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Francois Watkins LK, Luna S, Bruce BB, Medalla F, Reynolds JL, Ray LC, Wilson EL, Caidi H, Griffin PM. Clinical Outcomes of Patients With Nontyphoidal Salmonella Infections by Isolate Resistance-Foodborne Diseases Active Surveillance Network, 10 US Sites, 2004-2018. Clin Infect Dis 2024; 78:535-543. [PMID: 37823421 PMCID: PMC10954391 DOI: 10.1093/cid/ciad631] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/15/2023] [Revised: 08/22/2023] [Accepted: 10/09/2023] [Indexed: 10/13/2023] Open
Abstract
BACKGROUND Nontyphoidal Salmonella causes an estimated 1.35 million US infections annually. Antimicrobial-resistant strains are a serious public health threat. We examined the association between resistance and the clinical outcomes of hospitalization, length-of-stay ≥3 days, and death. METHODS We linked epidemiologic data from the Foodborne Diseases Active Surveillance Network with antimicrobial resistance data from the National Antimicrobial Resistance Monitoring System (NARMS) for nontyphoidal Salmonella infections from 2004 to 2018. We defined any resistance as resistance to ≥1 antimicrobial and clinical resistance as resistance to ampicillin, azithromycin, ceftriaxone, ciprofloxacin, or trimethoprim-sulfamethoxazole (for the subset of isolates tested for all 5 agents). We compared outcomes before and after adjusting for age, state, race/ethnicity, international travel, outbreak association, and isolate serotype and source. RESULTS Twenty percent of isolates (1105/5549) had any resistance, and 16% (469/2969) had clinical resistance. Persons whose isolates had any resistance were more likely to be hospitalized (31% vs 28%, P = .01) or have length-of-stay ≥3 days (20% vs 16%, P = .01). Deaths were rare but more common among those with any than no resistance (1.0% vs 0.4%, P = .01). Outcomes for patients whose isolates had clinical resistance did not differ significantly from those with no resistance. After adjustment, any resistance (adjusted odds ratio 1.23, 95% confidence interval 1.04-1.46) remained significantly associated with hospitalization. CONCLUSIONS We observed a significant association between nontyphoidal Salmonella infections caused by resistant pathogens and likelihood of hospitalization. Clinical resistance was not associated with poorer outcomes, suggesting that factors other than treatment failure (eg, strain virulence, strain source, host factors) may be important.
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Affiliation(s)
- Louise K Francois Watkins
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Sarah Luna
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Beau B Bruce
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Felicita Medalla
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Jared L Reynolds
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Logan C Ray
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elisha L Wilson
- Colorado Department of Public Health & Environment, Denver, Colorado, USA
| | - Hayat Caidi
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Patricia M Griffin
- Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
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Parisi A, Crump JA, Glass K, Howden BP, Furuya-Kanamori L, Vilkins S, Gray DJ, Kirk MD. Health Outcomes from Multidrug-Resistant Salmonella Infections in High-Income Countries: A Systematic Review and Meta-Analysis. Foodborne Pathog Dis 2018; 15:428-436. [PMID: 29624414 DOI: 10.1089/fpd.2017.2403] [Citation(s) in RCA: 63] [Impact Index Per Article: 10.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/13/2023] Open
Abstract
BACKGROUND Salmonella is a leading cause of foodborne enterocolitis worldwide. Antimicrobial use in food animals is the driving force for antimicrobial resistance among Salmonella particularly in high-income countries. Nontyphoidal Salmonella (NTS) infections that are multidrug resistant (MDR) (nonsusceptible to ≥1 agent in ≥3 antimicrobial categories) may result in more severe health outcomes, although these effects have not been systematically examined. We conducted a systematic review and meta-analysis to examine impacts of MDR NTS on disease outcomes in high-income settings. METHODS We systematically reviewed the literature from scientific databases, including PubMed, Scopus, and grey literature sources, using preferred reporting items for systematic reviews and meta-analyses (PRISMA) guidelines. We included peer-reviewed publications of case-control and cohort studies, outbreak investigations, and published theses, imposing no language restriction. We included publications from January 1, 1990 through September 15, 2016 from high-income countries as classified by the World Bank, and extracted data on duration of illness, hospitalization, morbidity and mortality of MDR, and pan-susceptible NTS infections. RESULTS After removing duplicates, the initial search revealed 4258 articles. After further screening, 16 eligible studies were identified for the systematic review, but, only 9 of these were included in the meta-analysis. NTS serotypes differed among the reported studies, but serotypes Typhimurium, Enteritidis, Newport, and Heidelberg were the most often reported MDR pathogens. Salmonella infections that were MDR were associated with excess bloodstream infections (odds ratio [OR] 1.73; 95% confidence interval [CI] 1.32-2.27), more frequent hospitalizations (OR 2.51; 95% CI 1.38-4.58), and higher mortality (OR 3.54; 95% CI 1.10-11.40) when compared with pan-susceptible isolates. CONCLUSIONS Our study suggests that MDR NTS infections have more serious health outcomes compared with pan-susceptible strains. With the emergence of MDR Salmonella strains in high-income countries, it is crucial to reduce the use of antimicrobials in animals and humans, and intervene to prevent foodborne infections.
