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Sriyapai T, Pulsrikarn C, Chansiri K, Sriyapai P. Molecular characterization of extended-spectrum cephalosporin and fluoroquinolone resistance genes in Salmonella and Shigella isolated from clinical specimens in Thailand. Heliyon 2022; 8:e12383. [PMID: 36619450 PMCID: PMC9813710 DOI: 10.1016/j.heliyon.2022.e12383] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2021] [Revised: 07/07/2022] [Accepted: 12/07/2022] [Indexed: 12/23/2022] Open
Abstract
Antimicrobial resistance of Salmonella and Shigella has become a major clinical and public health problem. The incident of co-resistance to third generation cephalosporins and fluoroquinolone is a serious therapeutic issue in Thailand. The present study aimed to investigate the antimicrobial resistance and molecular character of clinical Shigella and Salmonella isolates. A total of 33 Salmonella and 53 Shigella cefotaxime-resistant isolates were collected from human clinical cases in Thailand during the period from 2011-2018. The antimicrobial susceptibility of Salmonella and Shigella was determined by the disk diffusion method, and extended-spectrum beta-lactamase (ESBL) production was characterized by the double-disk synergy test. Genotype characterization was performed by PCR and DNA sequencing. Thirty-two (97.0%) and fifty-two (98.1%) isolates of cefotaxime-resistant Salmonella and Shigella, respectively, were identified as ESBL producers. Shigella sonnei (4 isolates), Salmonella serovar 4,5,12:i:- (6 isolates), Salmonella serovar Agona (2 isolates) and Salmonella serovar Rissen (2 isolates) showed co-resistance to ciprofloxacin and cefotaxime or ceftriaxone. The combination of bla CTX-M-15 plus other ESBL and/or AmpC β-lactamase genes was the most dominant of the genotype patterns in ESBL-producing isolates. The plasmid harbouring the aac(6')-Ib-cr gene and mutations of gyrA (S83F, D87Y or D87G) and parC (T57S) genes was found in 2 ESBL-producing Salmonella isolates. Three Shigella sonnei isolates harboured mutations in gyrA (S83L, D87Y or D87G), and only one Shigella sonnei phase I isolate showed mutations in both gyrA (S83L and D87G) and parC (S80I) genes. Among these clinical Shigella sonnei isolates, qnrS determinants were identified. Production of ESBLs is an important mechanism for resistance to extended-spectrum cephalosporins in Salmonella and Shigella. The emergence of a decreased susceptibility to extended-spectrum cephalosporins and fluoroquinolone in ESBL-producing isolates has important clinical and therapeutic implications.
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Affiliation(s)
- Thayat Sriyapai
- Faculty of Environmental Culture and Ecotourism, Srinakharinwirot University, Bangkok, Thailand,Center of Excellence in Biosensors, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Chaiwat Pulsrikarn
- Salmonella and Shigella Center, National Institute of Health, Department of Medical Sciences, Ministry of Public Health, Nonthaburi, Thailand
| | - Kosum Chansiri
- Center of Excellence in Biosensors, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand
| | - Pichapak Sriyapai
- Center of Excellence in Biosensors, Panyananthaphikkhu Chonprathan Medical Center, Srinakharinwirot University, Nonthaburi, Thailand,Department of Microbiology, Srinakharinwirot University, Bangkok, Thailand,Corresponding author.
