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Serotype Occurrence, Virulence Profiles, Antimicrobial Resistance and Molecular Characterization of Salmonella Isolated from Hospitalized Patients with Gastroenteritis in Great Tunisia between 2010 and 2020. Antibiotics (Basel) 2023; 12:antibiotics12030526. [PMID: 36978394 PMCID: PMC10044041 DOI: 10.3390/antibiotics12030526] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/30/2022] [Revised: 02/25/2023] [Accepted: 02/28/2023] [Indexed: 03/09/2023] Open
Abstract
Non-typhoid Salmonella is one of the major causes of food-borne infections worldwide. The aim of the current study is to determine the serotype occurrence, virulence factors and antimicrobial resistance patterns of Salmonella isolated from hospitalized patients. The identification of Salmonella strains was performed according to REMIC, 2018. The susceptibility of Salmonella isolates was assessed against 20 antimicrobials using the disk diffusion method. Some virulence and antimicrobial resistance genes were identified using PCR. Among the 61 isolated Salmonella strains, seven serotypes were identified and all were positive for the virulence genes invA, mgtC and sirA. Critical resistance rates (>40%) were detected for tetracycline, nalidixic acid, amoxicillin and fluoroquinolones. However, resistances to ertapenem, ceftazidim, aztreonam and colistin were null. In addition, 33% of the isolated strains were multidrug-resistant (MDR). Moreover, 80% and 60% of S. Kentucky isolates were identified as fluoroquinolone-resistant and MDR strains, respectively. The qnrB gene was amplified in 63.2% of fluoroquinolone-resistant strains. The dfrA1 gene was identified in 20% (4/20) of the trimethoprim-sulfamethoxazole resistant strains and the integrase Class 2 gene was amplified in only 8.2% (5/61) of the isolates. Our findings highlight the emergence of MDR Salmonella isolates. A rationalization of antimicrobial use is urgently recommended in both human and veterinary medicine.
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Kim SH, Sung GH, Park EH, Hwang IY, Kim GR, Song SA, Lee HK, Uh Y, Kim YA, Jeong SH, Shin JH, Shin KS, Lee J, Jeong J, Kim YR, Yong D, Lee M, Kim YK, Ryoo NH, Lee S, Kim J, Kim S, Kim HS, Shin JH. Serotype Distribution and Antimicrobial Resistance of Salmonella Isolates in Korea between 2016 and 2017. Ann Lab Med 2022; 42:268-273. [PMID: 34635618 PMCID: PMC8548255 DOI: 10.3343/alm.2022.42.2.268] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/21/2021] [Revised: 03/23/2021] [Accepted: 09/16/2021] [Indexed: 11/30/2022] Open
Abstract
Salmonella is one of the major causes of food-borne infections. We investigated the serotype distribution and antimicrobial resistance of Salmonella isolates collected in Korea between January 2016 and December 2017. In total, 669 Salmonella isolates were collected from clinical specimens at 19 university hospitals. Serotyping was performed according to the Kauffmann–White scheme, and antimicrobial susceptibility was tested using Sensititre EUVSEC plates or disk diffusion. Among the strains, C (39.8%) and B (36.6%) were the most prevalent serogroups. In total, 51 serotypes were identified, and common serotypes were S. enterica serovar I 4,[5],12:i:- (16.7%), S. Enteritidis (16.1%), S. Bareilly (14.6%), S. Typhimurium (9.9%), and S. Infantis (6.9%). The resistance rates to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole were 32.6%, 12.1%, and 8.4%, respectively. The resistance rates to cefotaxime and ciprofloxacin were 8.1% and 3.0%, respectively, while 5.4% were multidrug-resistant. S. enterica serovar I 4,[5],12:i:- and S. Enteritidis were highly prevalent, and there was an increase in rare serotypes. Multidrug resistance and ciprofloxacin resistance were highly prevalent. Periodic investigations of Salmonella serotypes and antimicrobial resistance are needed.
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Affiliation(s)
- Si Hyun Kim
- Department of Clinical Laboratory Science, Semyung University, Jecheon, Korea
| | | | - Eun Hee Park
- Busan Institute of Health and Environment, Busan, Korea
| | | | - Gyu Ri Kim
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea
| | - Sae Am Song
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea
| | - Hae Kyung Lee
- Department of Laboratory Medicine, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Young Uh
- Department of Laboratory Medicine, Wonju Severance Christian Hospital, Yonsei University Wonju College of Medicine, Wonju, Korea
| | - Young Ah Kim
- Department of Laboratory Medicine, National Health Insurance Service Ilsan Hospital, Goyang, Korea
| | - Seok Hoon Jeong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Jong Hee Shin
- Department of Laboratory Medicine, Chonnam National University Medical School, Gwangju, Korea
| | - Kyeong Seob Shin
- Department of Laboratory Medicine, College of Medicine, Chungbuk National University, Cheongju, Korea
| | - Jaehyeon Lee
- Department of Laboratory Medicine, Chonbuk National University Medical School, Jeonju, Korea
| | - Joseph Jeong
- Department of Laboratory Medicine, Ulsan University Hospital, University of Ulsan College of Medicine, Ulsan, Korea
| | - Young Ree Kim
- Department of Laboratory Medicine, School of Medicine, Jeju National University, Jeju, Korea
| | - Dongeun Yong
- Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
| | - Miae Lee
- Department of Laboratory Medicine, Ewha Womans University College of Medicine, Seoul, Korea
| | - Yu Kyung Kim
- Department of Laboratory Medicine, School of Medicine, Kyungpook National University, Daegu, Korea
| | - Nam Hee Ryoo
- Department of Laboratory Medicine, Keimyung University School of Medicine, Daegu, Korea
| | - Seungok Lee
- Department of Laboratory Medicine, Incheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Incheon, Korea
| | - Jayoung Kim
- Department of Laboratory Medicine, International St. Mary's Hospital, The Catholic Kwandong University College of Medicine, Incheon, Korea
| | - Sunjoo Kim
- Department of Laboratory Medicine, Gyeongsang National University College of Medicine, Jinju, Korea
| | - Hyun Soo Kim
- Department of Laboratory Medicine, Hallym University College of Medicine, Hwaseong, Korea
| | - Jeong Hwan Shin
- Department of Laboratory Medicine, Inje University College of Medicine, Busan, Korea.,Paik Institute for Clinical Research, Inje University, Busan, Korea
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In vitro susceptibility of ceftolozane/tazobactam against typhoidal, non-typhoidal and extended spectrum β-lactamase-producing Salmonella. Antimicrob Agents Chemother 2021; 66:e0122421. [PMID: 34662198 DOI: 10.1128/aac.01224-21] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Both typhoidal and non-typhoidal salmonellae are included in the top 15 drug-resistant threats described by the Center for Disease Control and Prevention of the United States. There is an urgent need to look for alternative antibiotics for the treatment of Salmonella infections. We examined the in vitro susceptibilities of ceftolozane/tazobactam and six other antibiotics on typhoidal and non-typhoidal salmonellae, including isolates that are extended-spectrum β-lactamase (ESBL)-positive, using the broth microdilution test. Of the 313 (52 typhoidal and 261 non-typhoidal) Salmonella isolates tested, 98.7% were susceptible to ceftolozane/tazobactam. Based on the overall MIC50/90 values, Salmonella isolates were more susceptible to ceftolozane/tazobactam (0.25/0.5 mg/L) compared to all other comparator agents: ampicillin (≥64/≥64 mg/L), levofloxacin (0.25/1 mg/L), azithromycin (4/16 mg/L), ceftriaxone (≤0.25/4 mg/L), chloramphenicol (8/≥64 mg/L) and trimethoprim/sulfamethoxazole (1/≥8 mg/L). When comparing the activity of the antimicrobial agents against non-typhoidal Salmonella isolates according to their serogroup, ceftolozane/tazobactam had the highest activity (100%) against Salmonella serogroups D, G, I and Q isolates, whereas the lowest activity (85.7%) was observed against serogroup E isolates. All the 10 ESBL-producing Salmonella (all non-typhoidal) isolates, of which 8 were CTX-M-55-producers and 2 were CTX-M-65-producers, were sensitive to ceftolozane/tazobactam albeit with a higher MIC50/90 value (1/2 mg/L) than non-ESBL-producers (0.25/0.5 mg/L). In summary, our data indicate that ceftolozane/tazobactam is active against most strains of both typhoidal and non-typhoidal salmonellae and also active against ESBL-producing salmonellae.
