 x 10 -3 per donor cells. Microbiological contamination of water was clearly evident in open water sources from northern Tanzania, and the presence of Salmonella spp. poses an immediate risk to anyone who consumes these waters if untreated.

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“…Similarly, non-typhoidal Salmonella was isolated from up to 35% of HIV-infected African adults with documented bloodstream infections and mortality rate of 35 -60% (Hohmann, 2001;Kankwatira et al, 2004). Keddy et al (2009) reported S. typhimurium as a major opportunistic pathogen particularly in HIV-positive individuals.…”

Section: Epidemiology Of Human Non-typhoidal Salmonellosismentioning

confidence: 99%

Untitled

2017

IRJPEH

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The impact of non-typhoidal Salmonella (NTS) infections on human and animal health, with the associated morbidity and mortality is a global issue of public health concern. The socioeconomic conditions in the developing countries particularly the sub-Saharan Africa seem to further aggravate the rate and seriousness of the infections. Thus the endemicity of NTS infections to sub-Saharan Africa as well as the resistance of the NTS strains to both antimicrobials and environmental stress is shown in this review. The association of Salmonella virulence plasmids with both antibiotic and stress resistance genes could play a major role in the persistence and spread of the resistance and virulence genes in Salmonella and other related pathogens. This may constitute a serious public health challenge in resource-limited rural African settings.

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

Cited by 24 publications

References 18 publications

An association between decreasing incidence of invasive non-typhoidal salmonellosis and increased use of antiretroviral therapy, Gauteng Province, South Africa, 2003–2013

An association between decreasing incidence of invasive non-typhoidal salmonellosis and increased use of antiretroviral therapy, Gauteng Province, South Africa, 2003–2013

Surface waters in northern Tanzania harbor fecal coliform and antibiotic resistant Salmonella spp. capable of horizontal gene transfer

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