Cargando…
Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics
Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals–Al Farwaniya and Al Amiri–in Kuwait, a subtropical country, from April 2013-Ma...
Autores principales: | , , , , , , , , |
---|---|
Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
Public Library of Science
2019
|
Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483562/ https://www.ncbi.nlm.nih.gov/pubmed/30986214 http://dx.doi.org/10.1371/journal.pntd.0007293 |
_version_ | 1783414017324220416 |
---|---|
author | Albert, M. John Bulach, Dieter Alfouzan, Wadha Izumiya, Hidemasa Carter, Glen Alobaid, Khaled Alatar, Fatemah Sheikh, Abdul Rashid Poirel, Laurent |
author_facet | Albert, M. John Bulach, Dieter Alfouzan, Wadha Izumiya, Hidemasa Carter, Glen Alobaid, Khaled Alatar, Fatemah Sheikh, Abdul Rashid Poirel, Laurent |
author_sort | Albert, M. John |
collection | PubMed |
description | Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals–Al Farwaniya and Al Amiri–in Kuwait, a subtropical country, from April 2013-May 2016. NTS bacteremia was present in 30 of 53,860 (0.75%) and 31 of 290,36 (1.33%) blood cultures in the two hospitals respectively. In Al Farwaniya hospital, one-third of the patients were from some tropical developing countries of Asia. About 66% of all patients (40/61) had diarrhea, and of these, 65% had the corresponding blood serovar isolated from stool culture. A few patients had Salmonella cultured from urine. Patients were either young or old. Most of the patients had co-morbidities affecting the immune system. Two patients each died in both hospitals. The number of different serovars cultured in each hospital was 13, and most infections were due to S. Enteritidis (all sequence type [ST]) 11) and S. Typhimurium (all ST19) except in a subgroup of expatriate patients from tropical developing countries in Al Farwaniya hospital. About a quarter of the isolates were multidrug-resistant. Most patients were treated with a cephalosporin with or without other antibiotics. S. Enteritidis and S. Typhimurium isolates were typed by pulsed field-gel electrophoresis (PFGE) and a selected number of isolates were whole-genome sequenced. Up to four different clades were present by PFGE in either species. Whole-genome sequenced isolates showed antibiotic-resistance genes that showed phenotypic correlation, and in some cases, phenotypes showed absence of specific genes. Whole-genome sequenced isolates showed presence of genes that contributed to blood-stream infection. Phylogeny by core genome analysis showed a close relationship with S. Typhimurium and S. Enteritidis from other parts of the world. The uniqueness of our study included the finding of a low prevalence of infection, mortality and multidrug-resistance, a relatively high prevalence of gastrointestinal infection in patients, and the characterization of selected isolates of S. Typhimurium and S. Enteritidis serovars by whole-genome sequencing that shed light on phylogeny, virulence and resistance. Similarities with studies from developing countries especially Africa included infection in patients with co-morbidities affecting the immune system, predominance of S. Typhimurium and S. Enteritidis serovars and presence of drug-resistance in isolates. |
format | Online Article Text |
id | pubmed-6483562 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | Public Library of Science |
record_format | MEDLINE/PubMed |
spelling | pubmed-64835622019-05-09 Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics Albert, M. John Bulach, Dieter Alfouzan, Wadha Izumiya, Hidemasa Carter, Glen Alobaid, Khaled Alatar, Fatemah Sheikh, Abdul Rashid Poirel, Laurent PLoS Negl Trop Dis Research Article Non-typhoidal Salmonella (NTS) bacteremia is a significant cause of morbidity and mortality worldwide. It is considered to be an emerging and neglected tropical disease in Africa. We studied this in two tertiary hospitals–Al Farwaniya and Al Amiri–in Kuwait, a subtropical country, from April 2013-May 2016. NTS bacteremia was present in 30 of 53,860 (0.75%) and 31 of 290,36 (1.33%) blood cultures in the two hospitals respectively. In Al Farwaniya hospital, one-third of the patients were from some tropical developing countries of Asia. About 66% of all patients (40/61) had diarrhea, and of these, 65% had the corresponding blood serovar isolated from stool culture. A few patients had Salmonella cultured from urine. Patients were either young or old. Most of the patients had co-morbidities affecting the immune system. Two patients each died in both hospitals. The number of different serovars cultured in each hospital was 13, and most infections were due to S. Enteritidis (all sequence type [ST]) 11) and S. Typhimurium (all ST19) except in a subgroup of expatriate patients from tropical developing countries in Al Farwaniya hospital. About a quarter of the isolates were multidrug-resistant. Most patients were treated with a cephalosporin with or without other antibiotics. S. Enteritidis and S. Typhimurium isolates were typed by pulsed field-gel electrophoresis (PFGE) and a selected number of isolates were whole-genome sequenced. Up to four different clades were present by PFGE in either species. Whole-genome sequenced isolates showed antibiotic-resistance genes that showed phenotypic correlation, and in some cases, phenotypes showed absence of specific genes. Whole-genome sequenced isolates showed presence of genes that contributed to blood-stream infection. Phylogeny by core genome analysis showed a close relationship with S. Typhimurium and S. Enteritidis from other parts of the world. The uniqueness of our study included the finding of a low prevalence of infection, mortality and multidrug-resistance, a relatively high prevalence of gastrointestinal infection in patients, and the characterization of selected isolates of S. Typhimurium and S. Enteritidis serovars by whole-genome sequencing that shed light on phylogeny, virulence and resistance. Similarities with studies from developing countries especially Africa included infection in patients with co-morbidities affecting the immune system, predominance of S. Typhimurium and S. Enteritidis serovars and presence of drug-resistance in isolates. Public Library of Science 2019-04-15 /pmc/articles/PMC6483562/ /pubmed/30986214 http://dx.doi.org/10.1371/journal.pntd.0007293 Text en © 2019 Albert 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 (http://creativecommons.org/licenses/by/4.0/) , which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited. |
spellingShingle | Research Article Albert, M. John Bulach, Dieter Alfouzan, Wadha Izumiya, Hidemasa Carter, Glen Alobaid, Khaled Alatar, Fatemah Sheikh, Abdul Rashid Poirel, Laurent Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title | Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title_full | Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title_fullStr | Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title_full_unstemmed | Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title_short | Non-typhoidal Salmonella blood stream infection in Kuwait: Clinical and microbiological characteristics |
title_sort | non-typhoidal salmonella blood stream infection in kuwait: clinical and microbiological characteristics |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6483562/ https://www.ncbi.nlm.nih.gov/pubmed/30986214 http://dx.doi.org/10.1371/journal.pntd.0007293 |
work_keys_str_mv | AT albertmjohn nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT bulachdieter nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT alfouzanwadha nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT izumiyahidemasa nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT carterglen nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT alobaidkhaled nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT alatarfatemah nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT sheikhabdulrashid nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics AT poirellaurent nontyphoidalsalmonellabloodstreaminfectioninkuwaitclinicalandmicrobiologicalcharacteristics |