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Affiliation(s)
- Andrea Parisi
- 1 National Center for Epidemiology and Population Health, Australian National University , Canberra, Australia
| | - John A Crump
- 2 Center for International Health, University of Otago , Dunedin, New Zealand
| | - Kathryn Glass
- 1 National Center for Epidemiology and Population Health, Australian National University , Canberra, Australia
| | - Benjamin P Howden
- 3 Department of Microbiology and Immunology, University of Melbourne , Melbourne, Australia
| | - Luis Furuya-Kanamori
- 4 Department of Population Medicine, College of Medicine, Qatar University , Doha, Qatar .,5 Department of Global Health, Australian National University , Canberra, Australia
| | - Samantha Vilkins
- 1 National Center for Epidemiology and Population Health, Australian National University , Canberra, Australia
| | - Darren J Gray
- 5 Department of Global Health, Australian National University , Canberra, Australia
| | - Martyn D Kirk
- 1 National Center for Epidemiology and Population Health, Australian National University , Canberra, Australia
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Krueger AL, Greene SA, Barzilay EJ, Henao O, Vugia D, Hanna S, Meyer S, Smith K, Pecic G, Hoefer D, Griffin PM. Clinical outcomes of nalidixic acid, ceftriaxone, and multidrug-resistant nontyphoidal salmonella infections compared with pansusceptible infections in FoodNet sites, 2006-2008. Foodborne Pathog Dis 2014; 11:335-41. [PMID: 24617446 DOI: 10.1089/fpd.2013.1642] [Citation(s) in RCA: 47] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
BACKGROUND Nontyphoidal Salmonella causes an estimated 1.2 million infections, 23,000 hospitalizations, and 450 deaths annually in the United States. Most illnesses are self-limited; however, treatment with antimicrobial agents can be life-saving for invasive infections. METHODS The Foodborne Diseases Active Surveillance Network and the National Antimicrobial Resistance Monitoring System collaborated on a prospective cohort study of patients with nontyphoidal Salmonella bloodstream and gastrointestinal infections to determine differences in the clinical outcomes of resistant compared with pansusceptible infections. Interviews were conducted within 85 days of specimen collection date. RESULTS Of 875 nontyphoidal Salmonella isolates, 705 (81%) were pansusceptible, 165 (19%) were resistant to at least 1 agent, and 5 (0.6%) had only intermediate resistance. The most common pattern, found in 51 (31%) of resistant isolates, was resistance to at least ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline (ACSSuT); 88% of isolates with this pattern were serotype Typhimurium or Newport. Fourteen (52%) of the 27 ceftriaxone-resistant isolates were also ACSSuT resistant. Adjusted for age and serotype, bloodstream infection was significantly more common among patients infected with strains resistant to only two, only three, or only five antimicrobial classes, to ACSSuT with or without other agents, to ACSSuT only, or to nalidixic acid with or without other agents than among patients with pansusceptible isolates. Adjusted for age, serotype, and bloodstream infection, hospitalization was significantly more common among patients infected with strains resistant to only three agents or to ceftriaxone (all ceftriaxone-resistant isolates were resistant to other agents) than among patients with pansusceptible isolates. CONCLUSION This study extends evidence that patients with antimicrobial-resistant nontyphoidal Salmonella infections have more severe outcomes. Prevention efforts are needed to reduce unnecessary antimicrobial use in patient care settings and in food animals to help prevent the emergence of resistance and infections with resistant nontyphoidal Salmonella.
