TY - JOUR T1 - The genomic epidemiology of multi-drug resistant invasive non-typhoidal <em>Salmonella</em> in selected sub-Saharan African countries JF - BMJ Global Health JO - BMJ Global Health DO - 10.1136/bmjgh-2021-005659 VL - 6 IS - 8 SP - e005659 AU - Se Eun Park AU - Duy Thanh Pham AU - Gi Deok Pak AU - Ursula Panzner AU - Ligia Maria Cruz Espinoza AU - Vera von Kalckreuth AU - Justin Im AU - Ondari D. Mogeni AU - Heidi Schütt-Gerowitt AU - John A Crump AU - Robert F Breiman AU - Yaw Adu-Sarkodie AU - Ellis Owusu-Dabo AU - Raphaël Rakotozandrindrainy AU - Abdramane Bassiahi Soura AU - Abraham Aseffa AU - Nagla Gasmelseed AU - Arvinda Sooka AU - Karen H Keddy AU - Jürgen May AU - Peter Aaby AU - Holly M Biggs AU - Julian T Hertz AU - Joel M Montgomery AU - Leonard Cosmas AU - Beatrice Olack AU - Barry Fields AU - Nimako Sarpong AU - Tsiriniaina Jean Luco Razafindrabe AU - Tiana Mirana Raminosoa AU - Leon Parfait Kabore AU - Emmanuel Sampo AU - Mekonnen Teferi AU - Biruk Yeshitela AU - Muna Ahmed El Tayeb AU - Ralf Krumkamp AU - Denise Myriam Dekker AU - Anna Jaeger AU - Adama Tall AU - Amy Gassama AU - Aissatou Niang AU - Morten Bjerregaard-Andersen AU - Sandra Valborg Løfberg AU - Jessica Fung Deerin AU - Jin Kyung Park AU - Frank Konings AU - Megan E Carey AU - Sandra Van Puyvelde AU - Mohammad Ali AU - John Clemens AU - Gordon Dougan AU - Stephen Baker AU - Florian Marks Y1 - 2021/08/01 UR - http://gh.bmj.com/content/6/8/e005659.abstract N2 - Background Invasive non-typhoidal Salmonella (iNTS) is one of the leading causes of bacteraemia in sub-Saharan Africa. We aimed to provide a better understanding of the genetic characteristics and transmission patterns associated with multi-drug resistant (MDR) iNTS serovars across the continent.Methods A total of 166 iNTS isolates collected from a multi-centre surveillance in 10 African countries (2010–2014) and a fever study in Ghana (2007–2009) were genome sequenced to investigate the geographical distribution, antimicrobial genetic determinants and population structure of iNTS serotypes–genotypes. Phylogenetic analyses were conducted in the context of the existing genomic frameworks for various iNTS serovars. Population-based incidence of MDR-iNTS disease was estimated in each study site.Results Salmonella Typhimurium sequence-type (ST) 313 and Salmonella Enteritidis ST11 were predominant, and both exhibited high frequencies of MDR; Salmonella Dublin ST10 was identified in West Africa only. Mutations in the gyrA gene (fluoroquinolone resistance) were identified in S. Enteritidis and S. Typhimurium in Ghana; an ST313 isolate carrying blaCTX-M-15 was found in Kenya. International transmission of MDR ST313 (lineage II) and MDR ST11 (West African clade) was observed between Ghana and neighbouring West African countries. The incidence of MDR-iNTS disease exceeded 100/100 000 person-years-of-observation in children aged &lt;5 years in several West African countries.Conclusions We identified the circulation of multiple MDR iNTS serovar STs in the sampled sub-Saharan African countries. Investment in the development and deployment of iNTS vaccines coupled with intensified antimicrobial resistance surveillance are essential to limit the impact of these pathogens in Africa.Data are available in a public, open access repository. Raw sequence data are available in the European Nucleotide Archive (Project number: ERP009684, ERP010763, ERP013866). ER -