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Lim C, Ashley EA, Hamers RL, Turner P, Kesteman T, Akech S, Corso A, Mayxay M, Okeke IN, Limmathurotsakul D, van Doorn HR. Surveillance strategies using routine microbiology for antimicrobial resistance in low- and middle-income countries. Clin Microbiol Infect 2021; 27:1391-1399. [PMID: 34111583 PMCID: PMC7613529 DOI: 10.1016/j.cmi.2021.05.037] [Citation(s) in RCA: 20] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2021] [Revised: 04/27/2021] [Accepted: 05/25/2021] [Indexed: 01/13/2023]
Abstract
BACKGROUND Routine microbiology results are a valuable source of antimicrobial resistance (AMR) surveillance data in low- and middle-income countries (LMICs) as well as in high-income countries. Different approaches and strategies are used to generate AMR surveillance data. OBJECTIVES We aimed to review strategies for AMR surveillance using routine microbiology results in LMICs and to highlight areas that need support to generate high-quality AMR data. SOURCES We searched PubMed for papers that used routine microbiology to describe the epidemiology of AMR and drug-resistant infections in LMICs. We also included papers that, from our perspective, were critical in highlighting the biases and challenges or employed specific strategies to overcome these in reporting AMR surveillance in LMICs. CONTENT Topics covered included strategies of identifying AMR cases (including case-finding based on isolates from routine diagnostic specimens and case-based surveillance of clinical syndromes), of collecting data (including cohort, point-prevalence survey, and case-control), of sampling AMR cases (including lot quality assurance surveys), and of processing and analysing data for AMR surveillance in LMICs. IMPLICATIONS The various AMR surveillance strategies warrant a thorough understanding of their limitations and potential biases to ensure maximum utilization and interpretation of local routine microbiology data across time and space. For instance, surveillance using case-finding based on results from clinical diagnostic specimens is relatively easy to implement and sustain in LMIC settings, but the estimates of incidence and proportion of AMR is at risk of biases due to underuse of microbiology. Case-based surveillance of clinical syndromes generates informative statistics that can be translated to clinical practices but needs financial and technical support as well as locally tailored trainings to sustain. Innovative AMR surveillance strategies that can easily be implemented and sustained with minimal costs will be useful for improving AMR data availability and quality in LMICs.
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Affiliation(s)
- Cherry Lim
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK.
| | - Elizabeth A Ashley
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Vientiane, Laos
| | - Raph L Hamers
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Eijkman-Oxford Clinical Research Unit, Jakarta, Indonesia
| | - Paul Turner
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Cambodia Oxford Medical Research Unit, Angkor Hospital for Children, Siem Reap, Cambodia
| | - Thomas Kesteman
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Hanoi, Viet Nam
| | - Samuel Akech
- KEMRI-Wellcome Trust Research Programme, Nairobi, Kenya
| | - Alejandra Corso
- National/Regional Reference Laboratory for Antimicrobial Resistance (NRL), Servicio Antimicrobianos, Instituto Nacional de Enfermedades Infecciosas ANLIS Dr. Carlos G. Malbrán, Buenos Aires, Argentina
| | - Mayfong Mayxay
- Lao-Oxford-Mahosot Hospital Wellcome Trust Research Unit, Vientiane, Laos; Institute of Research and Education Development (IRED), University of Health Sciences, Vientiane, Laos
| | - Iruka N Okeke
- Department of Pharmaceutical Microbiology, Faculty of Pharmacy, University of Ibadan, Ibadan, Nigeria
| | - Direk Limmathurotsakul
- Mahidol Oxford Tropical Medicine Research Unit, Faculty of Tropical Medicine, Mahidol University, Bangkok, Thailand; Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK
| | - H Rogier van Doorn
- Centre for Tropical Medicine and Global Health, Nuffield Department of Medicine, University of Oxford, Oxford, UK; Oxford University Clinical Research Unit, National Hospital for Tropical Diseases, Hanoi, Viet Nam.
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Whole-Genome Sequencing Reveals the Presence of the blaCTX-M-65 Gene in Extended-Spectrum β-Lactamase-Producing and Multi-Drug-Resistant Clones of Salmonella Serovar Infantis Isolated from Broiler Chicken Environments in the Galapagos Islands. Antibiotics (Basel) 2021; 10:antibiotics10030267. [PMID: 33807748 PMCID: PMC8000398 DOI: 10.3390/antibiotics10030267] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/27/2021] [Revised: 02/19/2021] [Accepted: 02/25/2021] [Indexed: 12/24/2022] Open
Abstract
Salmonella Infantis, a common contaminant of poultry products, is known to harbor mobile genetic elements that confer multi-drug resistance (MDR) and have been detected in many continents. Here, we report four MDR S. Infantis strains recovered from poultry house environments in Santa Cruz Island of the Galapagos showing extended-spectrum β-lactamase (ESBL) resistance and reduced fluoroquinolone susceptibility. Whole-genome sequencing (WGS) revealed the presence of the ESBL-conferring blaCTX-M-65 gene in an IncFIB-like plasmid in three S. Infantis isolates. Multi-locus sequence typing (MLST) and single nucleotide variant/polymorphism (SNP) SNVPhyl analysis showed that the S. Infantis isolates belong to sequence type ST32, likely share a common ancestor, and are closely related (1–3 SNP difference) to blaCTX-M-65-containing clinical and veterinary S. Infantis isolates from the United States and Latin America. Furthermore, phylogenetic analysis of SNPs following core-genome alignment (i.e., ParSNP) inferred close relatedness between the S. Infantis isolates from Galapagos and the United States. Prophage typing confirmed the close relationship among the Galapagos S. Infantis and was useful in distinguishing them from the United States isolates. This is the first report of MDR blaCTX-M-65-containing S. Infantis in the Galapagos Islands and highlights the need for increased monitoring and surveillance programs to determine prevalence, sources, and reservoirs of MDR pathogens.
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Qian WD, Huang J, Zhang JN, Li XC, Kong Y, Wang T, Li YD. Antimicrobial and Antibiofilm Activities and Mechanism of Action of Chelerythrine Against Carbapenem-Resistant Serratia marcescens In Vitro. Microb Drug Resist 2021; 27:1105-1116. [PMID: 33439767 DOI: 10.1089/mdr.2020.0207] [Citation(s) in RCA: 7] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
Aim: To evaluate the antimicrobial and antibiofilm effects of chelerythrine (CHE) against carbapenem-resistant Serratia marcescens (CRSM). Materials and Methods: The minimum inhibitory concentration (MIC) of CHE against CRSM was determined using the agar dilution method. Changes in intracellular adenosine triphosphate (ATP) concentration, intracellular pH, cell membrane potential, and cell membrane integrity were investigated to assess the influence of CHE on the cell membrane. The effects of CHE on cell morphology were observed by field emission scanning electron microscopy (FESEM) and transmission electron microscopy. The antibiofilm formation of CHE was measured by crystal violet staining and visualized with confocal laser scanning microscopy (CLSM) and FESEM. The influence of CHE on biofilm components was further investigated using CLSM specific combined with double-dyeing methods. Results: Our results showed that CHE had an MIC at 125 μg/mL against CRSM was capable of inhibiting the growth of CRSM and destroying its cell membrane integrity, as well as obviously changing the cell morphology. Sub-MIC CHE displayed robust inhibitory effects against CRSM biofilm formation by mediating the production of biofilm components. In addition, CLSM- and FESEM-mediated evaluation of the damage of biofilm cells and biofilm persistence revealed that at high concentrations, CHE could compromise the cells within biofilms and remove preformed biofilms. Conclusion: CHE shows promise as a natural antimicrobial substance against biofilm-positive CRSM, with the potential to serve as an alternative therapeutic agent.
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Affiliation(s)
- Wei-Dong Qian
- Department of Pharmacy, School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an, P.R. China
| | - Jie Huang
- Department of Pharmacy, School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an, P.R. China
| | - Jia-Ning Zhang
- Department of Pharmacy, School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an, P.R. China
| | - Xin-Cheng Li
- Department of Pharmacy, School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an, P.R. China
| | - Yi Kong
- Department of Clinical Laboratory Medicine, Jining First Peoples' Hospital, Jining, P.R. China
| | - Ting Wang
- Department of Pharmacy, School of Food and Biological Engineering, Shaanxi University of Science and Technology, Xi'an, P.R. China
| | - Yong-Dong Li
- Ningbo Municipal Center for Disease Control and Prevention, Ningbo, P.R. China
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Crouch CF, Pugh C, Patel A, Brink H, Wharmby C, Watts A, van Hulten MCW, de Vries SPW. Reduction in intestinal colonization and invasion of internal organs after challenge by homologous and heterologous serovars of Salmonella enterica following vaccination of chickens with a novel trivalent inactivated Salmonella vaccine. Avian Pathol 2020; 49:666-677. [PMID: 32907345 DOI: 10.1080/03079457.2020.1814200] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/23/2022]
Abstract
A novel inactivated vaccine, comprising three serovars of Salmonella enterica (Enteritidis, serogroup O:9; Typhimurium, serogroup O:4; Infantis, serogroup O:7) grown under conditions of iron restriction and adjuvanted with aluminium hydroxide, was evaluated for efficacy following challenge by homologous and heterologous serovars. Chickens were vaccinated at 6 and 10 weeks of age by the intramuscular route and challenged 4 to 9 weeks after the second vaccination with serovars belonging to serogroup O:9 (Enteritidis), O:4 (Typhimurium and Heidelberg), O:7 (Infantis and Virchow), and O:8 (Hadar). All vaccinated birds produced a marked systemic antibody response against each of the component vaccine antigens by the time of challenge. Significant reductions in both colonization of the intestinal tract and invasion of internal organs were observed in vaccinated birds compared with non-vaccinated controls, irrespective of the challenge serovar. The findings suggest that broad serovar protection within the constitutive serogroups of an inactivated multi-valent vaccine is possible and could, therefore, play an important role in future Salmonella control programmes. RESEARCH HIGHLIGHTS Novel inactivated trivalent Salmonella chicken vaccine was developed and tested. Vaccine induced marked systemic antibody response against all vaccine antigens. Significant reductions in intestinal tract colonization and internal organ invasion. Vaccine efficacy demonstrated against homologous and heterologous serovars.