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Affiliation(s)
- Amy L Krueger
- 1 Enteric Diseases Epidemiology Branch, Centers for Disease Control and Prevention , Atlanta, Georgia
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Taneja N, Appannanavar SB, Kumar A, Varma G, Kumar Y, Mohan B, Sharma M. Serotype profile and molecular characterization of antimicrobial resistance in non-typhoidal Salmonella isolated from gastroenteritis cases over nine years. J Med Microbiol 2013; 63:66-73. [PMID: 24149623 DOI: 10.1099/jmm.0.061416-0] [Citation(s) in RCA: 15] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Resistance to third-generation cephalosporins in non-typhoidal Salmonella (NTS) is emerging worldwide. We report the occurrence of extended-spectrum beta-lactamase (ESBL) phenotypes in 53.4 % of NTS isolated over a period of nine years from gastroenteritis cases. ESBL and AmpC co-production was observed in 21 % of the isolates. Occurrence of blaCTX-M-15 and blaCMY-2 resistance genes was observed in 11.6 % and 37 % of the isolates respectively. Overall, Salmonella enterica serovar Senftenberg was the predominant serovar carrying blaCTX-M-15 and blaCMY-2 resistance genes. We report for the first time from India, one isolate each of S. enterica serovar Thompson, S. enterica serovar Infantis and S. enterica serovar Newport, carrying the blaCTX-M-15 gene. We also report for the first time from India, a case of gastroenteritis due to S. enterica serovar Thompson.
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Affiliation(s)
- Neelam Taneja
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Suma B Appannanavar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Ajay Kumar
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Garima Varma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Yashwant Kumar
- National Salmonella and Escherichia Serotyping Centre, Central Research Institute, Kasauli, India
| | - Balvinder Mohan
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
| | - Meera Sharma
- Department of Medical Microbiology, Postgraduate Institute of Medical Education and Research, Chandigarh, India
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Abstract
Timely diagnosis of foodborne infection can be critical not only for the patient, but also for the larger community because of the potential to interrupt further spread. This article presents the diagnostic approach to patients with foodborne illness, discussing epidemiologic clues of various foodborne pathogens and their distinguishing clinical features of diagnostic importance. Also discussed are situations whereby stool cultures should be ordered; other helpful stool tests; nonculture methods of identifying organisms and their applicability in clinical settings; the role of pulsed-field gel electrophoresis in typing organisms; and large-scale sharing of data to aid in identification of large outbreaks.
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Affiliation(s)
- Michael S Donnenberg
- Department of Medicine, University of Maryland School of Medicine, 20 Penn Street, S243, Baltimore, MD 21201, USA; Department of Microbiology and Immunology, University of Maryland School of Medicine, 20 Penn Street, S243, Baltimore, MD 21201, USA; Medical Scientist Training Program, University of Maryland School of Medicine, 20 Penn Street, S243, Baltimore, MD 21201, USA.
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6
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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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Nelson JM, Griffin PM, Jones TF, Smith KE, Scallan E. Antimicrobial and Antimotility Agent Use in Persons with Shiga Toxin-Producing Escherichia coli O157 Infection in FoodNet Sites. Clin Infect Dis 2011; 52:1130-2. [DOI: 10.1093/cid/cir087] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/13/2022] Open
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Abstract
Salmonellosis caused by Salmonella enterica serovar Newport is a major global public health concern, particularly because S. Newport isolates that are resistant to multiple drugs (MDR), including third-generation cephalosporins (MDR-AmpC phenotype), have been commonly isolated from food animals. We analyzed 384 S. Newport isolates from various sources by a multilocus sequence typing (MLST) scheme to study the evolution and population structure of the serovar. These were compared to the population structure of S. enterica serovars Enteritidis, Kentucky, Paratyphi B, and Typhimurium. Our S. Newport collection fell into three lineages, Newport-I, Newport-II, and Newport-III, each of which contained multiple sequence types (STs). Newport-I has only a few STs, unlike Newport-II or Newport-III, and has possibly emerged recently. Newport-I is more prevalent among humans in Europe than in North America, whereas Newport-II is preferentially associated with animals. Two STs of Newport-II encompassed all MDR-AmpC isolates, suggesting recent global spread after the acquisition of the bla(CMY-2) gene. In contrast, most Newport-III isolates were from humans in North America and were pansusceptible to antibiotics. Newport was intermediate in population structure to the other serovars, which varied from a single monophyletic lineage in S. Enteritidis or S. Typhimurium to four discrete lineages within S. Paratyphi B. Both mutation and homologous recombination are responsible for diversification within each of these lineages, but the relative frequencies differed with the lineage. We conclude that serovars of S. enterica provide a variety of different population structures.
