Ceftazidime-resistant Salmonella enterica, Morocco

Antimicrobial Resistance, Virulence Genes, and Genetic Diversity of Salmonella enterica Isolated from Sausages

Salmonella is a major cause of morbidity and mortality in humans worldwide, and the infection with multidrug-resistant strains can cause severe diseases. This study was designed to evaluate the antimicrobial resistance, to detect the virulence genes, and to study the genetic diversity of isolated Salmonella strains using 16S rRNA sequences. For this, 34 Salmonella strains isolated from sausages were identified using biochemical and serological methods. Molecular tools were used to evaluate the presence of virulence genes (orgA, sitC, sipB, spiA, iroN, and sifA) using simplex and multiplex polymerase chain reaction (PCR) and to sequence 16S rRNA genes for phylogenetic analysis. The susceptibility to 24 selected antibiotics was also studied. The results of this study showed that all isolated Salmonella were positive for targeted virulence genes and were resistant to at least one antibiotic. However, the multidrug resistance was observed in 44% of isolated strains. The phylogenetic analysis of 16S rRNA sequences highlighted that Salmonella isolates were divided into 3 clusters and 3 sub-clusters, with a ≥98% similarity to Salmonella enterica species. From this study, we conclude that sausages are considered as a potential source of Salmonella, which could be a major risk to public health.

Molecular Characterization and Antibiotic Resistance of Foodborne Pathogens in Street-Vended Ready-to-Eat Meat Sold in South Africa

ABSTRACT

The consumption of food contaminated with microbial populations remains a key route of foodborne infection in developing countries and creates a serious public health burden. This study aimed at identifying foodborne pathogens and their antibiotic resistance profiles in ready-to-eat meat sold in public eateries in the Johannesburg area. A total of 115 samples were examined for the incidence of bacteria pathogens and their antibiotic resistance profiles against commonly used antibiotics (ampicillin, tetracycline, chloramphenicol, erythromycin, ciprofloxacin, streptomycin, and sulphonamides) using the molecular and the disc diffusion methods. Fifteen bacteria species were detected in the samples. Staphylococcus aureus had the highest prevalence (25%), and 53.33% of the isolates exhibited multidrug resistance to the antibiotics tested. Among the isolated bacteria, S. aureus; was resistant to at least six antimicrobial agents, whereas 100% of S. aureus,Enterococcus faecalis, and Planomicrobium glaciei were resistant to streptomycin, ciprofloxacin, and chloramphenicol, respectively. This study revealed that a wide diversity of bacteria species contaminate meat sold on the street, which indicates that consumers of ready-to-eat meat sold in public eateries are at risk of food poisoning. Hence, strict intervention strategies should be put in place by government agencies to reduce the menace of food poisoning in the country.

HIGHLIGHTS

RTE meats were analyzed for microbial contamination. Foodborne pathogens were detected in the meat samples. Antibiotic resistance profiles were tested. RTE meats contain foodborne pathogens, and isolates exhibited antibiotic resistance. Consumers of RTE meat in the Johannesburg CBD are at risk of food poisoning.

Prevalence and Antimicrobial Susceptibility Profile of Salmonella Serovars Isolated from Slaughtered Cattle in Addis Ababa, Ethiopia