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Beloborodov VB, Gusarov VG, Dekhnich AV, Zamyatin MN, Zubareva NA, Zyryanov SK, Kamyshova DA, Klimko NN, Kozlov RS, Kulabukhov VV, Polushin YS, Rudnov VA, Sidorenko SV, Shlyk IV, Edelshtein MV, Yakovlev SV. Guidelines of the Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), and NGO Russian Sepsis Forum Diagnostics and antimicrobial therapy of the infections caused by multiresistant microorganisms. MESSENGER OF ANESTHESIOLOGY AND RESUSCITATION 2020. [DOI: 10.21292/2078-5658-2020-16-1-52-83] [Citation(s) in RCA: 13] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Introduction. Strains of microorganisms resistant to antimicrobial agents are commonly found in medical units throughout most regions of the world, including Russia. This leads to lower antimicrobial therapy efficacy when treating nosocomial infections. In this regard, the timely implementation of adequate antibiotic therapy is of great importance.The objective of the guidelines: To provide summarized information on contemporary approaches to microbiological diagnostics and the assessment of results, as well as the principles of rational use of antimicrobial and antifungal agents, including treatment of infections caused by multiple drug-resistant strains of microorganisms.Subjects and methods. These guidelines are based on published data obtained in the course of randomized trials, as well as information presented in the provisions of international guidelines supported by high-level evidence. The guidelines were prepared by a working group of Russian experts with extensive experience in research and practical work in this area. On October 11, 2019, the final version of the guidelines was reviewed and approved at a joint meeting of the working group and representatives of the public organizations which initiated the development of these guidelines (Association of Anesthesiologists-Intensivists, the Interregional Non-Governmental Organization Alliance of Clinical Chemotherapists and Microbiologists, the Interregional Association for Clinical Microbiology and Antimicrobial Chemotherapy (IACMAC), NGO Russian Sepsis Forum).Conclusion. The guidelines reflect an interdisciplinary consensus of approaches to the diagnostics and antibiotic therapy of infections caused by multiresistant microorganisms. The provisions set forth should be used to decide on the strategy of empirical and etiotropic therapy of the most severe infections.
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Affiliation(s)
| | - V. G. Gusarov
- National Medical and Surgical Center named after N.I. Pirogov of the Russian Ministry of Health
| | - A. V. Dekhnich
- Antimicrobial Chemotherapy Research Institute of Smolensk State Medical University, Russian Ministry of Health
| | - M. N. Zamyatin
- National Medical and Surgical Center named after N.I. Pirogov of the Russian Ministry of Health
| | - N. A. Zubareva
- E.A. Vagner Perm State Medical University, Russian Ministry of Health
| | | | - D. A. Kamyshova
- National Medical and Surgical Center named after N.I. Pirogov of the Russian Ministry of Health
| | - N. N. Klimko
- I.I. Mechnikov North-Western State Medical University, the Russian Ministry of Health
| | - R. S. Kozlov
- Smolensk State Medical University, Russian Ministry of Health
| | | | - Yu. S. Polushin
- Pavlov First St.Petersburg State Medical University, Russian Ministry of Health
| | - V. A. Rudnov
- Smolensk State Medical University, Russian Ministry of Health
| | - S. V. Sidorenko
- I.I. Mechnikov North-Western State Medical University, the Russian Ministry of Health
| | - I. V. Shlyk
- Pavlov First St.Petersburg State Medical University, Russian Ministry of Health
| | | | - S. V. Yakovlev
- I.M. Sechenov First Moscow State Medical University (Sechenov University)
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Shen J, Yang B, Gu Q, Zhang G, Yang J, Xue F, Shao J, Yi X, Jiang Y. The Role of AcrAB-TolC Efflux Pump in Mediating Fluoroquinolone Resistance in Naturally Occurring Salmonella Isolates from China. Foodborne Pathog Dis 2017; 14:728-734. [PMID: 28926285 DOI: 10.1089/fpd.2017.2291] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The involvement of AcrAB-TolC efflux pump in regulating fluoroquinolone resistance of naturally occurring Salmonella isolates is insufficiently investigated. In this study, the regulatory genes, acrR, ramR, marRAB, and soxRS of AcrAB-TolC efflux pump, of 27 naturally occurring fluoroquinolone-resistant Salmonella isolates collected in China were sequenced. The expression levels of acrB, ramA, marA, and soxS were also examined using quantitative real-time polymerase chain reaction. Gene alterations were mainly observed for acrR (three mutation types) and ramR (four mutation types), not for marRAB (no mutation) or soxRS (one mutaton type). Overexpressions were also mainly observed for acrB and ramA, not for marA or soxS. Some mutations/deletions in ramR caused highly elevated expression of ramA. Complementation with wild-type ramR gene reduced mRNA levels of acrB and ramA by 1.7- to 2.2-fold and 10.5- to 30.1-fold, respectively, and lowered fluoroquinolones (FQ) minimum inhibitory concentrations by 2- to 8-fold. Neither MarA nor SoxS was found to be associated with increased FQ resistance. This study shows that the AcrAB efflux pump is playing a role in mediating fluoroquinolone resistance, and RamA may be the major global regulator of AcrAB-TolC-mediated fluoroquinolone resistance in Salmonella.
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Affiliation(s)
- Jinling Shen
- 1 Technology Center of Zhangjiagang Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China , Zhangjiagang, China .,4 Technical Center for Animal Plant and Food Inspection and Qurantine , Shanghai Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China, Shanghai, China
| | - Baowei Yang
- 2 College of Food Science and Engineering, Northwest A&F University , Yangling, China
| | - Qiang Gu
- 1 Technology Center of Zhangjiagang Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China , Zhangjiagang, China
| | - Guodong Zhang
- 3 Center for Food Safety and Applied Nutrition , U.S. Food and Drug Administration, College Park, Maryland
| | - Jielin Yang
- 4 Technical Center for Animal Plant and Food Inspection and Qurantine , Shanghai Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China, Shanghai, China
| | - Feng Xue
- 5 College of Veterinary Medicine, Nanjing Agricultural University , Nanjing, China .,6 Jiangsu Collaborative Innovation Center of Meat Production and Processing , Nanjing, China
| | - Jingdong Shao
- 1 Technology Center of Zhangjiagang Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China , Zhangjiagang, China
| | - Xiaojuan Yi
- 1 Technology Center of Zhangjiagang Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China , Zhangjiagang, China
| | - Yuan Jiang
- 4 Technical Center for Animal Plant and Food Inspection and Qurantine , Shanghai Entry-Exit Inspection and Quarantine Bureau of the People's Republic of China, Shanghai, China .,6 Jiangsu Collaborative Innovation Center of Meat Production and Processing , Nanjing, China
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10
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Mascaro V, Pileggi C, Crinò M, Proroga YTR, Carullo MR, Graziani C, Arigoni F, Turno P, Pavia M. Non-typhoidal Salmonella in Calabria, Italy: a laboratory and patient-based survey. BMJ Open 2017; 7:e017037. [PMID: 28893751 PMCID: PMC5595191 DOI: 10.1136/bmjopen-2017-017037] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 03/27/2017] [Revised: 05/25/2017] [Accepted: 06/28/2017] [Indexed: 11/22/2022] Open
Abstract
INTRODUCTION Although there has been a decrease in the number of cases of salmonellosis in the European Union, it still represents the primary cause of foodborne outbreaks. In Calabria region, data are lacking for the incidence of human non-typhoid salmonellosis as active surveillance has never been carried out. OBJECTIVE To report the results of a laboratory and patient-based morbidity survey in Calabria to describe the incidence and distribution of Salmonella serovars isolated from humans, with a focus on antimicrobial resistance patterns. METHODS Positive cultures from human samples were collected from every laboratory participating in the surveillance, with a minimum set of information about each isolate. A questionnaire was then administered to the patients by telephone interview to assess the potential risk exposures.Salmonella isolates underwent biochemical identification, molecular analysis by PCR and antimicrobial susceptibility testing by the disk-diffusion method. RESULTS During a 2-year period, 105 strains of Salmonella spp were isolated from samples of patients with diarrhoea, with the highest isolation rate for children aged 1-5 years. The standardised rate was 2.7 cases per 1 00 000 population. The most common Salmonella isolates belonged to monophasic variant of S. Typhimurium (S. 4,[5],12:i:-) (33.3%), followed by S. Typhimurium (21.9%). 30.5% of the isolates were susceptible to all microbial agents tested and the most common pan-susceptible serotype was S. Napoli (100%). S. 4,[5],12:i:- was resistant to ampicillin, streptomycin, sulfonamides and tetracyclines in 42.9% cases, while resistance to quinolones was seen in 14.3% of the isolates. CONCLUSIONS The results provide evidence that an active surveillance system effectively enhances Salmonella notifications. The high prevalence of antimicrobial resistance, including resistance to quinolones and multiresistance, enforces the need to strengthen strategies of surveillance and monitoring of antimicrobial use.