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Hengkrawit K, Tangjade C. Prevalence and Trends in Antimicrobial Susceptibility Patterns of Multi-Drug-Resistance Non-Typhoidal Salmonella in Central Thailand, 2012–2019. Infect Drug Resist 2022; 15:1305-1315. [PMID: 35378891 PMCID: PMC8976529 DOI: 10.2147/idr.s355213] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2021] [Accepted: 03/05/2022] [Indexed: 11/24/2022] Open
Abstract
Purpose Multi-drug resistance of non-typhoidal Salmonella (MDR-NTS) is an increasing threat worldwide. In Thailand, data for the past decade is limited. This research is to determine the prevalence and trends of nonsusceptibility patterns of the bacteria, especially to ciprofloxacin and ceftriaxone. Methods This retrospective study was extracted data of patients who had non-typhoidal Salmonella (NTS) infection, from 10 hospitals between June 2011 and June 2020. Demographic data, culture reports, and antimicrobial susceptibility were included in the analysis. Results A total of 433 patients were identified. The most common age group was less than 15 years old (53.6%), with a median age of 12 years (IQR 57–4). Of these people, 61.1% had gastroenteritis and 36.7% had bacteremia. The most prevalent serogroups was C (28.6%). MDR-NTS rate was 52.8% (95% CI 39–44). The resistant rates were 43%, 32.8%, 22.8%, 6.7%, 4%, 0.45%, 0.45% for sulfamethoxazole/trimethoprim, amoxicillin-clavulanic acid, cefotaxime, ampicillin/sulbactam, piperacillin/tazobactam, imipenem and meropenem retrospectively. Resistant rates have been increasing, especially for ciprofloxacin (30%), which rose from 16.6% in 2011–2015 to 39.5% in 2016–2020 (prevalence rate ratio (PRR) 2.4,95% CI 1.51–3.72) and for ceftriaxone 25.4% which rose from 16.1% to 32% (PRR 2 95% CI 1.24–3.16). Ampicillin, norfloxacin, tetracycline, amikacin, gentamicin, and ceftazidime remained static at 62.3%, 49.5%, 33.2%, 15.2%, 8.8%, 2.8%, respectively. Conclusion The prevalence of MDR-NTS has been increasing over the past decade, particularly those strains which demonstrate resistance to ciprofloxacin and ceftriaxone. Finding successful treatment requires a comprehensive selection of proper antimicrobials as well as close monitoring, especially in cases with severe infection.
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Affiliation(s)
- Kitchawan Hengkrawit
- Pediatric Infectious Disease Unit, Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakarinwirot University, Nonthaburi, Thailand
- Correspondence: Kitchawan Hengkrawit, Pediatric Infectious Disease unit, Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakarinwirot University, P.O.Box: 222 Moo 1, Tiwanon Road, Pak Kret, Nonthaburi, 11120, Thailand, Tel +66 2 502 2345, Fax +662 502-2305, Email
| | - Chidchanok Tangjade
- Pediatrics Gastroenterology and Hepatology Unit, Department of Pediatrics, Panyananthaphikkhu Chonprathan Medical Center, Srinakarinwirot University, Nonthaburi, Thailand
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Sriyapai P, Pulsrikarn C, Chansiri K, Nyamniyom A, Sriyapai T. Molecular Characterization of Cephalosporin and Fluoroquinolone Resistant Salmonella Choleraesuis Isolated from Patients with Systemic Salmonellosis in Thailand. Antibiotics (Basel) 2021; 10:844. [PMID: 34356765 PMCID: PMC8300840 DOI: 10.3390/antibiotics10070844] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2021] [Revised: 06/27/2021] [Accepted: 07/06/2021] [Indexed: 01/21/2023] Open
Abstract
The antimicrobial resistance of nontyphoidal Salmonella has become a major clinical and public health problem. Southeast Asia has a high level of multidrug-resistant Salmonella and isolates resistant to both fluoroquinolone and third-generation cephalosporins. The incidence of co-resistance to both drug classes is a serious therapeutic problem in Thailand. The aim of this study was to determine the antimicrobial resistance patterns, antimicrobial resistance genes and genotypic relatedness of third-generation cephalosporins and/or fluoroquinolone-resistant Salmonella Choleraesuis isolated from patients with systemic salmonellosis in Thailand. Antimicrobial susceptibility testing was performed using the agar disk diffusion method, and ESBL production was detected by the combination disc method. A molecular evaluation of S. Choleraesuis isolates was performed using PCR and DNA sequencing. Then, a genotypic relatedness study of S. Choleraesuis was performed by pulse field gel electrophoresis. All 62 cefotaxime-resistant S. Choleraesuis isolates obtained from 61 clinical specimens were multidrug resistant. Forty-four isolates (44/62, 71.0%) were positive for ESBL phenotypes. Based on the PCR sequencing, 21, 1, 13, 23, 20 and 6 ESBL-producing isolates harboured the ESBL genes blaCTX-M-14, blaCTX-M-15, blaCTX-M-55, blaCMY-2, blaACC-1 and blaTEM-1, respectively. This study also found that nine (9/62, 14.5%) isolates exhibited co-resistance to ciprofloxacin and cefotaxime. All of the co-resistant isolates harboured at least one PMQR gene. The qnr genes and the aac(6')-Ib-cr gene were the most prevalent genes detected. The QRDR mutation, including the gyrA (D87Y and D87G) and parC (T57S) genes, was also detected. PFGE patterns revealed a high degree of clonal diversity among the ESBL-producing isolates.