Salmonella is one of the top causes of foodborne bacterial illnesses in humans. The primary sources of human Salmonella infection are food producing animals such as cattle, poultry, and swine. A cross-sectional study was undertaken to estimate the prevalence and to determine the serovar distribution and antimicrobial susceptibility profiles of Salmonella spp. isolated from fecal (n=567) and carcass swab (n=159) samples of slaughtered cattle at Addis Ababa Abattoir Enterprise and Kara'alo PLC, Abattoirs, in Addis Ababa, Ethiopia between January 2014 and April 2015. Salmonella isolation was conducted according to Global Foodborne Infections Network Laboratory Protocol and isolates were confirmed by genus specific PCR and serotyped by slide agglutination test. Susceptibility of the isolates to 17 antimicrobials was testedusing the Kirby-Bauer disk diffusion method according to the guidelines of the Clinical and Laboratory Standards Institute. Out of the total 726 samples examined, 27 (3.7%) were positive for Salmonella. Salmonella was detected in 4.1% (23/567) fecal and 2.5% (4/159) carcass swab samples. Twelve different serovars were identified and the most predominant serovars were S. Dublin (n=10, 35.7%) and S. Virchow (n=5, 17.9%), followed by S. Braendrerup, S. Haifa, and S. Saintpaul which were isolated from 2 samples each (7.1%). All of the Salmonella isolates investigated were resistant or intermediately resistant to four or more of the 17 drugs tested. High resistance rate was recorded to streptomycin 25 (89.3%), cephalothin 20 (71.4%), ampicillin 19 (67.9%), and amoxicillin+clavulanic acid 19 (67.9%). Resistance to five or more antimicrobials was detected in 20 (71.5%) of the isolates. Multidrug resistance to more than 7 antimicrobials was detected in 5 (17.9%) of the isolates. Isolation of such multidrug resistant strains of Salmonella from slaughtered cattle poses a major public health concern. These findings imply the need for a strict biosecurity and regulation of antimicrobial use across the country.

Antimicrobial resistance and genetic diversity of Salmonella Infantis isolated from foods and human samples in Morocco

OBJECTIVES

Genotyping of Salmonella strains is an important molecular tool to discriminate isolates and to improve epidemiological studies when an outbreak occurs. Among the DNA-based genotyping methods, pulsed-field gel electrophoresis (PFGE) is currently used to subtype Salmonella isolates. In this study, the feasibility of genotyping Salmonella enterica serotype Infantis strains using XbaI restriction enzyme was evaluated. Separation of restricted fragments was performed by PFGE.

METHODS

To test the possibility of applying this methodology to epidemiological investigation, a collection of 26 Salmonella Infantis strains were tested for their susceptibility to 14 antimicrobial agents and were analysed by XbaI macrorestriction followed by PFGE. Detection of class 1 integrons as well as intI1 and bla_TEM genes in resistant strains was also studied.

RESULTS

Antimicrobial susceptibility testing showed that 84.6% (22/26) of Salmonella Infantis isolates were susceptible to all of the antimicrobials tested, whereas 7.7% (2/26) had low-level resistance to β-lactams and harboured the bla_TEM gene. A class 1 integron (0.8kb) and the intI1 gene (898bp) were detected in one Salmonella Infantis strain. However, five different PFGE profiles were defined by XbaI macrorestriction.

CONCLUSIONS

The PFGE method demonstrated adequate typing ability and represents a powerful tool to discriminate the serotype Salmonella Infantis.

Prevalence, antimicrobial susceptibility and risk factors associated with non-typhoidal Salmonella on Ugandan layer hen farms

BACKGROUND

Non-typhoidal Salmonella (NTS) are among the leading global foodborne pathogens and a significant public health threat. Their occurrence in animal reservoirs and their susceptibilities to commonly used antimicrobials are poorly understood in developing countries. The aim of this study was to estimate the prevalence, determine antimicrobial susceptibility and identify risk factors associated with NTS presence in laying hen farms in Uganda through a cross-sectional study.

RESULTS

Pooled faecal samples were collected from 237 laying hen farms and these were analysed for NTS following standard laboratory procedures. In total, 49 farms (20.7%; 95% Confidence interval (CI): 15.6-25.6%) were positive for NTS presence. Altogether, ten Salmonella serotypes were identified among the confirmed 78 isolates, and the predominant serotypes were Salmonella Newport (30.8%), S. Hadar (14.1%), S. Aberdeen (12.8%), S. Heidelberg (12.8%), and S. Bolton (12.8%). Phenotypic antimicrobial resistance was detected in 45(57.7%) of the isolates and the highest resistance was against ciprofloxacin (50.0%) followed by sulphonamides (26.9%) and sulphamethoxazole/trimethoprim (7.7%). Resistance was significantly associated with sampled districts (p = 0.034). Resistance to three or more drugs, multi-drug resistance (MDR) was detected in 12 (15.4%) of the isolates, 9 (75%) of these were from Wakiso district. A multivariable logistic model identified large farm size (OR = 7.0; 95% CI: 2.5-19.8) and the presence of other animal species on the farm (OR = 5.9; 95% CI: 2.1-16.1) as risk factors for NTS prevalence on farms. Having a separate house for birds newly brought to the farms was found to be protective (OR = 0,4; 95% CI: 0.2-0.8).