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Affiliation(s)
- Valentina Mascaro
- Department of Health Sciences, University of Catanzaro 'Magna Græcia', Catanzaro, Italy
| | - Claudia Pileggi
- Department of Health Sciences, University of Catanzaro 'Magna Græcia', Catanzaro, Italy
| | - Maria Crinò
- Department of Health Sciences, University of Catanzaro 'Magna Græcia', Catanzaro, Italy
| | - Yolande Therese Rose Proroga
- Department of Food Microbiology-Centro Pilota Tipizzazione Salmonelle, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - Maria Rosaria Carullo
- Department of Food Microbiology-Centro Pilota Tipizzazione Salmonelle, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Portici, Naples, Italy
| | - Caterina Graziani
- Dipartimento di Sanità Pubblica Veterinaria e Sicurezza Alimentare, Reparto di Epidemiologia Veterinaria e analisi del rischio, Istituto Superiore di Sanità, Rome, Italy
| | - Fabio Arigoni
- Dipartimento Tutela della Salute, Task Force per le Attività Veterinarie, Regione Calabria, Catanzaro, Italy
| | - Pasquale Turno
- Dipartimento Tutela della Salute, Task Force per le Attività Veterinarie, Regione Calabria, Catanzaro, Italy
| | - Maria Pavia
- Department of Health Sciences, University of Catanzaro 'Magna Græcia', Catanzaro, Italy
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Giuriatti J, Stefani LM, Brisola MC, Crecencio RB, Bitner DS, Faria GA. Salmonella Heidelberg: Genetic profile of its antimicrobial resistance related to extended spectrum β-lactamases (ESBLs). Microb Pathog 2017; 109:195-199. [PMID: 28578094 DOI: 10.1016/j.micpath.2017.05.040] [Citation(s) in RCA: 13] [Impact Index Per Article: 1.9] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2017] [Accepted: 05/30/2017] [Indexed: 10/19/2022]
Abstract
The objective of this study was to evaluate the phenotypic and genotypic profile of antimicrobial susceptibility and the possible involvement of extended spectrum beta-lactamases (ESBLs) in the resistance profile of Salmonella Heidelberg (SH) isolated from chicken meat. We used 18 SH isolates from chicken meat produced in 2013 in the state of Paraná, Southern Brazil. The isolates were submitted to disk-diffusion tests and from these results it was possible to determine the number of isolates considered multiresistant and the index of multiple antimicrobial resistance (IRMA) against ten antimicrobials routinely used in human and veterinary medicine. It was considered multidrug resistant the isolate that showed resistance to three or more classes of antibiotics. Another test performed was the disc-approximation in order to investigate interposed zones of inhibition, indicative of ESBLs production. In the isolates that presented multidrug resistance (18/18), a search of resistance genes involved in the production of ESBLs was performed using PCR: blaCMY-2, blaSHV-1, blaTEM-1, blaCTX-M2, blaOXA-1, blaPSE-1 and AmpC. The overall antimicrobial resistance was 80.55%. The highest levels of resistance were observed for nalidixic acid and ceftiofur (100%). The most commonly resistance pattern found (42.1%) was A (penicillin-cephalosporin-quinolone-tetracycline). The results were negative for ghost zone formation, indicative of ESBLs. However, PCR technique was able to detect resistance genes via ESBLs where the blaTEM-1 gene showed the highest amplification (83.33%), and the second most prevalent genes were blaCMY-2 (38.88%) and AmpC gene (38.88%). The blaOXA-1 and blaPSE-1 genes were not detected. These results are certainly of concern since SH is becoming more prevalent in the South of Brazil and able to cause severe disease in immune compromised individuals, showing high antimicrobial resistance to those drugs routinely used in the treatment and control of human and animal salmonellosis.
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Affiliation(s)
- Jéssica Giuriatti
- Graduate Program in Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil
| | - Lenita Moura Stefani
- Graduate Program in Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil; Department of Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil.
| | - Maiara Cristina Brisola
- Graduate Program in Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil
| | - Regiane Boaretto Crecencio
- Graduate Program in Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil
| | - Dinael Simão Bitner
- Department of Animal Science, Universidade Do Estado de Santa Catarina (UDESC), Chapecó, SC, Brazil
| | - Gláucia Amorim Faria
- Department of Mathematics, Universidade Estadual Paulista Júlio de Mesquita Filho (UNESP), Ilha Solteira, SP, Brazil
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Affiliation(s)
- Rodrigo Nogueira Angerami
- Epidemiological Surveillance Section, Division of Infectious Diseases, Hospital of Clinics; University of Campinas and Department of Public Health, School of Medical Sciences, University of Campinas; Campinas São Paulo Brazil
| | - Luiz Jacintho da Silva
- Division of Infectious Diseases, Department of Internal Medicine, School of Medical Sciences; University of Campinas; Campinas São Paulo Brazil
| | - Alfonso J. Rodriguez-Morales
- Public Health and Infection Research Group, Faculty of Health Sciences; Universidad Tecnologica de Pereira; Pereira Risaralda Colombia
- Infectious Diseases Research Group; Hospital Universitario de Sincelejo; Sucre Colombia
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Serratia marcescens resistance profile and its susceptibility to photodynamic antimicrobial chemotherapy. Photodiagnosis Photodyn Ther 2016; 14:185-90. [DOI: 10.1016/j.pdpdt.2016.04.007] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/13/2016] [Revised: 03/20/2016] [Accepted: 04/12/2016] [Indexed: 11/30/2022]
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Akinyemi KO, Iwalokun BA, Alafe OO, Mudashiru SA, Fakorede C. bla CTX-M-I group extended spectrum beta lactamase-producing Salmonella typhi from hospitalized patients in Lagos, Nigeria. Infect Drug Resist 2015; 8:99-106. [PMID: 25999745 PMCID: PMC4437039 DOI: 10.2147/idr.s78876] [Citation(s) in RCA: 27] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/08/2023] Open
Abstract
Purpose The global spread of blaCTX-M-I extended-spectrum beta-lactamase (ESBL)-producing Salmonella spp. remains a major threat to treatment and control. Evidence of emergence and spread of this marker are lacking in Nigeria. This study investigated blaCTX-M-I ESBL production among Salmonella isolates from hospitalized patients. Methods Patients (158 total) made up of two groups were evaluated. Group A was composed of 135 patients with persistent pyrexia and group B was composed of 23 gastroenteritis patients and their stool samples. Samples were cultured, and isolates were identified and were subjected to antibiotic susceptibility testing by standard methods. Isolates were further screened for ESBL production, blaCTX-M-I genes and transferability by double disk synergy test, plasmid extraction, polymerase chain reaction, and conjugation experiment. Results Thirty-five (25.9%) Salmonella isolates were identified from group A, of which 74.3% were S. typhi, 22.9% were S. paratyphi and two (5.7%) were invasive non-typhoidal S. enteritidis. Nine Plasmodium falciparum infections were recorded, four of which were identified as co-infections with typhoidal Salmonella. Only two (8.7%) S. enteritidis samples were obtained from group B (P>0.05). A total of 24 isolates were ESBL-positive, eliciting resistance to five to seven antibiotics, and were multiple-drug resistant. ESBL production due to the blaCTX-M-I gene cluster was detected in eleven (45.8%) Salmonella isolates. Nine (81.8%) of the eleven blaCTX-M-I ESBL producers were S. typhi and two (18.2%) isolates were S. enteritidis. Four of nine S. typhi blaCTX-M-I ESBL-producing strains harbored 23 kb self-transmissible plasmid that was co-transferred with cefotaxime and augmentin resistance to Escherichia coli j53-2 transconjugants. Conclusion This study revealed the emergence of blaCTX-M-IS. typhi as an agent of persistent pyrexia with potential to spread to other Enterobacteriaceae in Lagos, Nigeria. Cautionary prescription and judicious use of third-generation cephalosporins, particularly cefotaxime, for the treatment of typhoid fever and routine screening for P. falciparum co-infection with ESBL-producing Salmonella in the laboratories during diagnosis of persistent pyrexia conditions in patients are recommended.