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Affiliation(s)
- Pichapak Sriyapai
- Department of Microbiology, Faculty of Science, Srinakharinwirot University, Bangkok 10110, Thailand;
| | - Chaiwat Pulsrikarn
- WHO International Salmonella and Shigella Center, National Institute of Health, Nonthaburi 11000, Thailand;
| | - Kosum Chansiri
- Department of Biochemistry, Faculty of Medicine, Srinakharinwirot University, Bangkok 10110, Thailand;
| | - Arin Nyamniyom
- Faculty of Environmental Culture and Ecotourism, Srinakharinwirot University, Bangkok 10110, Thailand;
| | - Thayat Sriyapai
- Faculty of Environmental Culture and Ecotourism, Srinakharinwirot University, Bangkok 10110, Thailand;
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Kongsoi S, Chumsing S, Satorn D, Noourai P. Serotypes and antimicrobial resistance profiles of Salmonella enterica recovered from clinical swine samples. Vet World 2020; 13:2312-2318. [PMID: 33363320 PMCID: PMC7750222 DOI: 10.14202/vetworld.2020.2312-2318] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/12/2020] [Accepted: 09/22/2020] [Indexed: 11/18/2022] Open
Abstract
Background and Aim: Salmonella enterica is an important foodborne pathogen and is recognized as a major public health issue. The emergence of multidrug-resistant (MDR) S. enterica represents a major challenge for national public health authorities. We investigated the distribution of serovars and antimicrobial resistance of S. enterica isolates from clinical swine samples stored at the Veterinary Diagnostic Laboratory, Faculty of Veterinary Medicine, Kasetsart University from 2016 to 2017. Materials and Methods: Clinical samples were collected and subjected to standard microbiological techniques outlined in the Manual of Clinical Microbiology to identify Salmonella serovars. Susceptibility to antimicrobials was tested by the Kirby–Bauer disk diffusion method using a panel of 14 antimicrobials. Results: A total of 144 Salmonella isolates were identified and the dominant serovar was Salmonella Choleraesuis (66.67%), followed by monophasic Salmonella Typhimurium (18.75%), S. Typhimurium (9.03%), and Rissen (5.56%). The isolates displayed high resistance rates to ampicillin (AMP [100%]), amoxicillin (AX [100%]), tetracycline (TE [100%]), cefotaxime (CTX [89.58%]), ceftriaxone (CRO [87.50%]), chloramphenicol (C [82.64%]), gentamicin (CN [79.17%]), nalidixic acid (NA [72.92%]), and ceftazidime (CAZ [71.53%]). All isolates were MDR, with 29 distinct resistance patterns. The dominant MDR pattern among serovars Choleraesuis and Rissen exhibited resistance to 9 antimicrobials: (R7-14 AMP-AX-CAZ-CRO-CTX-NA-C-CN-TE). However, all tested isolates were susceptible to AX/clavulanic acid and fosfomycin. Conclusion: High resistance levels to the third generation of cephalosporins such as CAZ, CRO, and CTX highlight the need for careful and reasonable usage of antimicrobials in animals and humans, especially for S. Choleraesuis infections.