CONCLUSION

This study has highlighted a high prevalence and diversity of NTS species in laying hen farms in Uganda and identified associated risk factors. In addition, it has demonstrated high levels of antimicrobial resistance in isolates of NTS. This could be because of overuse or misuse of antimicrobials in poultry production. Also importantly, the insights provided in this study justifies a strong case for strengthening One Health practices and this will contribute to the development of NTS control strategies at local, national and international levels.

Prevalence and characterization of Salmonella among humans in Ghana

Background

Non-typhoidal Salmonella (NTS) is a public health problem worldwide and particularly in Africa with high disease burden. This study characterized Salmonella isolates from humans in Ghana to determine serovar distribution, phage types, and antimicrobial resistance. Further, the clonal relatedness among isolates was determined.

Methods

One hundred and thirty-seven Salmonella isolates (111 clinical and 26 public toilet) were characterized using standard serotyping, phage typing, and antimicrobial susceptibility testing methods. The molecular epidemiology of common serovars (Salmonella Typhimurium and Salmonella Enteritidis) was established by pulsed field gel electrophoresis (PFGE).

Results

Twenty-two serovars were identified with S. Enteritidis, S. Typhimurium, and Salmonella Derby as the most dominant. One hundred and twelve isolates showed resistance to more than one antimicrobial. Fifty-eight (n = 58/112; 54.5%) strains were multi-resistant with low resistance to cephalosporins ceftazidime (8.0%), cefotaxime (4.5%), and cefoxitin (2.7%) with synergy to clavulanic acid indicating possible ESBLs. Isolates showed high resistance to trimethoprim (66.1%), tetracycline (61.6%), ampicillin (57.1%), sulfamethoxazole (46.4%), chloramphenicol (33.9%), and ciprofloxacin (25.0%). The most common resistance pattern of multi-resistant serovars was to ampicillin, chloramphenicol, sulphonamide, and trimethoprim. S. Enteritidis (18/43) strains reacted with typing phages but did not conform to any phage type with PT14B and PT4 as predominant definitive phage types. Six S. Typhimurium strains reacted but did not conform to any recognized phage type while seven were non-typable. The predominant definitive phage types were DT1 and DT22. PFGE patterns of human S. Enteritidis were closely related to patterns of poultry isolates obtained in a previous study in Ghana.

Conclusions

Cephalosporin resistance is uncommon among Salmonella from humans in Ghana. Poultry may be an important source of human salmonellosis. There is an urgent need for the implementation of routine surveillance of antimicrobial use and bacterial resistance among humans in Ghana.

Fecal prevalence, serotype distribution and antimicrobial resistance of Salmonellae in dairy cattle in central Ethiopia

Background

Salmonellae are major worldwide zoonotic pathogens infecting a wide range of vertebrate species including humans. Consumption of contaminated dairy products and contact with dairy cattle represent a common source of non-typhoidal Salmonella infection in humans. Despite a large number of small-scale dairy farms in Addis Ababa and its surrounding districts, little is known about the status of Salmonella in these farms.