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9
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Solghan SM, Dumas NB, Root TP, Quinlan TM, Armstrong LR, Spina NL, Zansky SM. Multidrug-Resistant NontyphoidalSalmonellain New York State's Foodborne Diseases Active Surveillance Network Counties. Foodborne Pathog Dis 2010; 7:167-73. [DOI: 10.1089/fpd.2009.0329] [Citation(s) in RCA: 13] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Affiliation(s)
- Suzanne M. Solghan
- Emerging Infections Program, New York State Department of Health, Albany, New York
| | - Nellie B. Dumas
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Timothy P. Root
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Tammy M. Quinlan
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Leeanna R. Armstrong
- Wadsworth Center Public Health Laboratory, New York State Department of Health, Albany, New York
| | - Nancy L. Spina
- Emerging Infections Program, New York State Department of Health, Albany, New York
| | - Shelley M. Zansky
- Emerging Infections Program, New York State Department of Health, Albany, New York
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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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12
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Abstract
Salmonellae are endemic on most large intensive farms and salmonellosis is a common cause of neonatal morbidity and mortality. Disease and mortality usually reflect a variety of management events and environmental stressors that contribute to compromised host immunity and increased pathogen exposure. The diversity of salmonella serovars present on farms, and the potential for different serovars to possess different virulence factors, require the implementation of broad prophylactic strategies that are efficacious for all salmonellae. This article discusses strategies to promote host immunity and minimize pathogen exposure at the farm level. The benefits of control include a reduction in disease incidence and mortality, reduced drug and labor costs, and improved growth rates.
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Affiliation(s)
- Virginia L Mohler
- Livestock Veterinary Teaching and Research Unit, Faculty of Veterinary Science, University of Sydney, PMB 4, Narellan Delivery Centre, Camden, NSW 2567, Australia
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13
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Abstract
SUMMARY AmpC beta-lactamases are clinically important cephalosporinases encoded on the chromosomes of many of the Enterobacteriaceae and a few other organisms, where they mediate resistance to cephalothin, cefazolin, cefoxitin, most penicillins, and beta-lactamase inhibitor-beta-lactam combinations. In many bacteria, AmpC enzymes are inducible and can be expressed at high levels by mutation. Overexpression confers resistance to broad-spectrum cephalosporins including cefotaxime, ceftazidime, and ceftriaxone and is a problem especially in infections due to Enterobacter aerogenes and Enterobacter cloacae, where an isolate initially susceptible to these agents may become resistant upon therapy. Transmissible plasmids have acquired genes for AmpC enzymes, which consequently can now appear in bacteria lacking or poorly expressing a chromosomal bla(AmpC) gene, such as Escherichia coli, Klebsiella pneumoniae, and Proteus mirabilis. Resistance due to plasmid-mediated AmpC enzymes is less common than extended-spectrum beta-lactamase production in most parts of the world but may be both harder to detect and broader in spectrum. AmpC enzymes encoded by both chromosomal and plasmid genes are also evolving to hydrolyze broad-spectrum cephalosporins more efficiently. Techniques to identify AmpC beta-lactamase-producing isolates are available but are still evolving and are not yet optimized for the clinical laboratory, which probably now underestimates this resistance mechanism. Carbapenems can usually be used to treat infections due to AmpC-producing bacteria, but carbapenem resistance can arise in some organisms by mutations that reduce influx (outer membrane porin loss) or enhance efflux (efflux pump activation).
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Carpenter LR, Pont SJ, Cooper WO, Griffin MR, Dudley JA, Arbogast P, Schaffner W, Jones TF. Stool cultures and antimicrobial prescriptions related to infectious diarrhea. J Infect Dis 2008; 197:1709-12. [PMID: 18426365 DOI: 10.1086/588142] [Citation(s) in RCA: 15] [Impact Index Per Article: 0.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
Stool cultures can be important in guiding antimicrobial therapy for diarrhea. From among 11.64 million person-years of Tennessee Medicaid enrollment data collected from 1995 through 2004, 315,828 diarrheal episodes were identified. Stool cultures were performed for only 15,820 episodes (5.0%). Antimicrobials were prescribed for 32,949 episodes (10.4%), 89.4% of which were not accompanied by a stool culture. White race and urban residence were associated with higher rates of stool culture. Frequent use of antimicrobials for diarrhea without stool culture may indicate inappropriate antimicrobial use and has critical implications for public health.
