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Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults
BACKGROUND: Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007–December 2010). METHODOLOGY...
Autores principales: | , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2012
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521708/ https://www.ncbi.nlm.nih.gov/pubmed/23272255 http://dx.doi.org/10.1371/journal.pntd.0001933 |
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author | Vlieghe, Erika R. Phe, Thong De Smet, Birgit Veng, Chhun H. Kham, Chun Bertrand, Sophie Vanhoof, Raymond Lynen, Lut Peetermans, Willy E. Jacobs, Jan A. |
author_facet | Vlieghe, Erika R. Phe, Thong De Smet, Birgit Veng, Chhun H. Kham, Chun Bertrand, Sophie Vanhoof, Raymond Lynen, Lut Peetermans, Willy E. Jacobs, Jan A. |
author_sort | Vlieghe, Erika R. |
collection | PubMed |
description | BACKGROUND: Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007–December 2010). METHODOLOGY: Blood was cultured as part of a microbiological prospective surveillance study. Identification of Salmonella isolates was performed by conventional methods and serotyping. Antibiotic susceptibilities were assessed using disk diffusion, MicroScan and E-test macromethod. Clonal relationships were assessed by Pulsed Field Gel Electrophoresis; PCR and sequencing for detection of mutations in Gyrase and Topoisomerase IV and presence of qnr genes. PRINCIPAL FINDINGS: Seventy-two Salmonella isolates grew from 58 patients (mean age 34.2 years, range 8–71). Twenty isolates were identified as Salmonella Typhi, 2 as Salmonella Paratyphi A, 37 as Salmonella Choleraesuis and 13 as other non-typhoid Salmonella spp. Infection with human immunodeficiency virus (HIV) was present in 21 of 24 (87.5%) patients with S. Choleraesuis BSI. Five patients (8.7%) had at least one recurrent infection, all with S. Choleraesuis; five patients died. Overall, multi drug resistance (i.e., co-resistance to ampicillin, sulphamethoxazole-trimethoprim and chloramphenicol) was high (42/59 isolates, 71.2%). S. Typhi displayed high rates of decreased ciprofloxacin susceptibility (18/20 isolates, 90.0%), while azithromycin resistance was very common in S. Choleraesuis (17/24 isolates, 70.8%). Two S. Choleraesuis isolates were extended spectrum beta-lactamase producer. CONCLUSIONS AND SIGNIFICANCE: Resistance rates in Salmonella spp. in Cambodia are alarming, in particular for azithromycin and ciprofloxacin. This warrants nationwide surveillance and revision of treatment guidelines. |
format | Online Article Text |
id | pubmed-3521708 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2012 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-35217082012-12-27 Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults Vlieghe, Erika R. Phe, Thong De Smet, Birgit Veng, Chhun H. Kham, Chun Bertrand, Sophie Vanhoof, Raymond Lynen, Lut Peetermans, Willy E. Jacobs, Jan A. PLoS Negl Trop Dis Research Article BACKGROUND: Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007–December 2010). METHODOLOGY: Blood was cultured as part of a microbiological prospective surveillance study. Identification of Salmonella isolates was performed by conventional methods and serotyping. Antibiotic susceptibilities were assessed using disk diffusion, MicroScan and E-test macromethod. Clonal relationships were assessed by Pulsed Field Gel Electrophoresis; PCR and sequencing for detection of mutations in Gyrase and Topoisomerase IV and presence of qnr genes. PRINCIPAL FINDINGS: Seventy-two Salmonella isolates grew from 58 patients (mean age 34.2 years, range 8–71). Twenty isolates were identified as Salmonella Typhi, 2 as Salmonella Paratyphi A, 37 as Salmonella Choleraesuis and 13 as other non-typhoid Salmonella spp. Infection with human immunodeficiency virus (HIV) was present in 21 of 24 (87.5%) patients with S. Choleraesuis BSI. Five patients (8.7%) had at least one recurrent infection, all with S. Choleraesuis; five patients died. Overall, multi drug resistance (i.e., co-resistance to ampicillin, sulphamethoxazole-trimethoprim and chloramphenicol) was high (42/59 isolates, 71.2%). S. Typhi displayed high rates of decreased ciprofloxacin susceptibility (18/20 isolates, 90.0%), while azithromycin resistance was very common in S. Choleraesuis (17/24 isolates, 70.8%). Two S. Choleraesuis isolates were extended spectrum beta-lactamase producer. CONCLUSIONS AND SIGNIFICANCE: Resistance rates in Salmonella spp. in Cambodia are alarming, in particular for azithromycin and ciprofloxacin. This warrants nationwide surveillance and revision of treatment guidelines. Public Library of Science 2012-12-13 /pmc/articles/PMC3521708/ /pubmed/23272255 http://dx.doi.org/10.1371/journal.pntd.0001933 Text en © 2012 Vlieghe et al http://creativecommons.org/licenses/by/4.0/ This is an open-access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are properly credited. |
spellingShingle | Research Article Vlieghe, Erika R. Phe, Thong De Smet, Birgit Veng, Chhun H. Kham, Chun Bertrand, Sophie Vanhoof, Raymond Lynen, Lut Peetermans, Willy E. Jacobs, Jan A. Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title | Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title_full | Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title_fullStr | Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title_full_unstemmed | Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title_short | Azithromycin and Ciprofloxacin Resistance in Salmonella Bloodstream Infections in Cambodian Adults |
title_sort | azithromycin and ciprofloxacin resistance in salmonella bloodstream infections in cambodian adults |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3521708/ https://www.ncbi.nlm.nih.gov/pubmed/23272255 http://dx.doi.org/10.1371/journal.pntd.0001933 |
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