Results

Salmonella was recovered from the feces of at least one animal in 7.6 % (10/132) of the dairy farms. Out of 1203 fecal samples examined, 30 were positive for Salmonella resulting in a weighted animal level prevalence of 2.3 %. Detection of diarrhea in an animal and in a farm was significantly associated with animal level (p = 0.012) and herd level (p < 0.001) prevalence of Salmonella. Animal level prevalence of Salmonella was significantly associated with age (p = 0.023) and study location; it was highest among those under 6 months of age and in farms from Adaa district and Addis Ababa (p < 0.001). Nine different serotypes were identified using standard serological agglutination tests. The most frequently recovered serotypes were Salmonella Typhimurium (23.3 %), S. Saintpaul (20 %), S. Kentucky (16.7 %) and S. Virchow (16.7 %). All isolates were resistant or intermediately resistant to at least one of the 18 drugs tested. Twenty-six (86.7 %), 19 (63.3 %), 18 (60 %), 16 (53.3 %) of the isolates were resistant to streptomycin, nitrofurantoin, sulfisoxazole and tetracycline , respectively. Resistance to 2 drugs was detected in 27 (90 %) of the isolates. Resistance to 3 or more drugs was detected in 21 (70 %) of the isolates, while resistance to 7 or more drugs was detected in 11 (36.7 %) of the isolates. The rate of occurrence of multi-drug resistance (MDR) in Salmonella strains isolated from dairy farms in Addis Ababa was significantly higher than those isolated from farms outside of Addis Ababa (p = 0.009). MDR was more common in S. Kentucky, S. Virchow and S. Saintpaul.

Conclusion

Isolation of Salmonella serotypes commonly known for causing human salmonellosis that are associated with an MDR phenotype in dairy farms in close proximity with human population is a major public health concern. These findings imply the need for a strict pathogen reduction strategy.

Antibiotic resistance determinants and genetic analysis of Salmonella enterica isolated from food in Morocco

Antimicrobial-resistant non-typhoidal Salmonella (NTS) are an important cause of infection in Africa, but there is a lack of information on their molecular mechanisms of resistance and epidemiology. This study contributes to fill this gap through the characterization by pulsed-field gel electrophoresis (PFGE), multilocus sequence typing (MLST), plasmid profiling and analysis of antibiotic-resistance determinants of 94 Salmonella enterica strains isolated from food in Morocco. PFGE revealed considerable heterogeneity among the strains, showing 32 pulsotypes. MLST of strains representative of the different serovars evidenced 13 sequence types (STs), three of which were newly identified (ST1694, ST1768 and ST1818) and nine not previously reported in Morocco. Thirty-four strains harbored from one to four plasmids, of IncI1 group in S. Mbandaka, IncFIIA in S. Typhimurium, IncL/M in S. Hadar and S. Blockley. For the first time in Morocco an intact Salmonella Genomic Island 1 (SGI1) carrying the resistance genes aadA2, floR, tetG, blaPSE-1 and sul1 was detected in S. Typhimurium DT104. In serovar Hadar resistance to ampicillin, tetracycline and streptomycin was associated to blaTEM-1, tetA and strA genes respectively, whereas one mutation in gyrA (Asp87Asn) and one in parC (Thr54Ser) genes conferred resistance to nalidixic acid. These findings improve the information on foodborne Salmonella in Morocco, evidencing the presence of MDR strains potentially dangerous to humans, and provide useful data for future studies.

Fecal carriage of extended-spectrum β-lactamase-producing Enterobacteriaceae in community setting in Casablanca

BACKGROUND

The importance of community-acquired infections due to extended-spectrum β-lactamase-producing Enterobacteriaceae (ESBL-PE) has been increasingly recognized in recent years. This study aimed to determine the prevalence of intestinal carriage of ESBL-PE in the community in Casablanca, Morocco.

METHODS

During 6 months (2013), 93 fecal samples were examined for ESBL-PE. Isolates expressing an ESBL phenotype were investigated for the presence of genes encoding β-lactamases and plasmid-mediated quinolone resistance. Conjugation experiments were done to determine the mobility of ESBL genes.

