Validation and Identification of Invasive Salmonella Serotypes in Sub-Saharan Africa by Multiplex Polymerase Chain Reaction

Authors

Hassan M. Al-Emran, Ralf Krumkamp, Denise Myriam Dekker, Daniel Eibach, Peter Aaby, Yaw Adu-Sarkodie, Mohammad Ali, Mathew P. Rubach, Morten Bjerregaard-Andersen, John A. Crump, Ligia Maria Cruz Espinoza, Sandra Valborg Løfberg, Amy Gassama Sow, Julian T. Hertz, Justin Im, Anna Jaeger, Leon Parfait Kabore, Frank Konings, Christian G. Meyer, Aissatou Niang, Gi Deok Pak, Ursula Panzner, Se Eun Park, Henintsoa Rabezanahary, Raphaël Rakotozandrindrainy, Tiana Mirana Raminosoa, Tsiriniaina Jean Luco Razafindrabe, Emmanuel Sampo, Heidi Schütt-Gerowitt, Nimako Sarpong, Abdramane Bassiahi Soura, Adama Tall, Vera von Kalckreuth, Thomas F. Wierzba, Jürgen May, and Florian Marks

Abstract

Salmonella enterica serovar Typhi and nontyphoidal Salmonella (NTS) cause the majority of bloodstream infections in sub-Saharan Africa; however, serotyping is rarely performed. We validated a multiplex polymerase chain reaction (PCR) assay with the White–Kauffmann–Le Minor (WKLM) scheme of serotyping using 110 Salmonella isolates from blood cultures of febrile children in Ghana and applied the method in other Typhoid Fever Surveillance in Africa Program study sites. In Ghana, 47 (43%) S. Typhi, 36 (33%) Salmonella enterica serovar Typhimurium, 14 (13%) Salmonella enterica serovar Dublin, and 13 (12%) Salmonella enterica serovar Enteritidis were identified by both multiplex PCR and the WKLM scheme separately. Using the validated multiplex PCR assay, we identified 42 (66%) S. Typhi, 14 (22%) S. Typhimurium, 2 (3%) S. Dublin, 2 (3%) S. Enteritidis, and 4 (6%) other Salmonella species from the febrile patients in Burkina Faso, Guinea-Bissau, Madagascar, Senegal, and Tanzania. Application of this multiplex PCR assay in sub-Saharan Africa could advance the knowledge of serotype distribution of Salmonella.

 

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