Surveillance of Salmonella enterica serovar  Typhi in Colombia, 2012-2015

• Published in: PLoS neglected tropical diseases 2020-03, Vol.14 (3), p.e0008040-e0008040
• Main Authors: Diaz-Guevara, Paula, Montaño, Lucy Angeline, Duarte, Carolina, Zabaleta, Gabriela, Maes, Mailis, Martinez Angarita, Julio Cesar, Thanh, Duy Pham, León-Quevedo, William, Castañeda-Orjuela, Carlos, Alvarez Alvarez, Claudia Jimena, Guerrero, Jaime, Moroni, Miriam, Campos, Josefina, Pérez, Enrique, Baker, Stephen
• Format: Article
• Language: English
• Subjects: Adolescent; Adult; Age Distribution; Aged; Aged, 80 and over; Ampicillin; Antiinfectives and antibacterials; Antimicrobial agents; Biology and Life Sciences; Causes of; Child; Child, Preschool; Colombia - epidemiology; Countries; Departments; Disease hot spots; Diseases; Distribution; Drug Resistance, Bacterial; Earth Sciences; Ecology and Environmental Sciences; Enzymes; Epidemics; Epidemiological Monitoring; Epidemiology; Female; Fever; Genetic aspects; Genetic diversity; Genetic Variation; Genotype; Genotypes; Health aspects; Health surveillance; Humans; Identification; Immunology; Infant; Infectious diseases; Male; Medicine and Health Sciences; Methods; Microbial Sensitivity Tests; Middle Aged; Molecular Typing; Nalidixic acid; Pathogens; People and places; Public health; Retrospective Studies; Salmonella; Salmonella typhi; Salmonella typhi - classification; Salmonella typhi - drug effects; Salmonella typhi - genetics; Salmonella typhi - isolation & purification; Sentinel surveillance; Sex Distribution; Software; Surveillance; Transmission; Tropical diseases; Typhoid; Typhoid fever; Typhoid Fever - epidemiology; Waterborne diseases; Young Adult
• ISSN: 1935-2735; 1935-2727; 1935-2735
• DOI: 10.1371/journal.pntd.0008040

Salmonella Typhi (S. Typhi) is the causative agent of typhoid fever; a systemic disease affecting ~20 million people per year globally. There are little data regarding the contemporary epidemiology of typhoid in Latin America. Consequently, we aimed to describe some recent epidemiological aspects of typhoid in Colombia using cases reported to the National Public Health Surveillance System (Sivigila) between 2012 and 2015. Over the four-year reporting period there were 836 culture confirmed cases of typhoid in Colombia, with the majority (676/836; 80.1%) of reported cases originated from only seven departments. We further characterized 402 S. Typhi isolates with available corresponding data recovered from various departments of Colombia through antimicrobial susceptibility testing and molecular subtyping. The majority (235/402; 58.5%) of these typhoid cases occurred in males and were most commonly reported in those aged between 10 and 29 years (218/402; 54.2%); there were three (0.74%) reported fatalities. The overwhelming preponderance (339/402; 84.3%) of S. Typhi were susceptible to all tested antimicrobials. The most common antimicrobial to which the organisms exhibited non-susceptibility was ampicillin (30/402;7.5%), followed by nalidixic acid (23/402, 5.7%). Molecular subtyping identified substantial genetic diversity, which was well distributed across the country. Despite the diffuse pattern of S. Typhi genotypes, we identified various geographical hotspots of disease associated with local dominant genotypes. Notably, we found limited overlap of Colombian genotypes with organisms reported in other Latin American countries. Our work highlights a substantial burden of typhoid in Colombia, characterized by sustained transmission in some regions and limited epidemics in other departments. The disease is widely distributed across the country and associated with multiple antimicrobial susceptible genotypes that appear to be restricted to Colombia. This study provides a current perspective for typhoid in Latin America and highlights the importance of pathogen-specific surveillance to add insight into the limited epidemiology of typhoid in this region.