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Affiliation(s)
- Kabiru O Akinyemi
- Department of Microbiology, Lagos State University, Ojo, Lagos, Nigeria
| | - Bamidele A Iwalokun
- Biochemistry and Nutrition Division, Nigerian Institute of Medical Research, Yaba, Lagos, Nigeria
| | - Olajide O Alafe
- Department of Microbiology, Lagos State University, Ojo, Lagos, Nigeria
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Campos MJ, Palomo G, Hormeño L, Herrera-León S, Domínguez L, Vadillo S, Píriz S, Quesada A. Prevalence of quinolone resistance determinants in non-typhoidal Salmonella isolates from human origin in Extremadura, Spain. Diagn Microbiol Infect Dis 2014; 79:64-9. [DOI: 10.1016/j.diagmicrobio.2014.01.010] [Citation(s) in RCA: 12] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/08/2013] [Revised: 10/15/2013] [Accepted: 01/15/2014] [Indexed: 01/19/2023]
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Serotype distribution and antibiotic resistance of Salmonella in food-producing animals in Shandong province of China, 2009 and 2012. Int J Food Microbiol 2014; 180:30-8. [PMID: 24786550 DOI: 10.1016/j.ijfoodmicro.2014.03.030] [Citation(s) in RCA: 45] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/11/2013] [Revised: 12/06/2013] [Accepted: 03/29/2014] [Indexed: 10/25/2022]
Abstract
The aims of this study were to investigate the serotype distribution, genetic relationships and antibiotic resistance of Salmonella from food-producing animals in Shandong province of China in 2009 and 2012. A total of 362 out of 1825 samples from chickens, 53 out of 445 samples from ducks, and 50 out of 692 samples from pigs were positive for Salmonella. Isolates were subjected to serotyping, antibiotic susceptibility testing (15 antibiotics) and pulsed-field gel electrophoresis (PFGE). The most common serotypes recovered in the chicken samples were Enteritidis (n=294, 81.2%) and Indiana (n=45, 12.4%). For ducks, Cremieu (n=25, 47.2%), Indiana (n=13, 24.5%) and Typhimurium (n=9, 17%) were frequently isolated. In the pig samples, Derby (n=29, 58%), Typhimurium (n=9, 18%), and Enteritidis (n=6, 12%) were the most common serovars. PFGE results indicated that clonal dissemination of each serovar was prevalent, and that the Salmonella found on the poultry carcasses was caused by cross-contamination in the abattoirs. More than 99% of the Salmonella isolates collected were resistant to at least one antibiotic. The Salmonella resistance rates for 15 antibiotics in 2012 were significantly higher than those in 2009. In 2012, the highest resistance was to nalidixic acid (95.9%), followed by sulphafurazole (78.2%) and ampicillin (72.3%); the lowest levels of resistance were to kanamycin (40.1%) and amikacin (38.7%). Additionally, 41.5% and 42.2% of the Salmonella were resistant to ciprofloxacin and ceftiofur, respectively. Noticeably, 25% of the serovar Enteritidis and all of the serovar Indiana were resistant to at least 10 antibiotics in 2012. The increasing trend of antibiotic resistance in Shandong province indicates the need for more careful use of antibiotics.
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Fàbrega A, Soto SM, Ballesté-Delpierre C, Fernández-Orth D, Jiménez de Anta MT, Vila J. Impact of quinolone-resistance acquisition on biofilm production and fitness in Salmonella enterica. J Antimicrob Chemother 2014; 69:1815-24. [PMID: 24706735 DOI: 10.1093/jac/dku078] [Citation(s) in RCA: 37] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
OBJECTIVES To investigate the potential relationship between quinolone resistance and biofilm production in a collection of Salmonella enterica clinical isolates and in S. enterica serovar Typhimurium serial mutants with increasing resistance to ciprofloxacin. METHODS Nalidixic acid susceptibility and biofilm formation were assessed in a collection of 122 S. enterica clinical isolates. An in vitro quinolone-resistant mutant, 59-64, was obtained from a biofilm-producing and quinolone-susceptible clinical isolate, 59-wt, in a multistep selection process after increasing ciprofloxacin concentrations. The quinolone resistance mechanisms [target gene and multidrug resistance (MDR) regulatory mutations, MICs of several antibiotics, cell envelope protein analysis, real-time PCR and ciprofloxacin accumulation] were characterized for mutant strains. In addition, analysis of fitness, biofilm formation, rdar morphotype and expression of biofilm-related genes by real-time PCR were also determined. RESULTS Nalidixic acid-susceptible S. enterica strains were more prevalent in producing biofilm than the resistant counterparts. Strain 59-64 acquired five target gene mutations and showed an MDR phenotype. AcrAB and acrF overexpression were ruled out, whereas TolC did show increased expression in 59-64, which, in addition, accumulated less ciprofloxacin. Consistently, increased ramA expression was seen in 59-64 and attributed to a mutation within its promoter. Reduced biofilm production related to diminished csgB expression as well as reduced fitness was seen for 59-64, which was unable to form the rdar morphotype. CONCLUSIONS Quinolone resistance acquisition may be associated with decreased production of biofilm due to lower csgB expression. Efflux, biofilm production and fitness seem to be interrelated.
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Affiliation(s)
- Anna Fàbrega
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Sara M Soto
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Clara Ballesté-Delpierre
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - Dietmar Fernández-Orth
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain
| | - M Teresa Jiménez de Anta
- Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
| | - Jordi Vila
- Barcelona Centre for International Health Research (CRESIB, Hospital Clínic-Universitat de Barcelona), Barcelona, Spain Department of Clinical Microbiology, Hospital Clínic, School of Medicine, University of Barcelona, Barcelona, Spain
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Kweon OG, Kim JS, Kim GO, Lee CI, Jeong KH, Kim J. Characterization ofSalmonellaspp. Clinical Isolates in Gyeongsangbuk-do Province, 2012 to 2013. ANNALS OF CLINICAL MICROBIOLOGY 2014. [DOI: 10.5145/acm.2014.17.2.50] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Affiliation(s)
- Oh-Geun Kweon
- Division of Microbiology, Gyeongsangbuk-do Provincial Government Institute of Health and Environment, Cheongwon, Korea
| | - Jin Seok Kim
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, Cheongwon, Korea
| | - Gou-Ok Kim
- Division of Microbiology, Gyeongsangbuk-do Provincial Government Institute of Health and Environment, Cheongwon, Korea
| | - Chang-Il Lee
- Division of Microbiology, Gyeongsangbuk-do Provincial Government Institute of Health and Environment, Cheongwon, Korea
| | - Kwang-Hyeon Jeong
- Division of Microbiology, Gyeongsangbuk-do Provincial Government Institute of Health and Environment, Cheongwon, Korea
| | - Junyoung Kim
- Division of Enteric Diseases, Center for Infectious Diseases, Korea National Institute of Health, Cheongwon, Korea
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Identification of the first bla CMY-2 gene in Salmonella enterica serovar Typhimurium isolates obtained from cases of paediatric diarrhoea illness detected in South America. J Glob Antimicrob Resist 2013; 1:143-148. [PMID: 27873624 DOI: 10.1016/j.jgar.2013.04.003] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/26/2013] [Revised: 04/10/2013] [Accepted: 04/16/2013] [Indexed: 11/24/2022] Open
Abstract
The objectives of this study were to investigate clinical isolates of Salmonella enterica serovar Typhimurium resistant to β-lactam antibiotics, to characterise their mechanisms of antibiotic resistance and to evaluate the possible biological cost of expressing resistance genes. Two oxyimino-cephalosporin-resistant Salmonella isolates obtained from children with diarrhoea were characterised. The occurrence of plasmid-encoded blaCMY-2 genes was confirmed by molecular methods and conjugation assays; transcription levels were determined by quantitative real-time PCR (qRT-PCR). The genomic context of the β-lactamases, replicon type and addiction systems were analysed by PCR. Genomic relatedness of both isolates was studied by pulsed-field gel electrophoresis (PFGE) and multilocus sequence typing (MLST) assays. Growth curves, motility and invasiveness assays in Caco-2 cells were performed to analyse the bacterial fitness of both isolates. Both isolates carried a blaCMY-2-like allele in an IncI plasmid and belonged to the same MLST sequence type (ST19); nevertheless, they showed extensive differences in their PFGE profiles and virulotypes. Isolate STM709 appeared to lack the Salmonella virulence plasmid and displayed less motility and invasiveness in cultured cells than isolate STM910. qRT-PCR showed that isolate STM709 had higher blaCMY-2 mRNA levels compared with STM910. Altogether, the results suggest that a plasmid carrying blaCMY-2 could be disseminating among different clones of S. Typhimurium. Different levels of blaCMY-2 mRNA could have an effect on the fitness of this micro-organism, resulting in lower invasiveness and motility.