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Affiliation(s)
- Siriporn Kongsoi
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Kasetsart University, Nakhon Pathom 73140, Thailand
| | - Suksun Chumsing
- Department of Veterinary Public Health, Faculty of Veterinary Medicine, Kasetsart University, Nakhon Pathom 73140, Thailand
| | - Darunee Satorn
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
| | - Panisa Noourai
- Department of Microbiology, Faculty of Public Health, Mahidol University, Bangkok 10400, Thailand
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Whistler T, Sapchookul P, McCormick DW, Sangwichian O, Jorakate P, Makprasert S, Jatapai A, Naorat S, Surin U, Koosakunwat S, Supcharassaeng S, Piralam B, Mikoleit M, Baggett HC, Rhodes J, Gregory CJ. Epidemiology and antimicrobial resistance of invasive non-typhoidal Salmonellosis in rural Thailand from 2006-2014. PLoS Negl Trop Dis 2018; 12:e0006718. [PMID: 30080897 PMCID: PMC6095622 DOI: 10.1371/journal.pntd.0006718] [Citation(s) in RCA: 23] [Impact Index Per Article: 3.8] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2018] [Revised: 08/16/2018] [Accepted: 07/25/2018] [Indexed: 11/30/2022] Open
Abstract
INTRODUCTION Invasive salmonellosis is a common cause of bloodstream infection in Southeast Asia. Limited epidemiologic and antimicrobial resistance data are available from the region. METHODS Blood cultures performed in all 20 hospitals in the northeastern province of Nakhon Phanom (NP) and eastern province of Sa Kaeo (SK), Thailand were captured in a bloodstream infection surveillance system. Cultures were performed as clinically indicated in hospitalized patients; patients with multiple positive cultures had only the first included. Bottles were incubated using the BacT/Alert system (bioMérieux, Thailand) and isolates were identified using standard microbiological techniques; all Salmonella isolates were classified to at least the serogroup level. Antimicrobial resistance was assessed using disk diffusion. RESULTS Salmonella was the fifth most common pathogen identified in 147,535 cultures with 525 cases (211 in Nakhon Phanom (NP) and 314 in Sa Kaeo (SK)). The overall adjusted iNTS incidence rate in NP was 4.0 cases/100,000 person-years (95% CI 3.5-4.5) and in SK 6.4 cases/100,000 person-years (95% CI 5.7-7.1; p = 0.001). The most common serogroups were C (39.4%), D (35.0%) and B (9.9%). Serogroup D predominated in NP (103/211) with 59.2% of this serogroup being Salmonella serovar Enteritidis. Serogroup C predominated in SK (166/314) with 84.3% of this serogroup being Salmonella serovar Choleraesuis. Antibiotic resistance was 68.2% (343/503) for ampicillin, 1.2% (6/482) for ciprofloxacin (or 58.1% (280/482) if both intermediate and resistant phenotypes are considered), 17.0% (87/512) for trimethoprim-sulfamethoxazole, and 12.2% (59/484) for third-generation cephalosporins (cefotaxime or ceftazidime). Multidrug resistance was seen in 99/516 isolates (19.2%). CONCLUSIONS The NTS isolates causing bloodstream infections in rural Thailand are commonly resistant to ampicillin, cefotaxime, and TMP-SMX. Observed differences between NP and SK indicate that serogroup distribution and antibiotic resistance may substantially differ throughout Thailand and the region.
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Affiliation(s)
- Toni Whistler
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Patranuch Sapchookul
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - David W. McCormick
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Ornuma Sangwichian
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Possawat Jorakate
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Sirirat Makprasert
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Anchalee Jatapai
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Sathapana Naorat
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
| | - Uraiwan Surin
- Nakhon Phanom General Hospital, Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand
| | - Surathinee Koosakunwat
- Nakhon Phanom General Hospital, Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand
| | - Surachai Supcharassaeng
- Sa Kaeo Crown Prince Hospital, Sa Kaeo Provincial Health Office, Ministry of Public Health, Thailand
| | - Barameht Piralam
- Nakhon Phanom General Hospital, Nakhon Phanom Provincial Health Office, Nakhon Phanom, Thailand
| | - Mathew Mikoleit
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Henry C. Baggett
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Julia Rhodes
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
| | - Christopher J. Gregory
- Thailand Ministry of Public Health—US Centers for Disease Control and Prevention Collaboration (TUC), Nonthaburi, Thailand
