PT  - JOURNAL ARTICLE
AU  - Park, Se Eun
AU  - Pham, Duy Thanh
AU  - Pak, Gi Deok
AU  - Panzner, Ursula
AU  - Maria Cruz Espinoza, Ligia
AU  - von Kalckreuth, Vera
AU  - Im, Justin
AU  - Mogeni, Ondari D.
AU  - Schütt-Gerowitt, Heidi
AU  - Crump, John A
AU  - Breiman, Robert F
AU  - Adu-Sarkodie, Yaw
AU  - Owusu-Dabo, Ellis
AU  - Rakotozandrindrainy, Raphaël
AU  - Bassiahi Soura, Abdramane
AU  - Aseffa, Abraham
AU  - Gasmelseed, Nagla
AU  - Sooka, Arvinda
AU  - Keddy, Karen H
AU  - May, Jürgen
AU  - Aaby, Peter
AU  - Biggs, Holly M
AU  - Hertz, Julian T
AU  - Montgomery, Joel M
AU  - Cosmas, Leonard
AU  - Olack, Beatrice
AU  - Fields, Barry
AU  - Sarpong, Nimako
AU  - Razafindrabe, Tsiriniaina Jean Luco
AU  - Raminosoa, Tiana Mirana
AU  - Kabore, Leon Parfait
AU  - Sampo, Emmanuel
AU  - Teferi, Mekonnen
AU  - Yeshitela, Biruk
AU  - El Tayeb, Muna Ahmed
AU  - Krumkamp, Ralf
AU  - Dekker, Denise Myriam
AU  - Jaeger, Anna
AU  - Tall, Adama
AU  - Gassama, Amy
AU  - Niang, Aissatou
AU  - Bjerregaard-Andersen, Morten
AU  - Løfberg, Sandra Valborg
AU  - Deerin, Jessica Fung
AU  - Park, Jin Kyung
AU  - Konings, Frank
AU  - Carey, Megan E
AU  - Van Puyvelde, Sandra
AU  - Ali, Mohammad
AU  - Clemens, John
AU  - Dougan, Gordon
AU  - Baker, Stephen
AU  - Marks, Florian
TI  - The genomic epidemiology of multi-drug resistant invasive non-typhoidal <em>Salmonella</em> in selected sub-Saharan African countries
AID  - 10.1136/bmjgh-2021-005659
DP  - 2021 Aug 01
TA  - BMJ Global Health
PG  - e005659
VI  - 6
IP  - 8
4099  - http://gh.bmj.com/content/6/8/e005659.short
4100  - http://gh.bmj.com/content/6/8/e005659.full
SO  - BMJ Global Health2021 Aug 01; 6
AB  - 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 <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).