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Frye JG, Jackson CR. Genetic mechanisms of antimicrobial resistance identified in Salmonella enterica, Escherichia coli, and Enteroccocus spp. isolated from U.S. food animals. Front Microbiol 2013; 4:135. [PMID: 23734150 PMCID: PMC3661942 DOI: 10.3389/fmicb.2013.00135] [Citation(s) in RCA: 113] [Impact Index Per Article: 10.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/04/2013] [Accepted: 05/07/2013] [Indexed: 01/26/2023] Open
Abstract
The prevalence of antimicrobial resistance (AR) in bacteria isolated from U.S. food animals has increased over the last several decades as have concerns of AR foodborne zoonotic human infections. Resistance mechanisms identified in U.S. animal isolates of Salmonella enterica included resistance to aminoglycosides (e.g., alleles of aacC, aadA, aadB, ant, aphA, and StrAB), β-lactams (e.g., blaCMY−2, TEM−1, PSE−1), chloramphenicol (e.g., floR, cmlA, cat1, cat2), folate pathway inhibitors (e.g., alleles of sul and dfr), and tetracycline [e.g., alleles of tet(A), (B), (C), (D), (G), and tetR]. In the U.S., multi-drug resistance (MDR) mechanisms in Salmonella animal isolates were associated with integrons, or mobile genetic elements (MGEs) such as IncA/C plasmids which can be transferred among bacteria. It is thought that AR Salmonella originates in food animals and is transmitted through food to humans. However, some AR Salmonella isolated from humans in the U.S. have different AR elements than those isolated from food animals, suggesting a different etiology for some AR human infections. The AR mechanisms identified in isolates from outside the U.S. are also predominantly different. For example the extended spectrum β-lactamases (ESBLs) are found in human and animal isolates globally; however, in the U.S., ESBLs thus far have only been found in human and not food animal isolates. Commensal bacteria in animals including Escherichia coli and Enterococcus spp. may be reservoirs for AR mechanisms. Many of the AR genes and MGEs found in E. coli isolated from U.S. animals are similar to those found in Salmonella. Enterococcus spp. isolated from animals frequently carry MGEs with AR genes, including resistances to aminoglycosides (e.g., alleles of aac, ant, and aph), macrolides [e.g., erm(A), erm(B), and msrC], and tetracyclines [e.g., tet(K), (L), (M), (O), (S)]. Continuing investigations are required to help understand and mitigate the impact of AR bacteria on human and animal health.
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Affiliation(s)
- Jonathan G Frye
- Bacterial Epidemiology and Antimicrobial Resistance Research Unit, Agricultural Research Service, U.S. Department of Agriculture Athens, GA, USA
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Increased resistance to multiple antimicrobials and altered resistance gene expression in CMY-2-positive Salmonella enterica following a simulated patient treatment with ceftriaxone. Appl Environ Microbiol 2012; 78:8062-6. [PMID: 22961898 DOI: 10.1128/aem.02077-12] [Citation(s) in RCA: 9] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Salmonellosis is one of the most common causes of food-borne disease in the United States. Increasing antimicrobial resistance and corresponding increases in virulence present serious challenges. Currently, empirical therapy for invasive Salmonella enterica infection includes either ceftriaxone or ciprofloxacin (E. L. Hohmann, Clin. Infect. Dis. 32:263-269, 2001). The bla(CMY-2) gene confers resistance to ceftriaxone, the antimicrobial of choice for pediatric patients with invasive Salmonella enterica infections, making these infections especially dangerous (J. M. Whichard et al., Emerg. Infect. Dis. 11:1464-1466, 2005). We hypothesized that bla(CMY-2)-positive Salmonella enterica would exhibit increased MICs to multiple antimicrobial agents and increased resistance gene expression following exposure to ceftriaxone using a protocol that simulated a patient treatment in vitro. Seven Salmonella enterica strains survived a simulated patient treatment in vitro and, following treatment, exhibited a significantly increased ceftriaxone MIC. Not only would these isolates be less responsive to further ceftriaxone treatment, but because the bla(CMY-2) genes are commonly located on large, multidrug-resistant plasmids, increased expression of the bla(CMY-2) gene may be associated with increased expression of other drug resistance genes located on the plasmid (N. D. Hanson and C. C. Sanders, Curr. Pharm. Des. 5:881-894, 1999). The results of this study demonstrate that a simulated patient treatment with ceftriaxone can alter the expression of antimicrobial resistance genes, including bla(CMY-2) and floR in S. enterica serovar Typhimurium and S. enterica serovar Newport. Additionally, we have shown increased MICs following a simulated patient treatment with ceftriaxone for tetracycline, amikacin, ceftriaxone, and cefepime, all of which have resistance genes commonly located on CMY-2 plasmids. The increases in resistance observed are significant and may have a negative impact on both public health and antimicrobial resistance of Salmonella enterica.
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Minarini LAR, Darini ALC. Mutations in the quinolone resistance-determining regions of gyrA and parC in Enterobacteriaceae isolates from Brazil. Braz J Microbiol 2012; 43:1309-14. [PMID: 24031957 PMCID: PMC3769005 DOI: 10.1590/s1517-838220120004000010] [Citation(s) in RCA: 16] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2011] [Revised: 01/12/2012] [Accepted: 06/07/2012] [Indexed: 11/22/2022] Open
Abstract
Mutations in the quinolone resistance-determining regions (QRDR) in chromosomal gyrA and parC genes and fluoroquinolone susceptibility profiles were investigated in quinolone-resistant Enterobacteriaceae isolated from community and hospitalized patients in the Brazilian Southeast region. A total of 112 nalidixic acid-resistant enterobacterial isolates collected from 2000 to 2005 were investigated for mutations in the topoisomerases genes gyrA and parC by amplifying and sequencing the QRDR regions. Susceptibility to fluoroquinolones was tested by the agar dilution method. Amongst the 112 enterobacterial isolates, 81 (72.3%) were resistant to ciprofloxacin and 5 (4.5%) showed reduced susceptibility. Twenty-six (23.2%) were susceptible to ciprofloxacin. Several alterations were detected in gyrA and parC genes. Escherichia coli isolates (47.7%) showed double mutations in the gyrA gene and a single one in the parC gene. Two unusual aminoacid substitutions are reported, an Asp87-Asn in a Citrobacter freundii isolate with reduced susceptibility to fluoroquinolones and a Glu84-Ala in one E. coli isolate. Only a parC gene mutation was found in fluoroquinolone-susceptible Enterobacter aerogenes. None of the isolates susceptible to ciprofloxacin presented mutations in topoisomerase genes. This comprehensive analysis of QRDRs in gyrA and parC genes, covering commonly isolated Enterobacteriaceae in Brazil is the largest reported up to now.
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Affiliation(s)
- Luciene A R Minarini
- Departamento de Análises Clínicas, Toxicológicas e Bromatológicas, Faculdade de Ciências Farmacêuticas de Ribeirão Preto, Universidade de São Paulo , Ribeirão Preto, SP , Brasil ; Instituto de Ciências Ambientais, Químicas e Farmacêuticas, Universidade Federal de São Paulo , Diadema, SP , Brasil
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Scientific Opinion on the public health risks of bacterial strains producing extended-spectrum β-lactamases and/or AmpC β-lactamases in food and food-producing animals. EFSA J 2011. [DOI: 10.2903/j.efsa.2011.2322] [Citation(s) in RCA: 202] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/21/2022] Open
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In vitro and in vivo intracellular killing effects of tigecycline against clinical nontyphoid Salmonella isolates using ceftriaxone as a comparator. Antimicrob Agents Chemother 2011; 55:2755-9. [PMID: 21402846 DOI: 10.1128/aac.01807-10] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Salmonella is an important, worldwide food-borne pathogen. Resistance to fluoroquinolones and cephalosporins has been increasingly reported, and new therapeutic agents are desperately needed. In this study, we evaluated the in vitro antimicrobial susceptibility of clinical nontyphoidal Salmonella isolates to tigecycline. Antibacterial activity of tigecycline, ceftriaxone, and ciprofloxacin were investigated by time-kill studies and the murine peritonitis model. The MIC₅₀/MIC₉₀ values of tigecycline, ceftriaxone, and ciprofloxacin against 76 Salmonella isolates were 0.25/0.5, 1/8, and 0.125/0.5 μg/ml, respectively. The intracellular inhibitory activity of tigecycline at 0.5 μg/ml (1 × MIC) against Salmonella isolates in human peripheral blood mononuclear cells was sustained for 24 h. In a mouse peritonitis model, tigecycline reduced the extracellular and intracellular bacterial counts from 10⁷ CFU/ml and 10⁵ CFU/ml, respectively, to an undetectable level within 96 h. The results were similar to those obtained with ceftriaxone. The survival rate of mice exposed to tigecycline after being infected by an inoculum of 1 × 10⁵ CFU was 80%, and that of mice exposed to ceftriaxone was 100%. When the inoculum was increased to 1.3 × 10⁶ CFU, the survival rate of mice treated by tigecycline was 20%, and that of mice exposed to ceftriaxone was 0% (P = 0.2). When a ceftriaxone- and ciprofloxacin-resistant but tigecycline-susceptible isolate was tested, mice treated by tigecycline had a higher survival rate than those treated by ceftriaxone (15/20 [75%] versus 6/20 [30%]; P = 0.011). Our results suggest that tigecycline is at least as effective as ceftriaxone for murine Salmonella infections and warrants further clinical investigations to delineate its potential against human Salmonella infections.