RESULTS

The prevalence of fecal carriage of ESBL-PE was 4.3% (4/93; 95% CI, 0.2-8.4). Klebsiella pneumoniae (n = 2), Enterobacter cloacae (n = 2), Escherichia coli (n = 1), and Serratia odorifera (n = 1) were the ESBL-producing species. Four (66.7%) of these isolates were multidrug-resistant. The blaSHV-12 (n = 5) was the most frequent ESBL gene detected, followed by blaCTX-M-15 (n = 3).The non-ESBL gene detected was blaTEM-1 (n = 5). One isolate harbored the qnrB1 variant. RESULTS of conjugation experiments indicated that blaSHV-12 + blaTEM-1 + qnrB1 and blaCTX-M-15 + blaTEM-1 genes were co-transferred and that these genes were carried by a conjugative plasmid of high molecular weight (125 kb).

CONCLUSION

Our results show the importance of the intestinal tract as a reservoir for ESBL-PE in the community in Morocco.

Prevalence and characterization of extended-spectrum β-lactamase-producing clinical Salmonella enterica isolates in Dakar, Senegal, from 1999 to 2009

A total of 1623 clinical isolates of Salmonella belonging to 229 serotypes were received by the Senegalese Reference Center for Enterobacteria from January 1999 to December 2009. The most common serotypes were Enteritidis (19% of the isolates), Typhi (8%), Typhimurium (7%) and Kentucky (4%). A significant increase in the prevalence of resistance to amoxicillin (0.9% in 1999 to 11.1% in 2009) and nalidixic acid (0.9% in 1999 to 26.7% in 2009) was observed in non-typhoidal Salmonella serotypes. For critically important antibiotics, notably ciprofloxacin and extended-spectrum cephalosporins (ESCs), the rates of resistance were low: 0.3% and 0.5%, respectively. Seven ESC-resistant Salmonella strains and three additional ESC-resistant strains from Senegal (1990) and Mali (2007) were studied to identify the genetic basis of their antibiotic resistance. All ESC-resistant strains produced an extended-spectrum β-lactamase (ESBL). These were CTX-M-15 (n = 6; 2000-2008), SHV-12 (n = 3; 2000-2001) and SHV-2 (n = 1; 1990). A large IncHI2 ST1 pK29-like plasmid was found in six strains (three producing SHV-12 and three CTX-M-15), whereas IncN and IncF plasmids were found in three strains and one strain, respectively. The association of plasmid-mediated quinolone resistance (PMQR) genes qnrB1 and aac(6')-Ib-cr was found in four ESBL-producing strains, leading to decreased susceptibility and even full resistance to ciprofloxacin (MIC range 0.75-2 mg/L) despite the absence of mutations in the quinolone resistance-determining region (QRDR) of gyrA, gyrB, parC and parE. This association of ESBL and multiple PMQR mechanisms within the same strains is therefore a serious concern as it hampers the use of both ESCs and fluoroquinolones for severe Salmonella infections.

Prevalence and genotypic analysis of plasmid-mediated β-lactamases among urinary Klebsiella pneumoniae isolates in Moroccan community

The aim of this study is to assess the prevalence and molecular characterization of the extended spectrum β-lactamases (ESBL)-producing Klebsiella pneumoniae isolated from community acquired urinary tract infections and collected in five Moroccan cities during a 2010 survey. In all, 34 (7.5%) of the 453 K. pneumoniae isolates studied were positive for an ESBL phenotype and 91.1% of these isolates were multidrug resistant. The bla(CTX-M-15) (n=31) was the most frequent ESBL genes detected, followed equally by bla(SHV-28) and bla(SHV-12) (n=3), then bla(TEM-3), bla(SHV-36), bla(SHV-110) and bla(CTX-M-1) with one isolate for each (n=1). Eight isolates co-expressed more than one ESBL with bla(CTX-M-15). The non-ESBL genes detected were bla(SHV-1), bla(SHV-11), bla(SHV-32), bla(SHV-26), bla(SHV-76), bla(TEM-1), bla(TEM-1b) and bla(OXA-1). Plasmid-mediated AmpC β-lactamase genes, bla(ACT-2), bla(DHA-1) and a new β-lacatamase named bla(EBC-1464), were detected in 11.7% of isolates. Fourteen (41.1%) isolates harbored qnr genes; qnrA6 (n=1), qnrB1 (n=8), qnrB2 (n=1) and qnrS1 (n=4) types were detected. Twenty-six isolates (76.4%) were positive for aac(6')-Ib-cr gene. Results of conjugation experiments indicated that bla(CTX-M-15), bla(TEM-1b), bla(OXA-1), aac(6')-Ib-cr and qnrB1 genes were co-transferred and that these genes were carried by a conjugative plasmid of high molecular weight. With the exception of qnrB1, all the antibiotic resistance genes were clustered in a 12-kb region. The results of this work report the genetic diversity of ESBL genes, with the CTX-M-15 enzyme being most common among ESBL-producing K. pneumoniae in Moroccan community. Furthermore, a major finding is that bla(EBC-1464) detection is a first in Morocco.

