Persistent Colonization of Ciprofloxacin-Resistant and Extended-Spectrum β-Lactamase (ESBL)-Producing Salmonella enterica Serovar Kentucky ST198 in a Patient with Inflammatory Bowel Disease

Yue Jiang; Huilin Yang; Zhen-Yu Wang; Da-Chuan Lin; Xinan Jiao; Yunlong Hu; Jing Wang

doi:10.2147/IDR.S447971

Persistent Colonization of Ciprofloxacin-Resistant and Extended-Spectrum β-Lactamase (ESBL)-Producing Salmonella enterica Serovar Kentucky ST198 in a Patient with Inflammatory Bowel Disease

Infect Drug Resist. 2024 Apr 12:17:1459-1466. doi: 10.2147/IDR.S447971. eCollection 2024.

Authors

Yue Jiang^#^{1

2}, Huilin Yang^#³, Zhen-Yu Wang^{1

2}, Da-Chuan Lin⁴, Xinan Jiao^{1

2}, Yunlong Hu^{3

4}, Jing Wang^{1

2}

Affiliations

¹ Jiangsu Key Laboratory of Zoonosis, Yangzhou University, Yangzhou, 225009, People's Republic of China.
² Key Laboratory of Prevention and Control of Biological Hazard Factors (Animal Origin) for Agrifood Safety and Quality, Ministry of Agriculture of China, Yangzhou University, Yangzhou, 225009, People's Republic of China.
³ Department of Clinical Laboratory, Peking University Shenzhen Hospital, Shenzhen, 518036, People's Republic of China.
⁴ Guangdong Key Laboratory of Regional Immunity and Diseases, Shenzhen University School of Medicine, Shenzhen University, Shenzhen, 518060, People's Republic of China.

^# Contributed equally.

Abstract

Objective: Salmonella enterica serovar Kentucky ST198 has emerged as a global threat to humans. In this study, we aimed to characterize the prolonged carriage of ciprofloxacin-resistant and extended-spectrum β-lactamase (ESBL)-producing S. Kentucky ST198 in a single patient with inflammatory bowel disease (IBD).

Methods: Three S. Kentucky strains were collected from a single patient with IBD on 11th January, 23rd January, and 8th February, 2022, respectively. Antimicrobial susceptibility testing, whole-genome sequencing, and phylogenetic analysis with 38 previously described Chinese S. Kentucky ST198 strains from patients and food were performed.

Results: All three S. Kentucky isolates belonged to ST198. They carried identical 16 resistance genes, such as bla_CTX-M-55, tet(A), and qnrS1, and had identical mutations within gyrA (S83F and D87N) and parC (S80I). Therefore, they exhibited identical multidrug-resistant profiles, including the clinically important antibiotics cephalosporins (ceftazidime and cefepime), fluoroquinolones (ciprofloxacin and levofloxacin), and third-generation tetracycline (tigecycline). Our three S. Kentucky strains were classified into the subclade ST198.2-2, and were genetically identical (2-6 SNPs) to each other. They exhibited a close genetic similarity (15-20 SNPs) to the isolate NT-h3189 from a patient and AH19MCS1 from chicken meat in China, indicating a possible epidemiological link between these S. Kentucky ST198 isolates from the patients and chicken meat.

Conclusion: Long-term colonization of ciprofloxacin-resistant and ESBL-producing S. Kentucky ST198 in a single patient is a matter of concern. Due to the potential transfer of S. Kentucky ST198 from food sources to humans, ongoing surveillance of this particular clone in animals, animal-derived food products, and humans should be strengthened.

Keywords: Kentucky; MDR; Salmonella; persistent colonization.

Grants and funding

This work was supported by the fifth phase of “333 project” scientific research project in Jiangsu Province (BRA2020002), the Priority Academic Program Development of Jiangsu Higher Education Institutions (PAPD), and the 111 Project (D18007).