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Müller S, Tappe D, Frosch M, Abele-Horn M, Valenza G. Resistance to ampicillin, third-generation cephalosporins, ciprofloxacin, co-trimoxazole and azithromycin in clinical isolates of Salmonella enterica subsp. enterica from Germany: Real problem or sporadic circumstance? ACTA ACUST UNITED AC 2011; 43:389-91. [DOI: 10.3109/00365548.2011.553242] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022]
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Ye J, Su LH, Chen CL, Hu S, Wang J, Yu J, Chiu CH. Analysis of pSC138, the multidrug resistance plasmid of Salmonella enterica serotype Choleraesuis SC-B67. Plasmid 2010; 65:132-40. [PMID: 21111756 DOI: 10.1016/j.plasmid.2010.11.007] [Citation(s) in RCA: 12] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2009] [Revised: 10/19/2010] [Accepted: 11/21/2010] [Indexed: 11/16/2022]
Abstract
Salmonella enterica serotype Choleraesuis (S. Choleraesuis) usually causes systemic infections in man and needs antimicrobial treatment. Multidrug resistance (MDR) in S. Choleraesuis is thus a great concern in the treatment of systemic non-typhoid salmonellosis. A large plasmid, pSC138, was identified in 2002 from a S. Choleraesuis strain SC-B67 that was resistant to all antimicrobial agents commonly used to treat salmonellosis, including ciprofloxacin and ceftriaxone. Complete DNA sequence of the plasmid had been determined previously (Chiu et al., 2005). In the present study, the sequence of pSC138 was reannotated in detail and compared with several newly sequenced plasmids. Some transposable elements and drug resistance genes were further delineated. Plasmid pSC138 was 138,742 bp in length and consisted of 177 open reading frames (ORFs). While 134 of the ORFs displayed significant identity levels to other plasmid and prokaryotic sequences, the remaining 43 ORFs have not been previously reported. Mobile elements, including two integrons, seven insertion sequences and eight transposons, and a truncated prophage together encompass at least 66,781 bp (48.1%) of the plasmid genome. The sequence of pSC138 consists of three major regions: a large composite transposable region Tn6088 with a Tn21-like backbone inserted by a variety of integrons or transposable elements; a transfer/maintenance region that contains a conserved ISEcp1-mediated transposon-like element Tn6092, carrying an AmpC gene, bla(CMY-2), that confers the ceftriaxone resistance; and a Rep_3 type of replication region. Another seven bacteremic strains of S. Choleraesuis that expressed the same MDR phenotype were identified during 2003-2008. The same Rep_3 type replicase and the bla(CMY-2)-containing, ISEcp1-mediated transposon-like element were found in the MDR isolates, suggesting a successful preservation and dissemination of the MDR plasmid. Comparison of pSC138 with other recently published plasmids revealed a high identity level between partial sequences of pSC138 and plasmids of the same or different incompatibility groups. The large MDR region found in pSC138 may provide a niche for the future evolution of the plasmid by acquisition of relevant resistance genes through the panoply of mobile elements and illegitimate recombination events.
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Affiliation(s)
- Jiehua Ye
- James D. Watson Institute of Genome Sciences, Zhejiang University, Hangzhou, China
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Souza RB, Ferrari RG, Magnani M, Kottwitz LBM, Alcocer I, Tognim MCB, Oliveira TCRM. Ciprofloxacin susceptibility reduction of Salmonella strains isolated from outbreaks. Braz J Microbiol 2010; 41:497-500. [PMID: 24031522 PMCID: PMC3768671 DOI: 10.1590/s1517-838220100002000033] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/09/2009] [Revised: 08/23/2009] [Accepted: 01/20/2010] [Indexed: 11/22/2022] Open
Abstract
The antimicrobial susceptibility of 212 Salmonella strains isolated from patients and foods was evaluated and 45% were found to be resistant to nalidixic acid. Nalidixic acid resistant strains showed a higher minimal inhibitory concentration for ciprofloxacin than sensitive strains. During the study an increase of strains with reduced susceptibility to ciprofloxacin was also observed.
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Affiliation(s)
- Roberta B Souza
- Departamento de Ciência e Tecnologia, Centro de Ciências Agrárias , Universidade Estadual de Londrina, PR , Brasil
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Abstract
Orbital bone infarction with subsequent orbital compression syndrome presenting as orbital cellulitis is reported in a child with sickle cell anemia. She deteriorated despite the use of antibiotics and improved after the surgical drainage of the collection. Radiographic findings, absence of sinusitis, hemorrhagic nature of the collection, and negative cultures all were consistent with orbital compression syndrome secondary to a vasoocclusive crisis. This condition needs to be differentiated from the more common orbital cellulitis secondary to sinusitis.
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Scientific Advisory Group on Antimi. Reflection paper on the use of third and fourth generation cephalosporins in food producing animals in the European Union: development of resistance and impact on human and animal health. J Vet Pharmacol Ther 2009; 32:515-33. [DOI: 10.1111/j.1365-2885.2009.01075.x] [Citation(s) in RCA: 52] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
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30
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High rate of reduced susceptibility to ciprofloxacin and ceftriaxone among nontyphoid Salmonella clinical isolates in Asia. Antimicrob Agents Chemother 2009; 53:2696-9. [PMID: 19332677 DOI: 10.1128/aac.01297-08] [Citation(s) in RCA: 80] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
This multinational study from Asia revealed that reduced susceptibility to ciprofloxacin (MIC, 0.125 to 1 microg/ml) in nontyphoid Salmonella isolates was common in Taiwan (48.1%) and Thailand (46.2%) and in S. enterica serotype Choleraesuis (68.8%) and S. Virchow (75.0%) from all countries. Reduced susceptibility to ceftriaxone (MIC, 2 to 8 microg/ml) remained uncommon in Asia, except in Taiwan (38.0%) or in S. Typhimurium (25.0%) from all countries.
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Park SH, Seo YH, Ahn JY, Park PH, Kim KH, Song YH, Kim JE. Characteristics of CTX-M Type Extended Spectrum β-lactamase Producing Non-typhoi dal Salmonella Isolates. Infect Chemother 2009. [DOI: 10.3947/ic.2010.42.1.35] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Affiliation(s)
- Soon-Ho Park
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Yiel-Hea Seo
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Jeong-Yeal Ahn
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Pil-Hwan Park
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Kyung-Hee Kim
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Young-Hee Song
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
| | - Jung-Eun Kim
- Department of Laboratory Medicine, Gachon University Gil Hospital, Incheon, Korea
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Frye JG, Fedorka-Cray PJ, Jackson CR, Rose M. Analysis ofSalmonella entericawith Reduced Susceptibility to the Third-Generation Cephalosporin Ceftriaxone Isolated from U.S. Cattle During 2000–2004. Microb Drug Resist 2008; 14:251-8. [DOI: 10.1089/mdr.2008.0844] [Citation(s) in RCA: 20] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Affiliation(s)
- Jonathan G. Frye
- Bacterial Epidemiology and Antimicrobial Resistance Research Unit, USDA, Agricultural Research Service, Athens, Georgia
| | - Paula J. Fedorka-Cray
- Bacterial Epidemiology and Antimicrobial Resistance Research Unit, USDA, Agricultural Research Service, Athens, Georgia
| | - Charlene R. Jackson
- Bacterial Epidemiology and Antimicrobial Resistance Research Unit, USDA, Agricultural Research Service, Athens, Georgia
| | - Markus Rose
- Intervet Innovation GmbH, Schwabenheim, Rheinland-Pfalz, Germany
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Masterton R. The importance and future of antimicrobial surveillance studies. Clin Infect Dis 2008; 47 Suppl 1:S21-31. [PMID: 18713046 DOI: 10.1086/590063] [Citation(s) in RCA: 37] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/18/2022] Open
Abstract
Surveillance studies provide important information that allows for the identification of trends in pathogen incidence and antimicrobial resistance, including identification of emerging pathogens at national and global levels. Routine surveillance is critical for creating and refining approaches to controlling antimicrobial resistance and for guiding clinician decisions regarding appropriate treatment. The traditional approach has been to monitor pathogen antimicrobial susceptibility; numerous large studies have been performed, and their designs have evolved over time. Longitudinal studies are particularly useful because important information can be obtained by comparing data over time. Another approach to surveillance, that of monitoring antimicrobial use, can help to identify trends in dosing, to prevent the development of resistance. Several studies have incorporated this approach into their methods, and both large and small studies have attempted to correlate antimicrobial use data with antimicrobial resistance data. Overall, care must be taken to coordinate programs for optimal utilization of resources, to avoid duplication of effort.
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Affiliation(s)
- Robert Masterton
- Ayrshire and Arran National Health Service Board, The Ayr Hospital, Ayr, United Kingdom.
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Whichard JM, Gay K, Stevenson JE, Joyce KJ, Cooper KL, Omondi M, Medalla F, Jacoby GA, Barrett TJ. Human Salmonella and concurrent decreased susceptibility to quinolones and extended-spectrum cephalosporins. Emerg Infect Dis 2008; 13:1681-8. [PMID: 18217551 PMCID: PMC3375806 DOI: 10.3201/eid1311.061438] [Citation(s) in RCA: 81] [Impact Index Per Article: 5.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022] Open
Abstract
For complicated infections, decreased susceptibility could compromise treatment with drugs from either antimicrobial class. The National Antimicrobial Resistance Monitoring System monitors susceptibility among Enterobacteriaceae in humans in the United States. We studied isolates exhibiting decreased susceptibility to quinolones (nalidixic acid MIC >32 µg/mL or ciprofloxacin MIC >0.12 µg/mL) and extended-spectrum cephalosporins (ceftiofur or ceftriaxone MIC >2 µg/mL) during 1996–2004. Of non-Typhi Salmonella, 0.19% (27/14,043) met these criteria: 11 Senftenberg; 6 Typhimurium; 3 Newport; 2 Enteridis; and 1 each Agona, Haifa, Mbandaka, Saintpaul, and Uganda. Twenty-six isolates had gyrA mutations (11 at codon 83 only, 3 at codon 87 only, 12 at both). All Senftenberg isolates had parC mutations (S80I and T57S); 6 others had the T57S mutation. The Mbandaka isolate contained qnrB2. Eight isolates contained blaCMY-2; 1 Senftenberg contained blaCMY-23. One Senftenberg and 1Typhimurium isolate contained blaSHV-12; the Mbandaka isolate contained blaSHV-30. Nine Senftenberg isolates contained blaOXA-1; 1 contained blaOXA-9. Further studies should address patient outcomes, risk factors, and resistance dissemination prevention strategies.