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Affiliation(s)
- L Rand Carpenter
- Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
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15
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Karon AE, Archer JR, Sotir MJ, Monson TA, Kazmierczak JJ. Human multidrug-resistant Salmonella Newport infections, Wisconsin, 2003-2005. Emerg Infect Dis 2008; 13:1777-80. [PMID: 18217570 PMCID: PMC3375811 DOI: 10.3201/eid1311.061138] [Citation(s) in RCA: 28] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
We conducted a retrospective study of Salmonella Newport infections among Wisconsin residents during 2003-2005. Multidrug resistance prevalence was substantially greater in Wisconsin than elsewhere in the United States. Persons with multidrug-resistant infections were more likely than persons with susceptible infections to report exposure to cattle, farms, and unpasteurized milk.
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Affiliation(s)
- Amy E Karon
- University of Wisconsin School of Medicine and Public Health, Madison, Wisconsin, USA.
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Mohler V, Heithoff D, Mahan M, Walker K, Hornitzky M, Shum L, Makin K, House J. Cross-protective immunity conferred by a DNA adenine methylase deficient Salmonella enterica serovar Typhimurium vaccine in calves challenged with Salmonella serovar Newport. Vaccine 2008; 26:1751-8. [DOI: 10.1016/j.vaccine.2008.01.018] [Citation(s) in RCA: 24] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2007] [Revised: 01/09/2008] [Accepted: 01/14/2008] [Indexed: 10/22/2022]
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Abstract
The Foodborne Diseases Active Surveillance Network (FoodNet) performs active, population-based laboratory surveillance for nine common foodborne pathogens and one syndrome in a catchment area of 44.5 million persons. FoodNet surveillance data are an important resource for examining trends in specific diseases over time. Population surveys and laboratory surveys have been used to estimate the burden of disease, for example that there are 38.6 cases of Salmonella infection for each reported case. FoodNet case-control studies have identified new risk factors for E. coli O157, Campylobacter, and several Salmonella serotypes. FoodNet sites have demonstrated the value of delivered stool kits for improving the rate of confirming an etiology in foodborne disease outbreaks. FoodNet helps build capacity for foodborne disease surveillance in participating sites and through close collaborations with PulseNet, EHS-Net, Global SalmSurv, and other partners.
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Dagnra AY, Akolly K, Gbadoe A, Aho K, David M. [Emergence of multidrug resistant Salmonella strains in Lome (Togo)]. Med Mal Infect 2007; 37:266-9. [PMID: 17459634 DOI: 10.1016/j.medmal.2007.02.002] [Citation(s) in RCA: 8] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/28/2006] [Accepted: 02/27/2007] [Indexed: 11/15/2022]
Abstract
OBJECTIVE This study had for aim to compare antibiotic resistance of 332 Salmonella enterica strains identified in human samples in the course of infections, in Lome. DESIGN The strains were collected over two periods: 1998-2002 (N=168) and 2003-2004 (N=164). The antibiotic susceptibility test was performed by disk diffusion assay. RESULTS The main serotypes identified were 147 Salmonella Typhi (44.3%), 97 Salmonella Typhimurium (29.2%), and 74 Salmonella Enteritidis (22.3%). The proportions of strains resistant to chloramphenicol, cotrimoxazol, and amoxicillin (first line antibiotics) varied respectively from 33, 46, and 57% in 1998-2002 to 73, 79, and 82% in 2003-2004 (P<0.0001). The percentage of resistance to ciprofloxacin or ceftriaxone was inferior to 10%. CONCLUSION Fluoroquinolones and third generation cephalosporins have become the first line antibiotics for the treatment of Salmonella in Lome (Togo).
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Affiliation(s)
- A-Y Dagnra
- Laboratoire de bactériologie-virologie, CHU Tokoin, 08 BP 8742 Lomé, Togo.
