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Background: Salmonella enterica is a major global food-borne pathogen, causing life-threatening infections. Ciprofloxacin and extended-spectrum cephalosporins (ESCs) are the drugs of choice for severe infections. We previously reported a ciprofloxacin-resistant S. enterica serotype Kentucky (S Kentucky) ST198-X1 strain that emerged in Egypt and spread throughout Africa and the Middle East from 2002 to 2008. We aimed to monitor recent trends in the location of transmission and antimicrobial resistance of this strain.

Methods: We analysed isolates of S Kentucky collected by the French national surveillance system for salmonellosis in France from Jan 1, 2000, to Dec 31, 2011, and at two sites in Casablanca, Morocco, between Jan 1, 2003, and Dec 31, 2011. We analysed patterns of travel of patients infected with a ciprofloxacin-resistant strain of S Kentucky. We identified isolates showing resistance to ESCs or decreased susceptibility to carbapenems, characterised isolates by XbaI-pulsed field gel electrophoresis and multilocus sequence typing, and assessed mechanisms of bacterial resistance to antimicrobial drugs.

Findings: 954 (1%) of 128,836 serotyped Salmonella spp isolates in France were identified as S Kentucky, as were 30 (13%) of 226 Salmonella spp isolates from Morocco. During 2000-08, 200 (40%) of 497 subculturable isolates of S Kentucky obtained in France were resistant to ciprofloxacin, compared with 376 (83%) of 455 isolates in 2009-11, suggesting a recent increase in ciprofloxacin resistance in France. Travel histories suggested S Kentucky infections originated predominantly in east Africa, north Africa, west Africa, and the Middle East, but also arose in India. We report several occurrences of acquisition of extended-spectrum β-lactamase (CTX-M-1, CTX-M-15), plasmid-encoded cephalosporinase (CMY-2), or carbapenemase (OXA-48, VIM-2) genes by ciprofloxacin-resistant isolates of S Kentucky ST198-X1 from the Mediterranean area since 2009. Many of these highly drug-resistant isolates were also resistant to most aminoglycosides, to co-trimoxazole (trimethoprim-sulfamethoxazole), and to azithromycin.

Interpretation: The potential risk to public health posed by ciprofloxacin-resistant S Kentucky ST198-X1 warrants its inclusion in national programmes for the control of S. enterica in food-producing animals, in particular in poultry.

Funding: Institut Pasteur, Institut de Veille Sanitaire, Fondation pour la Recherche Médicale, French Government Investissement d'Avenir programme.

Titel:	Highly drug-resistant Salmonella enterica serotype Kentucky ST198-X1: a microbiological study.
Autor/in / Beteiligte Person:	Le Hello, S ; Harrois, D ; Bouchrif, B ; Sontag, L ; Elhani, D ; Guibert, V ; Zerouali, K ; Weill, FX
Link:	Zum Volltext
Zeitschrift:	The Lancet. Infectious diseases, Jg. 13 (2013-08-01), Heft 8, S. 672
Veröffentlichung:	New York, NY : Elsevier Science ; The Lancet Pub. Group, 2001-, 2013
Medientyp:	academicJournal
ISSN:	1474-4457 (electronic)
DOI:	10.1016/S1473-3099(13)70124-5
Schlagwort:	Adolescent Adult Aged Aged, 80 and over Aminoglycosides Azithromycin Bacterial Proteins genetics Child Female France epidemiology Humans Male Microbial Sensitivity Tests Morocco epidemiology Travel Trimethoprim, Sulfamethoxazole Drug Combination Young Adult beta-Lactamases genetics Anti-Bacterial Agents Ciprofloxacin Drug Resistance, Multiple, Bacterial genetics Salmonella Infections epidemiology Salmonella Infections microbiology Salmonella enterica genetics
Sonstiges:	Nachgewiesen in: MEDLINE Sprachen: English Publication Type: Case Reports; Journal Article; Research Support, Non-U.S. Gov't Language: English [Lancet Infect Dis] 2013 Aug; Vol. 13 (8), pp. 672-9. <i>Date of Electronic Publication: </i>2013 May 28. MeSH Terms: Anti-Bacterial Agents* ; Ciprofloxacin* ; Drug Resistance, Multiple, Bacterial* / genetics ; Salmonella enterica* / genetics ; Salmonella Infections / epidemiology ; Salmonella Infections / microbiology ; Adolescent ; Adult ; Aged ; Aged, 80 and over ; Aminoglycosides ; Azithromycin ; Bacterial Proteins / genetics ; Child ; Female ; France / epidemiology ; Humans ; Male ; Microbial Sensitivity Tests ; Morocco / epidemiology ; Travel ; Trimethoprim, Sulfamethoxazole Drug Combination ; Young Adult ; beta-Lactamases / genetics Comments: Comment in: Lancet Infect Dis. 2013 Aug;13(8):641-3. (PMID: 23721757) ; Comment in: Lancet Infect Dis. 2014 Apr;14(4):270-1. (PMID: 24670624) Substance Nomenclature: 0 (Aminoglycosides) ; 0 (Anti-Bacterial Agents) ; 0 (Bacterial Proteins) ; 5E8K9I0O4U (Ciprofloxacin) ; 8064-90-2 (Trimethoprim, Sulfamethoxazole Drug Combination) ; 83905-01-5 (Azithromycin) ; EC 3.5.2.- (beta-lactamase CMY-2) ; EC 3.5.2.- (beta-lactamase CTX-M-15) ; EC 3.5.2.- (beta-lactamase TEM-3) ; EC 3.5.2.6 (beta-Lactamases) ; EC 3.5.2.6 (carbapenemase) Entry Date(s): Date Created: 20130601 Date Completed: 20131106 Latest Revision: 20220321 Update Code: 20240513

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Highly drug-resistant Salmonella enterica serotype Kentucky ST198-X1: a microbiological study.