- Division of Global Health Protection, Centers for Disease Control and Prevention, Atlanta, Georgia, United States of America
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High prevalence of ceftriaxone resistance among invasive Salmonella enterica serotype Choleraesuis isolates in Thailand: The emergence and increase of CTX-M-55 in ciprofloxacin-resistant S. Choleraesuis isolates. Int J Med Microbiol 2018; 308:447-453. [PMID: 29605531 DOI: 10.1016/j.ijmm.2018.03.008] [Citation(s) in RCA: 28] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/20/2017] [Revised: 03/19/2018] [Accepted: 03/21/2018] [Indexed: 11/23/2022] Open
Abstract
S. Choleraesuis is a highly invasive zoonotic pathogen that causes a serious systemic infection in humans. The emergence and increase of resistance to ceftriaxone and ciprofloxacin among S. Choleraesuis has become a serious therapeutic problem. The present study demonstrated high frequency of antimicrobial resistance in Salmonella Choleraesuis among 414 nontyphoidal Salmonella isolates from bacteremic patients in Thailand. High rates of ceftriaxone (58.3%) and ciprofloxacin (19.6%) resistances were observed in S. Choleraesuis isolates. The dissemination of the self-transferable blaCTX-M-14-carrying IncFIIs, IncFII, and IncI1 plasmids and blaCMY-2-carrying IncA/C plasmid along with the clonal spread of blaCMY-2-harbouring S. Choleraesuis isolates contributed to the high frequency of resistance to extended-spectrum cephalosporins (ESCs; third- and fourth-generation cephalosporins) during 2005-2007. We reported the first occurrence of ceftazidime-hydrolysing CTX-M-55 in S. Choleraesuis isolates which dramatically increased and became the most abundant CTX-M variant among ESC-resistant S. Choleraesuis isolates during 2012-2016. The spread of clone pulsotype B3 was due to the dissemination of IncA/C plasmids carrying both blaCTX-M-55 and qnrS1 among ciprofloxacin-resistant S. Choleraesuis isolates harbouring D87G in GyrA. These isolates were apparently responsible for the high rates of co-resistance to ESCs and ciprofloxacin (51.3%) during 2012-2016. This study emphasizes the importance to have an action plan to control the dissemination of antimicrobial resistance in S. Choleraesuis since this poses a threat to global health due to travel and trade in animal food products.
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Im H, Son S, Mitchell RJ, Ghim CM. Serum albumin and osmolality inhibit Bdellovibrio bacteriovorus predation in human serum. Sci Rep 2017; 7:5896. [PMID: 28725056 PMCID: PMC5517470 DOI: 10.1038/s41598-017-06272-2] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/05/2017] [Accepted: 06/16/2017] [Indexed: 02/07/2023] Open
Abstract
We evaluated the bactericidal activity of Bdellovibrio bacteriovorus, strain HD100, within blood sera against bacterial strains commonly associated with bacteremic infections, including E. coli, Klebsiella pneumoniae and Salmonella enterica. Tests show that B. bacteriovorus HD100 is not susceptible to serum complement or its bactericidal activity. After a two hour exposure to human sera, the prey populations decreased 15- to 7,300-fold due to the serum complement activity while, in contrast, the B. bacteriovorus HD100 population showed a loss of only 33%. Dot blot analyses showed that this is not due to the absence of antibodies against this predator. Predation in human serum was inhibited, though, by both the osmolality and serum albumin. The activity of B. bacteriovorus HD100 showed a sharp transition between 200 and 250 mOsm/kg, and was progressively reduced as the osmolality increased. Serum albumin also acted to inhibit predation by binding to and coating the predatory cells. This was confirmed via dot blot analyses and confocal microscopy. The results from both the osmolality and serum albumin tests were incorporated into a numerical model describing bacterial predation of pathogens. In conclusion, both of these factors inhibit predation and, as such, they limit its effectiveness against pathogenic prey located within sera.
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Affiliation(s)
- Hansol Im
- School of Life Sciences, Ulsan National Institute of Science & Technology, 50 UNIST-gil Ulju-gun, Ulsan, 44919, Republic of Korea
| | - Sangmo Son
- School of Life Sciences, Ulsan National Institute of Science & Technology, 50 UNIST-gil Ulju-gun, Ulsan, 44919, Republic of Korea
| | - Robert J Mitchell
- School of Life Sciences, Ulsan National Institute of Science & Technology, 50 UNIST-gil Ulju-gun, Ulsan, 44919, Republic of Korea.
| | - Cheol-Min Ghim
- School of Life Sciences, Ulsan National Institute of Science & Technology, 50 UNIST-gil Ulju-gun, Ulsan, 44919, Republic of Korea. .,Department of Physics, Ulsan National Institute of Science & Technology, 50 UNIST-gil Ulju-gun, Ulsan, 44919, Republic of Korea.
