Molecular and Clinical Epidemiology of Salmonella Paratyphi A Isolated from Patients with Bacteremia in Nepal

Jatan Bahadur Sherchan Department of Clinical Microbiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal;

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Masatomo Morita Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;

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Takashi Matono Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;

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Hidemasa Izumiya Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;

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Makoto Ohnishi Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan;

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Jeevan B. Sherchand Public Health Research Laboratory, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal;

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Sarmila Tandukar Public Health Research Laboratory, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal;

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Ujjwal Laghu Public Health Research Laboratory, Institute of Medicine, Tribhuvan University Teaching Hospital, Kathmandu, Nepal;

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Maki Nagamatsu Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan

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Yasuyuki Kato Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan

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Norio Ohmagari Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan

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Kayoko Hayakawa Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan

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Little is known about the epidemiology of typhoid and paratyphoid fever in Nepal. We aimed to elucidate the molecular and clinical epidemiology of Salmonella Paratyphi A in Nepal. Isolates were collected from 23 cases of bacteremia due to S. Paratyphi A between December 2014 and October 2015. Thirteen patients (57%) were male, and the median age was 21 years. None of the patients had an underlying chronic disease. All S. Paratyphi A isolates were sensitive to ampicillin, trimethoprim/sulfamethoxazole, ceftriaxone, and chloramphenicol. All isolates were resistant to nalidixic acid and were categorized as intermediately susceptible to levofloxacin. Phylogenetic analysis revealed close relatedness among the isolates, including several clonal groups, suggesting local spread. Patients with bacteremia due to S. Paratyphi A in Kathmandu, Nepal, were relatively young and nondebilitated. Improving control of S. Paratyphi infections should focus on effective infection control measures and selection of empirical therapy based on current resistance patterns.

Author Notes

Address correspondence to Kayoko Hayakawa, Disease Control and Prevention Center, National Center for Global Health and Medicine, 1-21-1 Toyama, Shinjuku-ku, Tokyo 162-8655, Japan. E-mail: kayokohayakawa@gmail.com

Financial support: This work was supported by a grant in Clinical Epidemiology Research, St. Luke’s International University, Tokyo, Japan (2016).

Authors’ addresses: Jatan Bahadur Sherchan, Department of Clinical Microbiology, Kathmandu University School of Medical Sciences, Dhulikhel, Nepal, E-mail: jatansherchan@gmail.com. Masatomo Morita, Takashi Matono, Hidemasa Izumiya, and Makoto Ohnishi, Department of Bacteriology I, National Institute of Infectious Diseases, Tokyo, Japan, E-mails: mmorita@niid.go.jp, tmatono@niid.go.jp, izumiya@nih.go.jp, and ohnishi7@nih.go.jp. Jeevan B. Sherchand, Sarmila Tandukar, and Ujjwal Laghu, Department of Microbiology and Parasitology, Tribhuvan University Teaching Hospital, Kathmandu, Nepal, E-mails: jeevansherchand@hotmail.com, sar1234tan@gmail.com, and ujjwal111@iom.edu.np. Maki Nagamatsu, Yasuyuki Kato, Norio Ohmagari, and Kayoko Hayakawa, Disease Control and Prevention Center, National Center for Global Health and Medicine, Tokyo, Japan, E-mails: dfrmm217@yahoo.co.jp, ykato@hosp.ncgm.go.jp, nohmagari@hosp.ncgm.go.jp, and kayokohayakawa@gmail.com.

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