High prevalence of ceftriaxone resistance among invasive Salmonella enterica serotype Choleraesuis isolates in Thailand: The emergence and increase of CTX-M-55 in ciprofloxacin-resistant S. Choleraesuis isolates

Int J Med Microbiol. 2018 Jun;308(4):447-453. doi: 10.1016/j.ijmm.2018.03.008. Epub 2018 Mar 23.

Abstract

S. Choleraesuis is a highly invasive zoonotic pathogen that causes a serious systemic infection in humans. The emergence and increase of resistance to ceftriaxone and ciprofloxacin among S. Choleraesuis has become a serious therapeutic problem. The present study demonstrated high frequency of antimicrobial resistance in Salmonella Choleraesuis among 414 nontyphoidal Salmonella isolates from bacteremic patients in Thailand. High rates of ceftriaxone (58.3%) and ciprofloxacin (19.6%) resistances were observed in S. Choleraesuis isolates. The dissemination of the self-transferable blaCTX-M-14-carrying IncFIIs, IncFII, and IncI1 plasmids and blaCMY-2-carrying IncA/C plasmid along with the clonal spread of blaCMY-2-harbouring S. Choleraesuis isolates contributed to the high frequency of resistance to extended-spectrum cephalosporins (ESCs; third- and fourth-generation cephalosporins) during 2005-2007. We reported the first occurrence of ceftazidime-hydrolysing CTX-M-55 in S. Choleraesuis isolates which dramatically increased and became the most abundant CTX-M variant among ESC-resistant S. Choleraesuis isolates during 2012-2016. The spread of clone pulsotype B3 was due to the dissemination of IncA/C plasmids carrying both blaCTX-M-55 and qnrS1 among ciprofloxacin-resistant S. Choleraesuis isolates harbouring D87G in GyrA. These isolates were apparently responsible for the high rates of co-resistance to ESCs and ciprofloxacin (51.3%) during 2012-2016. This study emphasizes the importance to have an action plan to control the dissemination of antimicrobial resistance in S. Choleraesuis since this poses a threat to global health due to travel and trade in animal food products.

Keywords: Bacteremia; CTX-M-55; Ceftriaxone; Ciprofloxacin; Salmonella enterica.

MeSH terms

  • Adult
  • Animals
  • Anti-Bacterial Agents / pharmacology*
  • Anti-Bacterial Agents / therapeutic use
  • Bacteremia / microbiology
  • Ceftazidime / pharmacology
  • Ceftazidime / therapeutic use
  • Ceftriaxone / pharmacology*
  • Ceftriaxone / therapeutic use
  • Child, Preschool
  • Ciprofloxacin / pharmacology*
  • Ciprofloxacin / therapeutic use
  • DNA, Circular / drug effects
  • DNA, Circular / genetics
  • Drug Resistance, Multiple, Bacterial*
  • Female
  • Humans
  • Male
  • Middle Aged
  • Salmonella Infections / drug therapy
  • Salmonella Infections / epidemiology
  • Salmonella Infections / microbiology*
  • Salmonella enterica / classification
  • Salmonella enterica / drug effects*
  • Salmonella enterica / isolation & purification
  • Serogroup
  • Thailand
  • beta-Lactamases / genetics
  • beta-Lactamases / metabolism

Substances

  • Anti-Bacterial Agents
  • DNA, Circular
  • Ciprofloxacin
  • Ceftriaxone
  • Ceftazidime
  • beta-Lactamases