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Crump JA, Sjölund-Karlsson M, Gordon MA, Parry CM. Epidemiology, Clinical Presentation, Laboratory Diagnosis, Antimicrobial Resistance, and Antimicrobial Management of Invasive Salmonella Infections. Clin Microbiol Rev 2015; 28:901-37. [PMID: 26180063 PMCID: PMC4503790 DOI: 10.1128/cmr.00002-15] [Citation(s) in RCA: 651] [Impact Index Per Article: 72.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/15/2023] Open
Abstract
Salmonella enterica infections are common causes of bloodstream infection in low-resource areas, where they may be difficult to distinguish from other febrile illnesses and may be associated with a high case fatality ratio. Microbiologic culture of blood or bone marrow remains the mainstay of laboratory diagnosis. Antimicrobial resistance has emerged in Salmonella enterica, initially to the traditional first-line drugs chloramphenicol, ampicillin, and trimethoprim-sulfamethoxazole. Decreased fluoroquinolone susceptibility and then fluoroquinolone resistance have developed in association with chromosomal mutations in the quinolone resistance-determining region of genes encoding DNA gyrase and topoisomerase IV and also by plasmid-mediated resistance mechanisms. Resistance to extended-spectrum cephalosporins has occurred more often in nontyphoidal than in typhoidal Salmonella strains. Azithromycin is effective for the management of uncomplicated typhoid fever and may serve as an alternative oral drug in areas where fluoroquinolone resistance is common. In 2013, CLSI lowered the ciprofloxacin susceptibility breakpoints to account for accumulating clinical, microbiologic, and pharmacokinetic-pharmacodynamic data suggesting that revision was needed for contemporary invasive Salmonella infections. Newly established CLSI guidelines for azithromycin and Salmonella enterica serovar Typhi were published in CLSI document M100 in 2015.
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Affiliation(s)
- John A Crump
- Centre for International Health, University of Otago, Dunedin, Otago, New Zealand Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Maria Sjölund-Karlsson
- Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Melita A Gordon
- Department of Clinical Infection, Microbiology and Immunology, Institute of Infection and Global Health, University of Liverpool, Liverpool, United Kingdom Malawi-Liverpool-Wellcome Trust Clinical Research Programme, Blantyre, Malawi
| | - Christopher M Parry
- School of Tropical Medicine and Global Health, Nagasaki University, Nagasaki, Japan Department of Clinical Research, London School of Hygiene and Tropical Medicine, London, United Kingdom Department of Clinical Sciences, Liverpool School of Tropical Medicine, Liverpool, United Kingdom
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First case report of blood and urine cultures positive bacteraemia by Salmonella enterica serotype Choleraesuis from India. JMM Case Rep 2014. [DOI: 10.1099/jmmcr.0.003210] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
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10
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Ananchaipattana C, Hosotani Y, Kawasaki S, Bari ML, Yamaguchi KA, Inatsu Y. Serotyping, RAPD Grouping and Antibiotic Susceptibility Testing of Salmonella Enterica Isolated from Retail Foods in Thailand. FOOD SCIENCE AND TECHNOLOGY RESEARCH 2014. [DOI: 10.3136/fstr.20.905] [Citation(s) in RCA: 4] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 11/03/2022]
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Van TTH, Nguyen HNK, Smooker PM, Coloe PJ. The antibiotic resistance characteristics of non-typhoidal Salmonella enterica isolated from food-producing animals, retail meat and humans in South East Asia. Int J Food Microbiol 2012; 154:98-106. [PMID: 22265849 DOI: 10.1016/j.ijfoodmicro.2011.12.032] [Citation(s) in RCA: 59] [Impact Index Per Article: 4.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/04/2011] [Revised: 12/16/2011] [Accepted: 12/24/2011] [Indexed: 11/26/2022]
Abstract
Antimicrobial resistance is a global problem. It is most prevalent in developing countries where infectious diseases remain common, the use of antibiotics in humans and animals is widespread, and the replacement of older antibiotics with new generation antibiotics is not easy due to the high cost. Information on antibiotic resistance phenotypes and genotypes of Salmonella spp. in food animals and humans in different countries and geographic regions is necessary to combat the spread of resistance. This will improve the understanding of antibiotic resistance epidemiology, tracing of new emerging pathogens, assisting in disease treatment, and enhancing prudent use of antibiotics. However, the extent of antibiotic resistance in food-borne pathogens and humans in many developing countries remains unknown. The goal of this review is to discuss the current state of antibiotic resistance of non-typhoid Salmonella spp. in food-producing animals, retail meat and humans from South East Asia. It is focused on resistance characteristics of traditional and "critically important" antibiotics in this region, and the emergence of multidrug resistant strains and genetic elements that contribute to the development of multidrug resistance, including integrons and the Salmonella Genomic Island (SGI).
