Journal Article

Increasing ceftriaxone resistance in <i>Salmonella</i> isolates from a university hospital in Taiwan

Lin-Hui Su, Tsu-Lan Wu, Ju-Hsin Chia, Chishih Chu, An-Jing Kuo and Cheng-Hsun Chiu

in Journal of Antimicrobial Chemotherapy

Published on behalf of British Society for Antimicrobial Chemotherapy

Volume 55, issue 6, pages 846-852
Published in print June 2005 | ISSN: 0305-7453
Published online May 2005 | e-ISSN: 1460-2091 | DOI: http://dx.doi.org/10.1093/jac/dki116
Increasing ceftriaxone resistance in Salmonella isolates from a university hospital in Taiwan

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Objectives: Salmonella infection is a distressing health problem worldwide. This study reports the changing epidemiology of Salmonella infections in Taiwan during 1999–2003, with emphasis on increasing ceftriaxone resistance.

Methods: Records of Salmonella clinical isolates in Chang Gung Memorial Hospital during 1999–2003 were reviewed. All isolates were identified and antimicrobial susceptibility determined by standard methods. A total of 22 ceftriaxone-resistant isolates were investigated by PCR sequencing of the blaTEM, blaSHV, blaCTX-M and ampC genes. Southern-blot hybridization was used to localize the ampC gene. Infrequent-restriction-site PCR was used to genotype these isolates.

Results: A total of 3635 Salmonella isolates, including 3592 (98.8%) non-typhoid Salmonella, were identified. Serogroup B (55.6%) remained the most predominant, but the prevalence has been decreasing. In contrast, serogroup D infections have increased significantly from 13.6 to 22.8%. Overall resistance to ampicillin and chloramphenicol remained high, with the highest rate (91% to both drugs) observed in Salmonella enterica serotype Choleraesuis in 2003. A sudden upsurge of ciprofloxacin resistance from zero to 69% was found in S. Choleraesuis. Ceftriaxone resistance increased in several serogroups (0.8–2.1%; average, 1.5%). The resistance was associated with plasmid-mediated blaCMY-2 in 14 cases and extended-spectrum β-lactamases (ESBLs), including CTX-M-3 (n=6), SHV-2a (n=1) and SHV-12 (n=1), in others. Diverse serotypes and genotypes were found among the ceftriaxone-resistant isolates.

Conclusions: Increasing ceftriaxone resistance in non-typhoid Salmonella appears to link to the spread of plasmid-mediated ampC or ESBL genes. Effective measures should be taken to prevent the problem worsening.

Keywords: antimicrobial resistance; ampC; extended-spectrum β-lactamases

Journal Article.  3671 words.  Illustrated.

Subjects: Medical Oncology ; Critical Care

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