TY - JOUR T1 - Invasive Salmonella Infections at Multiple Surveillance Sites in the Democratic Republic of the Congo, 2011-2014. JF - Clin Infect Dis Y1 - 2015 A1 - Lisette Mbuyi Kalonji A1 - Post, Annelies A1 - Phoba, Marie-France A1 - Falay, Dadi A1 - Ngbonda, Dauly A1 - Muyembe, Jean-Jacques A1 - Sophie Bertrand A1 - Pieter-Jan Ceyssens A1 - Wesley Mattheus A1 - Verhaegen, Jan A1 - Barbé, Barbara A1 - Kuijpers, Laura A1 - Van Geet, Chris A1 - Lunguya, Octavie A1 - Jacobs, Jan KW - ADOLESCENT KW - Adult KW - Aged KW - Anti-Bacterial Agents KW - Azithromycin KW - Bacteremia KW - beta-Lactamases KW - Child KW - Child, Preschool KW - Ciprofloxacin KW - Democratic Republic of the Congo KW - Drug Resistance, Multiple, Bacterial KW - Epidemiological Monitoring KW - Female KW - Humans KW - Infant KW - Male KW - Microbial Sensitivity Tests KW - middle aged KW - Salmonella KW - Salmonella enteritidis KW - Salmonella Infections KW - Salmonella typhi KW - Salmonella typhimurium KW - Seasons KW - Young adult AB -

BACKGROUND: This study reports the microbiological landscape of Salmonella Typhi and invasive nontyphoidal Salmonella (iNTS) in the Democratic Republic of the Congo (DRC).

METHODS: Blood cultures obtained from hospital-admitted patients suspected of bloodstream infection (BSI) in 4 of 11 provinces in DRC (Kinshasa, Bas-Congo, Equateur, and Orientale) were processed. Sampling had started in 2007; the results for the period 2011-2014 are reported.

RESULTS: Salmonella Typhi and iNTS were cultured from 194 (1.4%) and 840 (5.9%), respectively, of 14,110 BSI episodes and ranked first among BSI pathogens in adults (65/300 [21.7%]) and children (783/1901 [41.2%]), respectively. A total of 948 of 1034 (91.7%) isolates were available for analysis (164 Salmonella Typhi and 784 iNTS). Salmonella Typhimurium and Salmonella Enteritidis represented 386 (49.2%) and 391 (49.9%), respectively, of iNTS isolates, fluctuating over time and geography and increasing during the rainy season. Adults accounted for <5% of iNTS BSI episodes. Children <5 years accounted for 20.3% of Salmonella Typhi BSI episodes. Among Salmonella Typhi, rates of multidrug resistance and decreased ciprofloxacin susceptibility (DCS) were 37.8% and 37.2%, respectively, and 18.3% displayed combined multidrug resistance and DCS; rates of azithromycin and ceftriaxone resistance were 0.6% and absent, respectively. Among NTS isolates, ≥80% (79.7% of Salmonella Enteritidis and 90.2% of Salmonella Typhimurium isolates) showed multidrug resistance, and <2.5% showed DCS. Combined extended-spectrum β-lactamase production (blaTEM-1 gene) and azithromycin resistance was noted in 12.7% of Salmonella Typhimurium isolates, appearing in Bas-Congo from 2013 onward.

CONCLUSIONS: Salmonella Typhi and NTS are major causes of BSI in DRC; their antimicrobial resistance is increasing.

VL - 61 Suppl 4 U1 - http://www.ncbi.nlm.nih.gov/pubmed/26449951?dopt=Abstract M3 - 10.1093/cid/civ713 ER -