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Affiliation(s)
- Thi Thu Hao Van
- School of Applied Sciences, RMIT University, Bundoora West Campus, Bundoora, Victoria 3083, Australia
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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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Pornruangwong S, Hendriksen RS, Pulsrikarn C, Bangstrakulnonth A, Mikoleit M, Davies RH, Aarestrup FM, Garcia-Migura L. Epidemiological investigation of Salmonella enterica serovar Kedougou in Thailand. Foodborne Pathog Dis 2010; 8:203-11. [PMID: 21034262 DOI: 10.1089/fpd.2010.0626] [Citation(s) in RCA: 7] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
OBJECTIVE Salmonella enterica serovar Kedougou is among the top 10 serovars reported in northern Thailand. The objective of this study was to identify risk factors associated with Salmonella Kedougou infection in Thailand and to compare the molecular types and antimicrobial resistance with Salmonella Kedougou isolates of human origin from United States and of animal origin from the United Kingdom. METHODS Data from 13,976 Salmonella infections of which 253 were Salmonella Kedougou collected in Thailand between 2002 and 2008 were analyzed by logistic regression. Antimicrobial susceptibility testing and pulsed-field gel electrophoresis (PFGE) were performed on selected Salmonella Kedougou strains causing infections in Thailand (n = 66), and compared to isolates from the United States (n = 5) and the United Kingdom (n = 20). RESULTS Logistic analysis revealed season (hot/dry; p = 0.023), region (northern Thailand; p < 0.001), and specimen (stool; p < 0.001) as significant risk factors associated with Salmonella Kedougou infection compared to other nontyphoid Salmonella. Of the Salmonella Kedougou isolates of human origin, 84% exhibited resistance to at least three antimicrobial classes. Three strains recovered from human stool in Thailand were resistant to third-generation cephalosporins: two harbored bla(CTX-M-63) and one bla(CMY-2). PFGE revealed 45 unique clusters. Isolates obtained from humans in Thailand and the United States presented identical PFGE profiles suggesting a travel association, whereas the majority of the animal isolates from United Kingdom clustered separately. CONCLUSIONS This study reveals Salmonella Kedougou as a major cause of human infections in northern Thailand especially during the hot period and suggests a global spread probably due to travel. The clonal types causing infections in humans differed from those observed in animals in United Kingdom, which suggests the absence of an epidemiological link and could suggest differences in virulence. The high frequency of antimicrobial resistance, including emergence of resistance to fluoroquinolones and third-generation cephalosporins, might pose problems for treatment of infections.
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Affiliation(s)
- Srirat Pornruangwong
- Department of Medical Science, Ministry of Public Health, WHO International Salmonella and Shigella Centre, National Institute of Health, Bangkok, Thailand
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Hendriksen RS, Bangtrakulnonth A, Pulsrikarn C, Pornruangwong S, Noppornphan G, Emborg HD, Aarestrup FM. Risk factors and epidemiology of the ten most common Salmonella serovars from patients in Thailand: 2002-2007. Foodborne Pathog Dis 2010; 6:1009-19. [PMID: 19735204 DOI: 10.1089/fpd.2008.0245] [Citation(s) in RCA: 44] [Impact Index Per Article: 3.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
Abstract
We conducted a retrospective observational study to assess epidemiological trends and risk factors associated with the 10 most common Salmonella serovars isolated from humans in Thailand between 2002 and 2007. A total of 11,656 Salmonella isolates covering all 6 years were included in the study. The top 10 Salmonella serovars identified during the course of this study were Enteritidis, Stanley, Weltevreden, Rissen, I [1],4,[5],12:i:-, Choleraesuis, Anatum, Typhimurium, Corvallis, and Panama, which accounted for 8108 (69.6%) of the isolates. Most isolates were from patients <5 years (33%), were isolated during June (13%), and were recovered from stool (82%) and from patients in Bangkok (27%). Statistical analysis revealed that S. Enteritidis and S. Choleraesuis were recovered from blood with a higher frequency than other nontyphoidal serovars. While both serovars tended to be isolated from patients >5 years; S. Choleraesuis was recovered with a higher frequency from patients in Bangkok and the central region, whereas S. Enteritidis was recovered predominantly from patients in the southern region. This study also indicates a shift in prevalence of the most common Salmonella serovars responsible for human infections in Thailand compared to previous studies. Notably, there was an increase in human infections with S. Stanley, S. Corvallis, and S. Choleraesuis, three serovars that have previously been associated with swine, and a decrease in infections due to S. Weltevreden and S. Anatum. The study also revealed differences in the epidemiology among the different serovars, suggesting that serovar-specific interventions are needed. We recommend initiating targeted interventions for the two serovars associated with a high odds ratio for submitted blood samples, S. Enteritidis and S. Choleraesuis. The authors also recommend additional epidemiologic studies to investigate the observed increase in swine associated serovars (S. Stanley, S. Corvallis, and S. Choleraesuis) and determine interventions to reduce the burden of disease from these serovars.
