First report on antimicrobial resistance and molecular characterization of Salmonella enterica serotype Typhi isolated from human specimens in Luanda, Angola

OBJECTIVES:

Typhoid fever is a common infection in Africa and in spite of scarce surveillance reports, its incidence is commonly considered high by the Angolan Health system. Drug-resistant Salmonella enterica serotype Typhi has emerged, turning antimicrobial susceptibility testing essential to provide clinical guidance. This is the first report analyzing antimicrobial resistance patterns and population structure of the few S. enterica ser. Typhi isolated from patients with Typhoid fever in Luanda, Angola.

METHODS:

Isolates were collected by the National Institute of Public Health of Angola, between September 2013 and May 2014. A total of 10 isolates were identified by API20E system and serotyping, and the genus confirmed by PCR. All isolates were tested for antibiotic susceptibility and the presence of resistance genes (blaCTX-M, blaSHV, blaTEM, blaOXA-1, several plasmid-borne genes encoding AmpC β-lactamases, sul and qnr genes, dfrIa, dfrA12, aac(6′)- Ib, cmlA and floR) screened by PCR. Isolates were typed by PFGE and MLST.

RESULTS:

Several isolates were identified with resistance to trimethoprim-sulfamethoxazole (n=6), beta-lactams (n=5), chloramphenicol (n=1) and reduced susceptibility to ciprofloxacin (n=2). PFGE revealed eight closely related restriction patterns and MLST grouped these in three sequence types: ST1, ST2 and ST8, with ST2 being predominant.

CONCLUSION:

This first epidemiological report provides a preliminary portray of the S. enterica ser. Typhi strains that circulate in Luanda, Angola and emphasizes the demand for a continuous monitoring of this pathogen to provide information to implement better epidemiological strategies for the control of Typhoid fever in Angola.