Falay Dadi, Hardy Liselotte, Bonebe Edmonde, Mattheus Wesley, Ngbonda Dauly, Lunguya Octavie, Jacobs Jan
Department of Pediatrics, University Hospital of Kisangani, Kisangani, Democratic Republic of Congo.
Department of Clinical Sciences, Institute of Tropical Medicine, Antwerp, Belgium.
Front Microbiol. 2023 Oct 12;14:1241961. doi: 10.3389/fmicb.2023.1241961. eCollection 2023.
Invasive non-typhoidal (iNTS), mainly Typhimurium and Enteritidis, causes a severe burden in sub-Saharan Africa; however, its reservoir (animal or environmental) is unclear. The present study assessed healthy household members of index patients for intestinal carriage of .
Index patients were admitted to the University Hospital of Kisangani (DR Congo), and was grown from blood cultures. Household members were asked to provide three stool samples for culture for . Typhimurium and . Enteritidis isolates from index patients, and household members were assessed for genetic relatedness using the multiple-locus variable number of tandem repeat analysis (MLVA), and the multilocus sequence type (ST) was determined by whole genome sequencing.
Between May 2016 and January 2020, 22 households were visited. The index patient serotypes were Typhimurium, Enteritidis, Typhi, and Paratyphi C; II:42:r:-; and I:7:y:- ( = 8, 7, 5, and each 1, respectively). The median (range) delay between the index patient and household sampling was 25 days (2 days to 7.3 months); 203 household members provided at least one stool sample. In all, 15 (7.3%) carriers were found in nine of 22 households. For one index patient, the household comprised . Typhimurium in four household members, including the index patient, sampled 27 days after bloodstream infection; the MLVA types of these five isolates were similar. They belonged to ST313 lineage 2 and were closely related [0-1 allelic distance (AD) among the stool isolates and eight AD with the blood culture isolate]. In another household, the stool culture of the index patient (obtained 67 days after bloodstream infection) grew . Enteritidis of the same MLVA type; both isolates belonged to the ST11 Central/Eastern African clade and were closely related (three AD).
The present study provides evidence of household clustering of . Typhimurium ST313 and intestinal carriage of iNTS several weeks after bloodstream infection.
侵袭性非伤寒沙门氏菌（iNTS），主要是鼠伤寒沙门氏菌和肠炎沙门氏菌，在撒哈拉以南非洲造成了沉重负担；然而，其储存宿主（动物或环境）尚不清楚。本研究评估了首例患者的健康家庭成员的肠道携带情况。
首例患者入住基桑加尼大学医院（刚果民主共和国），从血培养中培养出[未提及的细菌名称]。要求家庭成员提供三份粪便样本用于[未提及的细菌名称]培养。对首例患者以及家庭成员的鼠伤寒沙门氏菌和肠炎沙门氏菌分离株，使用多位点可变数目串联重复分析（MLVA）评估遗传相关性，并通过全基因组测序确定多位点序列类型（ST）。
2016年5月至2020年1月期间，走访了22户家庭。首例患者的血清型为鼠伤寒沙门氏菌、肠炎沙门氏菌、伤寒沙门氏菌和副伤寒丙沙门氏菌；II:42:r:-；以及I:7:y:-（分别为8例、7例、5例和各1例）。首例患者与家庭采样之间的中位（范围）延迟为25天（2天至7.3个月）；203名家庭成员提供了至少一份粪便样本。总共在22户家庭中的9户发现了15名（7.3%）[未提及的细菌名称]携带者。对于一名首例患者，其家庭中的四名家庭成员（包括首例患者）在血流感染27天后采样，检测出鼠伤寒沙门氏菌；这五株分离株的MLVA类型相似。它们属于ST313谱系2，并且密切相关[粪便分离株之间的等位基因距离（AD）为0至1，与血培养分离株的AD为8]。在另一户家庭中，首例患者的粪便培养物（在血流感染67天后获得）培养出相同MLVA类型的肠炎沙门氏菌；两株分离株均属于ST11中非/东非分支，并且密切相关（AD为3）。
本研究提供了鼠伤寒沙门氏菌ST313家庭聚集以及血流感染数周后iNTS肠道携带的证据。