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Affiliation(s)
- Rene S Hendriksen
- World Health Organization (WHO) Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and EU Community Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, DK-1790 Copenhagen V, Denmark.
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Molecular characterization of extended-spectrum cephalosporinase-producing Salmonella enterica serovar Choleraesuis isolates from patients in Thailand and Denmark. J Clin Microbiol 2009; 48:883-8. [PMID: 20032253 DOI: 10.1128/jcm.01792-09] [Citation(s) in RCA: 43] [Impact Index Per Article: 2.9] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
The objective of this study was to characterize extended-spectrum cephalosporinase (ESC)-producing isolates of Salmonella enterica serovar Choleraesuis recovered from patients in Thailand and Denmark. Twenty-four blood culture isolates from 22 patients were included in the study, of which 23 isolates were recovered from 21 Thai patients during 2003, 2007, or 2008 and one isolate was recovered from a Danish traveler to Thailand. ESC production was confirmed in 13 out of the 24 isolates by MIC testing. Microarray and plasmid profiling (replicon typing and restriction fragment length polymorphism [RFLP]) were used to characterize the genetic mechanisms of antimicrobial resistance in the 13 ESC-producing isolates. Pulsed-field gel electrophoresis (PFGE) and MIC testing were used to compare the clonality between the 13 ESC-producing isolates and the 11 non-ESC-producing isolates. Based on susceptibility patterns, the ESC-producing isolates were more closely related than non-ESC-producing isolates. Microarray, PCR, plasmid profiling, and replicon typing revealed that the 13 ESC-producing isolates harbored either bla(CMY-2) containing incA/C or bla(CTX-M-14) containing incFIIA, incFrepB, and an unknown replicon located on plasmids ranging in size from 75 to 200 kb. The RFLP and replicon typing clustered the isolates into four distinct groups. PFGE revealed 16 unique patterns and five clusters; each cluster contained two or three of the 24 isolates. The isolate from the Danish patient was indistinguishable from two Thai clinical isolates by PFGE. This study revealed the emergence of the bla(CTX-M-14) gene among several clones of Salmonella serovar Choleraesuis. Numerous plasmids were identified containing up to two different ESC genes and four distinct replicons. A "travel-associated" spread was confirmed. Overall, a high degree of clonal diversity between isolates resistant and susceptible to cephalosporins was observed. The findings represent a serious threat to public health for the Thai people and tourists.
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Molecular typing and antimicrobial resistance of Salmonella enterica subspecies enterica serovar Choleraesuis isolates from diseased pigs in Japan. Comp Immunol Microbiol Infect Dis 2008; 33:109-19. [PMID: 18809209 DOI: 10.1016/j.cimid.2008.08.004] [Citation(s) in RCA: 23] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Accepted: 08/02/2008] [Indexed: 11/20/2022]
Abstract
Salmonella enterica serovar Choleraesuis (S. Choleraesuis) isolates derived from diseased pigs in Japan during 2001 and 2005 were analyzed for biotype, based on H(2)S production and dulcitol fermentation, pulsed-field gel electrophoresis (PFGE) profile, and antimicrobial resistance profile. S. Choleraesuis biotype Choleraesuis (biotype Choleraesuis) was classified into one genotype, while varietas Kunzendorf (var. Kunzendorf) was classified into two genotypes. The isolates of var. Kunzendorf belonging to one genotype were isolated in a limited area of Japan. Variation in the antimicrobial resistance pattern was observed in isolates of both biotypes Choleraesuis and var. Kunzendorf. We have also shown that the PFGE profile was associated with the biotype and isolation region of each isolate.
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