Characterization of Invasive Serogroup C1 Infections in Mali.

Nontyphoidal (NTS) are the leading cause of foodborne infections worldwide and a major cause of bloodstream infections in infants and HIV-infected adults in sub-Saharan Africa (SSA). Typhimurium (serogroup B) and Enteritidis (serogroup D) are the most common serovars in this region. However, data describing rarer invasive NTS serovars, particularly those belonging to serogroups C1 and C2, circulating in SSA are lacking. We previously conducted systematic blood culture surveillance on pediatric patients in Bamako, Mali, from 2002 to 2014, and the results showed that serovars Typhimurium and Enteritidis accounted for 32% and 36% of isolates, respectively. Here, we present data on 27 serogroup C1 strains that were isolated during this previous study. The strains were typed by serum agglutination and multilocus sequence typing (MLST). Sixteen strains were Paratyphi C, four were Colindale, and two were Virchow. Interestingly, five strains were identified as the very rare Brazzaville using a combination of serum agglutination and flagellin gene typing. Phenotypic characterization showed that Brazzaville produced biofilm and exhibited catalase activity, which were not statistically different from the gastroenteritis-associated Typhimurium sequence type (ST) 19. All tested Paratyphi C strains were poor biofilm producers and showed significantly less catalase activity than Typhimurium ST19. Overall, our study provides insight into the serogroup C1 serovars that cause invasive disease in infants in Mali. In addition, we show that MLST and flagellin gene sequencing, in association with traditional serum agglutination, are invaluable tools to help identify rare serovars.