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Journal of Clinical Microbiology, August 1999, p. 2466-2472, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.

Molecular Typing of Multiple-Antibiotic-Resistant Salmonella enterica Serovar Typhi from Vietnam: Application to Acute and Relapse Cases of Typhoid Fever

John Wain,1 Tran T. Hien,2 Phillippa Connerton,3 Tahir Ali,3 Christopher M. Parry,1 Nguyen T. T. Chinh,4 Ha Vinh,1 Cao X. T. Phuong,5 Vo A. Ho,6 To S. Diep,2 Jeremy J. Farrar,1 Nicholas J. White,1 and Gordon Dougan3,*

The University of Oxford-Wellcome Trust Clinical Research Unit1 and the Centre for Tropical Diseases,2 Cho Quan Hospital, and Department of Infectious Diseases, Department of Medicine and Pharmacy,4 Ho Chi Minh City, Dong Nai Paediatric Centre, Bien Hoa, Dong Nai,5 and Dong Thap Provincial Hospital, Cao Lanh, Dong Thap,6 Vietnam, and Department of Biochemistry, Imperial College of Science, Technology and Medicine, London SW7 2AZ, United Kingdom3

Received 17 September 1998/Returned for modification 20 January 1999/Accepted 21 April 1999

The rate of multiple-antibiotic resistance is increasing among Salmonella enterica serovar Typhi strains in Southeast Asia. Pulsed-field gel electrophoresis (PFGE) and other typing methods were used to analyze drug-resistant and -susceptible organisms isolated from patients with typhoid fever in several districts in southern Vietnam. Multiple PFGE and phage typing patterns were detected, although individual patients were infected with strains of a single type. The PFGE patterns were stable when the S. enterica serovar Typhi strains were passaged many times in vitro on laboratory medium. Paired S. enterica serovar Typhi isolates recovered from the blood and bone marrow of individual patients exhibited similar PFGE patterns. Typing of S. enterica serovar Typhi isolates from patients with relapses of typhoid indicated that the majority of relapses were caused by the same S. enterica serovar Typhi strain that was isolated during the initial infection. However, some individuals were infected with distinct and presumably newly acquired S. enterica serovar Typhi isolates.

* Corresponding author. Mailing address: Wellcome Trust Clinical Research Unit, The Centre for Tropical Diseases, 190 Ben Ham Tu Quan 5, Ho Chi Minh City, Vietnam. Phone: 84 8 835 3954. Fax: 84 8 835 3904. E-mail: jeremyjf{at}hcm.vnn.vn.

Journal of Clinical Microbiology, August 1999, p. 2466-2472, Vol. 37, No. 8
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.


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