Antimicrobial susceptibility patterns and phage types of Salmonella typhi from Vietnam.

A retrospective study of the patterns of antimicrobial susceptibility and phage types of 111 Salmonella typhi strains isolated in 1996 from Vietnam was carried out. The strains were tested for susceptibility to chloramphenicol, ampicillin, tetracycline, trimethoprim-sulfamethoxazole, nalidixic acid, ceftazidime, ceftriaxone and ciprofloxacin. Simultaneous resistance to chloramphenicol, ampicillin, tetracycline and trimethoprim-sulfamethoxazole were present in 84 strains (75.7%). Nalidixic acid resistance was only observed in 2 multidrug-resistant strains (1.8%). Twenty-one strains (18.9%) were completely susceptible to all drugs tested. All 111 strains were susceptible to ceftazidime, ceftriaxone and cipropfloxacin. The MIC values for chloramphenicol, ampicillin and trimethoprim-sulfamethoxazole corresponded with the results by disk diffusion method. On Vi phage-typing, 5 different phage types (28, A, D1, E1 and M1) were found in 12 strains (10.8%). However, most S. typhi strains were indistinguishable by this typing technique because they were degraded Vi-positive or untypeable Vi-positive strains (35.1% and 54.1%, respectively). There were no correlations between antimicrobial resistance patterns and phage types in the tested S. typhi strains in this study.

Modeling the impact of rubella vaccination in Vietnam.

Supported by GAVI Alliance, measles-rubella vaccination was introduced in Vietnam in 2014, involving a mass campaign among 1-14 year olds and routine immunization of children aged 9 months. We explore the impact on the incidence of Congenital Rubella Syndrome (CRS) during 2013-2050 of this strategy and variants involving women aged 15-35 years. We use an age and sex-structured dynamic transmission model, set up using recently-collected seroprevalence data from Central Vietnam, and also consider different levels of transmission and contact patterns. If the serological profile resembles that in Central Vietnam, the planned vaccination strategy could potentially prevent 125,000 CRS cases by 2050 in Vietnam, despite outbreaks predicted in the meantime. Targeting the initial campaign at 15-35 year old women with or without children aged 9 months-14 years led to sustained reductions in incidence, unless levels of ongoing transmission were medium-high before vaccination started. Assumptions about contact greatly influenced predictions if the initial campaign just targeted 15-35 year old women and/or levels of ongoing transmission were medium-high. Given increased interest in rubella vaccination, resulting from GAVI Alliance funding, the findings are relevant for many countries.