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Affiliation(s)
- Jean M Whichard
- Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
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Clinical response and outcome of infection with Salmonella enterica serotype Typhi with decreased susceptibility to fluoroquinolones: a United States foodnet multicenter retrospective cohort study. Antimicrob Agents Chemother 2008; 52:1278-84. [PMID: 18212096 DOI: 10.1128/aac.01509-07] [Citation(s) in RCA: 113] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Patients with typhoid fever due to Salmonella enterica serotype Typhi strains for which fluoroquinolones MICs are elevated yet that are classified as susceptible by the current interpretive criteria of the Clinical and Laboratory Standards Institute may not respond adequately to fluoroquinolone therapy. Patients from seven U.S. states with invasive Salmonella serotype Typhi infection between 1999 and 2002 were enrolled in a multicenter retrospective cohort study. Patients infected with Salmonella serotype Typhi isolates with ciprofloxacin MICs of 0.12 to 1 microg/ml (decreased ciprofloxacin susceptibility but not resistant to ciprofloxacin [DCS]) were compared with patients infected with isolates with ciprofloxacin MICs <0.12 microg/ml for fever clearance time and treatment failure. Of 71 patients, 30 (43%) were female and 24 (34%) were infected with Salmonella serotype Typhi with DCS; the median age was 14 years (range, 1 to 51 years). Twenty-one (88%) of 24 isolates with DCS were resistant to nalidixic acid. The median antimicrobial-related fever clearance times in the DCS and non-DCS groups were 92 h (range, 21 to 373 h) and 72 h (range, 19 to 264 h) (P = 0.010), respectively, and the fluoroquinolone-related fever clearance times in the DCS and non-DCS groups were 90 h (range, 9 to 373 h) and 64 h (range, 34 to 204 h) (P = 0.153), respectively. Four (17%) of 24 patients in the DCS group and 2 (4%) of 46 patients in the non-DCS group (relative risk, 2.5; 95% confidence interval, 1.2 to 5.1) experienced treatment failure. Associations persisted after adjustment for potential confounders. We demonstrate that patients infected with Salmonella serotype Typhi isolates with DCS show evidence of a longer time to fever clearance and more frequent treatment failure. Nalidixic acid screening does not detect all isolates with DCS.
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Monno R, Rizzo C, De Vito D, Nucleo E, Migliavacca R, Pagani L, Rizzo G. Prevalence, antimicrobial resistance, and extended-spectrum beta-lactamases characterization of Salmonella isolates in Apulia, southern Italy (2001-2005). Microb Drug Resist 2008; 13:124-9. [PMID: 17650965 DOI: 10.1089/mdr.2007.683] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
The prevalence, antimicrobial susceptibility, and production of extended-spectrum beta-lactamases (ESBLs) of Salmonella collected from several hospitals in Apulia (southern Italy) were evaluated. The most common Salmonella isolates were Salmonella enterica serovar Typhimurium (44.6%), S. enterica serovar Enteritidis (33.4 %), S. enterica serovar Infantis (3.2 %), S. enterica serovar Typhi (1.5%), and S. enterica serovar Bovismorbificans (1.5%). The other serovars accounted for less than 1% each. Our data show a high resistance to ampicillin, tetracycline, and chloramphenicol. The isolates were pansensitive (53.5%), resistant to one antimicrobial agent (10.5%), resistant to two antimicrobial agents (22.1%), resistant to three antimicrobial agents (10.8%), and to four antimicrobial agents (2.7%). Resistance to more than four antibiotics was observed in 0.5% of strains. The presence of ESBL was found in only one strain of S. enterica serovar Bovismorbificans. The CTX-M-1 type-producing strain was identified by isoelectric focusing and molecular analysis. Results were consistent with the presence of a pI 8.6 ESBL active on cefotaxime, ceftazidime, cefepime, and aztreonam. Mating experiments showed that the CTX-M-1 determinant was transferable. To the best of our knowledge, this is the first report of CTX-M-1 type ESBL in Salmonella serovar Bovismorbificans.
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Affiliation(s)
- Rosa Monno
- Department of Internal Medicine and Public Health, University of Bari, I 70124 Bari, Italy.
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Rotimi VO, Jamal W, Pal T, Sonnevend A, Dimitrov TS, Albert MJ. Emergence of multidrug-resistant Salmonella spp. and isolates with reduced susceptibility to ciprofloxacin in Kuwait and the United Arab Emirates. Diagn Microbiol Infect Dis 2008; 60:71-7. [DOI: 10.1016/j.diagmicrobio.2007.07.007] [Citation(s) in RCA: 26] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/22/2007] [Revised: 07/09/2007] [Accepted: 07/10/2007] [Indexed: 10/22/2022]
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Boscán-Duque LA, Arzálluz-Fisher AM, Ugarte C, Sánchez D, Wittum TE, Hoet AE. Reduced susceptibility to quinolones among Salmonella serotypes isolated from poultry at slaughter in Venezuela. J Food Prot 2007; 70:2030-5. [PMID: 17900079 DOI: 10.4315/0362-028x-70.9.2030] [Citation(s) in RCA: 17] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Today there are recognized global "hot spots" that are areas in which nontyphoid Salmonella serotypes have been reported to have a high prevalence of quinolone resistance. There is concern that resistant strains can be disseminated from these localized geographical areas by travelers or via commercial food products. The objective of this article is to report a high frequency of reduced susceptibility to first- and second-generation quinolones among nontyphoid Salmonella isolates from poultry at slaughter in two processing plants belonging to the largest poultry integration companies in Zulia State, Venezuela. Nearly all (74 of 77; 96.1%) of the isolated strains were resistant to nalidixic acid, and 3.7% were resistant to ciprofloxacin; most (45 of 77; 58%) exhibited reduced susceptibility to ciprofloxacin and norfloxacin (15 of 77; 19.5%). In contrast, all of the isolates were susceptible to beta-lactamic antimicrobial drugs. Ninety-three percent (72 of 77) of the isolates were either Salmonella Parathyphi B or Salmonella Heidelberg, which have been reported as invasive Salmonella. The predominant serotypes in each slaughter plant showed different antimicrobial susceptibilities, only having in common their high resistance to nalidixic acid, suggesting that different clones disseminated in each commercial integration. The detection of high frequency of reduced susceptibility to first- and second-generation quinolones among nontyphoid Salmonella isolates from fresh poultry during processing is noteworthy. Resistance to quinolone drugs will not only make antimicrobial therapy more complicated if foodborne disease results, but also these quinolone-resistant strains can disseminate from this local hot spot to other geographical areas, spreading the resistance against this important antimicrobial drug.
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Affiliation(s)
- Leonardo A Boscán-Duque
- Infectious Diseases Course, College of Veterinary Sciences, University of Zulia, Maracaibo, Venezuela
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McMahan ZH, DuPont HL. Review article: the history of acute infectious diarrhoea management--from poorly focused empiricism to fluid therapy and modern pharmacotherapy. Aliment Pharmacol Ther 2007; 25:759-69. [PMID: 17373914 DOI: 10.1111/j.1365-2036.2007.03261.x] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/18/2022]
Abstract
BACKGROUND Acute diarrhoea management has progressed from largely ineffective measures in the early years to a more effective physiologic approach in recent years. AIM To review the history of acute diarrhoea management. METHODS Citations in PubMed were reviewed on 'acute diarrhoea treatment' along with an extensive file maintained by the corresponding author. RESULTS Freedom from diarrhoea was equated in early military conflicts with bravery and strength where diarrhoea-free soldiers had the 'guts' to fight. Until early 20th century, colonic irrigants, purgatives and emetic drugs were used to help eliminate undesired intestinal contents. Only a few early authorities suggested the need for replacement of fluids and salt, now standard treatment. Drugs aimed at diarrhoea symptom control have been broadly used for more than 100 years. The evolving history of one of those drugs, kaopectate is unappreciated. Once understanding the pathophysiology and infectious aetiology of acute diarrhoea, new oral fluids, pharmacologic agents designed to block specific secretory alterations and anti-infective drugs have been identified. CONCLUSIONS Physiologic and antimicrobial approaches to controlling diarrhoea can lead to reduction of stool number and enteric complaints, important in industrialized areas, with the potential for decreasing threat of fatal illness among infants in developing regions.
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Affiliation(s)
- Z H McMahan
- University of Texas Southwestern, Dallas, TX, USA
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