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Antimicrobial resistance of Salmonella enterica Typhi in the Western and Southern Regions of the Democratic Republic of the Congo: Phenotypic profile and molecular characterization of isolates associated with epidemics of Typhoid Fever

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Association between the phenotypic profile and the intl-1
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Submitted   Mar 13, 2022
Published   Apr 28, 2022
Issue    Vol 4 No 1 (2022)
DOI   10.25082/AGPM.2022.01.001

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Kumel Kasongo Kumelundu corresponding author
[1] Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo; [2] National Institute for Biomedical Research (INRB) of Kinshasa, Democratic Republic of the Congo; [3] Higher Institute of the Medical Techniques of Kinshasa (ISTM-KIN), Democratic Republic of the Congo
Berthe Nkema Miwanda
National Institute for Biomedical Research (INRB) of Kinshasa, Democratic Republic of the Congo
Ronald Ng'etich
Kenya Medical Research Institute (KEMRI), Republic of Kenya
Samuel Njoroge
Kenya Medical Research Institute (KEMRI), Republic of Kenya
Denis Kakongo Kandolo
Higher Institute of the Medical Techniques of Kinshasa (ISTM-KIN), Democratic Republic of the Congo
Michel Balaka Ekwalanga
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Emmanuel Mposhi Malangu
Faculty of Veterinary Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Victor Ndibualonji
Faculty of Veterinary Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Claude Lubobo Kazadi
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Philomène Anzwal Lungu
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Clément Numbi Kashindi
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Prosper Muenze Kalenga
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo
Léon Kafita Cibuabua
Medicinal Plants Division, NCF-AMR, Ministry of Public Health, Hygiene and Prevention, Democratic Republic of the Congo
John Kiiru
Kenya Medical Research Institute (KEMRI), Republic of Kenya
Samuel Kariuki
Kenya Medical Research Institute (KEMRI), Republic of Kenya
Jean-Jacques Tamfum Muyembe
National Institute for Biomedical Research (INRB) of Kinshasa, Democratic Republic of the Congo
Christophe Mukena Nyembo
Faculty of Medicine, University of Lubumbashi (UNILU), Democratic Republic of the Congo

Abstract

Background: This study has its foundation following the emergence of the phenomenon of antimicrobial resistance of Salmonella enterica enterica Typhi associated with severe complications, such as intestinal perforations with a significant lethality.
Objectives: Of this antimicrobial resistance, to determine the phenotypic profile, to detect the chromosomal molecular markers (CMMs) such as the class 1 integrons (intl-1) and ESBLs (blaTEM-1, blaOXA-1 and blaCTX-M-1) and to measure the association between the phenotypic profile and CMMs of typhoid isolates in concerned areas.
Methods:  Salmonella Typhi strains of typhoid epidemic areas were confirmed by serotyping tests. The antimicrobial susceptibility testing was conducted by disc diffusion method using the following commercial antimicrobials: Chloramphenicol-C, Ampicillin-AMP, Sulfamethoxazole-RL and Trimethoprim-W (former first-line antimicrobials), Ciprofloxacin-CIP or Cefotaxime-CTX, Ceftriaxone-CRO, Ceftazidime-CAZ (first-line antimicrobials), Tetracycline-TE, Amoxicillin-Potassium clavulanate-AMC, Nalidixic acid-NA, Cefoxitine-FOX, Gentamicin-CN (varied antimicrobials) and FEP-Cefepime (4GC). The phenotypic antimicrobial resistance profile was determined by Kirby-Bauer diffusion method on Mueller-Hinton agar. To perform the molecular characterization, the Salmonella Typhi isolates DNA has been extracted by Sigma Aldrich kit and the CMMs detection was performed by DNA Engine for PCR test. The association between phenotypic profile and CMMs has been measured by Pearson’s chi-square test.
Results: Out of 320 Salmonella Typhi isolates, 50 were identified conform. The phenotypic profile of antimicrobial resistance was 59.5% in all the Western and Southern regions and 61% in the provinces of Kinshasa City and Bas-Congo to the former antimicrobials of first intention and the mean of CMMs rates were 22.5% and 27.4%, respectively. Those isolates showed a significant resistance profile to AMP, C and RL in those last two provinces.
Conclusion: The rate of phenotypic multidrug-resistance of Salmonella Typhi isolates was more than 50% with the predominance of CMMs in Kinshasa and Bas-Congo. This study suggests to give up the use of AMP, C and RL in those two provinces. This may also indicate that the antimicrobial resistance surveillance system would be one strategy to manage food borne pathogens.

Keywords
multidrug-resistance, Salmonella Typhi, phenotypic profile, chromosomal markers

Article Details

How to Cite
Kumelundu, K. K., Miwanda, B. N., Ng’etich, R., Njoroge, S., Kandolo, D. K., Ekwalanga, M. B., Malangu, E. M., Ndibualonji, V., Kazadi, C. L., Lungu, P. A., Kashindi, C. N., Kalenga, P. M., Cibuabua, L. K., Kiiru, J., Kariuki, S., Muyembe, J.-J. T., & Nyembo, C. M. (2022). Antimicrobial resistance of Salmonella enterica Typhi in the Western and Southern Regions of the Democratic Republic of the Congo: Phenotypic profile and molecular characterization of isolates associated with epidemics of Typhoid Fever. Advances in General Practice of Medicine, 4(1), 28-41. https://doi.org/10.25082/AGPM.2022.01.001
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