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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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20
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Scallan E. Activities, achievements, and lessons learned during the first 10 years of the Foodborne Diseases Active Surveillance Network: 1996-2005. Clin Infect Dis 2007; 44:718-25. [PMID: 17278067 DOI: 10.1086/511648] [Citation(s) in RCA: 77] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2006] [Accepted: 11/20/2006] [Indexed: 11/03/2022] Open
Abstract
Since the establishment of the Foodborne Diseases Active Surveillance Network (FoodNet) in 1996, it has been an essential resource for the surveillance and investigation of foodborne disease in the United States. FoodNet has had a major impact on food safety because it conducts population-based, active surveillance for laboratory-confirmed infections from 9 pathogens commonly transmitted through food. Each year, FoodNet publishes the National Report Card on Food Safety, which is used by regulatory agencies, industry and consumer groups, and public health personnel to prioritize and evaluate food safety interventions and monitor progress toward national health objectives. FoodNet also determines the human-health impact of foodborne illness by conducting related epidemiological studies that contribute to the estimates of the overall burden of foodborne illness, attribute the burden of foodborne illness to specific foods and settings, and address important foodborne disease-related issues, such as antimicrobial resistance and sequelae from foodborne infections. This article summarizes the activities, achievements, and lessons learned during the first 10 years of FoodNet.
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Affiliation(s)
- Elaine Scallan
- Enteric Diseases Epidemiology Branch, Division of Foodborne, Bacterial, and Mycotic Diseases, National Center for Zoonotic, Vectorborne, and Enteric Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
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Jones TF, Ingram LA, Fullerton KE, Marcus R, Anderson BJ, McCarthy PV, Vugia D, Shiferaw B, Haubert N, Wedel S, Angulo FJ. A case-control study of the epidemiology of sporadic Salmonella infection in infants. Pediatrics 2006; 118:2380-7. [PMID: 17142522 DOI: 10.1542/peds.2006-1218] [Citation(s) in RCA: 76] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
OBJECTIVE Rates of Salmonella infection are highest in infants, but little is known about potential sources of infection in this high-risk population. We performed a case-control study to identify dietary and environmental risk factors for sporadic salmonellosis among infants. PATIENTS AND METHODS In 2002-2004, the Foodborne Diseases Active Surveillance Network conducted a population-based, case-control study of sporadic salmonellosis among infants <1 year of age in 8 states. Cases were identified via active laboratory-based surveillance. Healthy controls were frequency matched by age and identified through birth registries or published birth announcements. We assessed diet and environmental exposures in the 5 days before illness onset or interview. Data were analyzed by using logistic regression adjusting for age. RESULTS The study enrolled 442 subjects and 928 controls. Compared with healthy controls, infants with Salmonella infection were less likely to have been breastfed and more likely to have had exposure to reptiles, to have ridden in a shopping cart next to meat or poultry, or to have consumed concentrated liquid infant formula during the 5-day exposure period. Travel outside the United States was associated with illness in infants 3 to 6 and >6 months of age. Attending day care with a child with diarrhea was associated with salmonellosis in infants >6 months of age. CONCLUSIONS We identified a number of modifiable protective and risk factors for salmonellosis in infants. Attention should be directed at developing effective preventive measures for this high-risk population.
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Affiliation(s)
- Timothy F Jones
- Communicable and Environmental Disease Services, Tennessee Department of Health, 4th Floor, Cordell Hull Building, 425 5th Ave N, Nashville, TN 37247, USA.
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Livermore DM, Woodford N. The beta-lactamase threat in Enterobacteriaceae, Pseudomonas and Acinetobacter. Trends Microbiol 2006; 14:413-20. [PMID: 16876996 DOI: 10.1016/j.tim.2006.07.008] [Citation(s) in RCA: 341] [Impact Index Per Article: 18.9] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/07/2006] [Revised: 06/23/2006] [Accepted: 07/18/2006] [Indexed: 12/26/2022]
Abstract
Over the past 60 years, the use of successive generations of beta-lactam antibiotics has selected successive generations of beta-lactamase enzymes, each more potent than the last. Currently, rising problems include CTX-M extended-spectrum beta-lactamases (ESBLs), plasmid-mediated AmpC beta-lactamases and KPC carbapenemases in Enterobacteriaceae, while OXA- and metallo- carbapenemases are of growing importance in Acinetobacter spp. and (less so) in other non-fermenters. Escherichia coli isolates with CTX-M ESBLs are spreading multiresistance in the community and in hospitals, while carbapenemase-producing Acinetobacter spp., mostly from intensive care, are among the most multiresistant nosocomial bacteria known and are often susceptible only to polymyxins and, potentially, tigecycline. This review discusses the epidemiology and microbiology of these resistance problems, along with possible solutions.
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Affiliation(s)
- David M Livermore
- Antibiotic Resistance Monitoring and Reference Laboratory, Health Protection Agency Centre for Infections, 61 Colindale Avenue, London, NW9 5EQ, UK.
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