Antimicrobial resistance in Salmonella serovars isolated from meat shops at the markets in North Vietnam

A total of 97 out of 245 carcass, sewage effluent, and table surface samples in meat shops at the retail markets in North Vietnam showed Salmonella positive. Eleven Salmonella serovars, including Infantis, Anatum, Rissen, Reading, London, Typhimurium, Enteritidis, Agona, Newport, Emek, and Derby, were identified. The Salmonella isolates were tested for antimicrobial susceptibility and further investigated for antimicrobial resistance genes. Resistance to kanamycin, gentamicin, neomycin, nalidixic acid, chloramphenicol, trimethoprim, streptomycin, tetracycline, ampicillin, and sulphonamides was found in 28.9-56.7%. The isolates were neither resistant to ceftazidime nor norfloxacin. Sixty-four (66.0%) out of 97 isolates were resistant to at least one of 14 antimicrobials, and 55 (85.9%) out of the 64 isolates showed multidrug resistance. Thirteen resistance genes (bla(TEM), bla(OXA-1), aadA1, sul1, tetA, tetB, tetG, cmlA1, floR, dfrA1, dfrA12, aac(3)-IV, and aphA1-1AB) were detected in the resistant isolates. This study indicates that Salmonella isolated from meat shops were resistant to multiple antimicrobials, and the resistance genes were widespread among the serovars isolated.

Antibiotic resistance profiles of Salmonella serovars isolated from retail pork and chicken meat in North Vietnam

The spread of antibiotic resistance via meat poses a serious public health concerns. During 2007-2009, a total of 586 retail meat samples (318 pork and 268 chicken meats) were collected from three provinces (Bac Ninh, Ha Noi and Ha Tay) of North Vietnam to determine the prevalence of Salmonella. Isolates were characterized by serotyping and antibiotic susceptibility testing. Approximately 39.6% (n=126) of pork and 42.9% (n=115) of chicken samples were Salmonella-positive, and 14 Salmonella serovars were identified. Anatum (15.8%) was the most common serovar, followed by Infantis (13.3%), Emek (10.4%), Derby and Rissen (9.5%), Typhimurium (9.1%), Reading (7.5%) and London (6.2%). The isolation frequency of serovars Enteritidis, Albany, Hadar, Weltevreden, Newport and Blockey ranged from 1.2%-5.8%. Resistance to at least one antibiotic agent was detected in 78.4% of isolates (n=189) and the most frequent resistance were to tetracycline (58.5%), sulphonamides (58.1%), streptomycin (47.3%), ampicillin (39.8%), chloramphenicol (37.3%), trimethoprim (34.0%) and nalidixic acid (27.8%). No Salmonella isolates were resistant to ceftazidime. Chicken isolates had higher resistance to antibiotic agents than pork isolates (P<0.05). It showed that 159 Salmonella isolates belong to the 14 serovars were multidrug resistant (MDR) and 50 MDR patterns were found. This study indicated that Salmonella serovars isolated from retail meat samples were resistant to multiple antibiotics and this resistance was widespread among different serovars. The widespread resistance may have arisen from misuse or overuse of antibiotics during animal husbandry in North Vietnam.