Clustering Analysis of Salmonella enterica Serovar Typhi Isolates in Korea by PFGE, Ribotying, and Phage Typing

Salmonella enterica serovar Typhi is a Gram-negative bacterium causing the acute febrile disease typhoid fever. In Korea from 2004 to 2006, a total of 51 Salmonella Typhi isolates were identified in stool and blood from healthy carriers and patients with or without overseas travel histories. In this study, antibiogram, pulsed-field gel electrophoresis (PFGE), and automated ribotyping were performed as molecular epidemiological methods with phage typing as a classical subtyping tool of the isolates. Only two isolates were multidrug resistant and 82.3% of the isolates were susceptible to 16 antimicrobial agents tested. When the dendrogram was created based on the PFGE results, the subtypes could be clustered into five groups by 80% similarity criterion. The PFGE patterns of 31 isolates (60.8%) belonged to Cluster 3, the predominant cluster in the study. Three overseas travel associated cases were differentiated into Cluster 4 of which three isolates were nalidixic acid or multidrug resistant. Major phage type and ribotype were A and PvuII-436-8-S-6, respectively. This study also showed the prevalence of PFGE Cluster 3 in Korea by clustering analysis and the link between some typhoid cases and travel to Cambodia, India, or Indonesia.