A Multicountry Molecular Analysis of Salmonella enterica Serovar Typhi With Reduced Susceptibility to Ciprofloxacin in Sub-Saharan Africa

作者：Al Emran Hassan M^*; Eibach Daniel; Krumkamp Ralf; Ali Mohammad; Baker Stephen; Biggs Holly M; Bjerregaard Andersen Morten; Breiman Robert F; Clemens John D; Crump John A; Espinoza Ligia Maria Cruz; Deerin Jessica; Dekker Denise Myriam; Gassama Sow Amy; Hertz Julian T; Im Justin; Ibrango Samuel; von Kalckreuth Vera; Kabore Leon Parfait; Konings Frank; Lofberg Sandra Valborg; Meyer Christian G; Mintz Eric D; Montgomery Joel M; Olack Beatrice; Pak Gi Deok

来源：Clinical Infectious Diseases, 2016, 62(suppl 1): S42-S46.

DOI：10.1093/cid/civ788

• sub-Saharan Africa
• ciprofloxacin
• S. Typhi
• susceptible

Methods.aEuro integral Febrile patients from 9 sites within 6 countries in SSA with a body temperature of a parts per thousand yen38.0A degrees C were enrolled in this study. Blood samples were obtained for bacterial culture, and Salmonella isolates were identified biochemically and confirmed by multiplex polymerase chain reaction (PCR). Antimicrobial susceptibility of all Salmonella isolates was performed by disk diffusion test, and minimum inhibitory concentrations (MICs) against ciprofloxacin were measured by Etest. All Salmonella isolates with reduced susceptibility to ciprofloxacin (MIC > 0.06 A mu g/mL) were screened for mutations in quinolone resistance-determining regions in target genes, and the presence of plasmid-mediated quinolone resistance (PMQR) genes was assessed by PCR.
Results.aEuro integral A total of 8161 blood cultures were performed, and 100 (1.2%) S. Typhi, 2 (< 0.1%) Salmonella enterica serovar Paratyphi A, and 27 (0.3%) nontyphoid Salmonella (NTS) were isolated. Multidrug-resistant S. Typhi were isolated in Kenya (79% [n = 38]) and Tanzania (89% [n = 8]) only. Reduced ciprofloxacin-susceptible (22% [n = 11]) S. Typhi were isolated only in Kenya. Among those 11 isolates, all had a Glu133Gly mutation in the gyrA gene combined with either a gyrA (Ser83Phe) or gyrB mutation (Ser464Phe). One Salmonella Paratyphi A isolate with reduced susceptibility to ciprofloxacin was found in Senegal, with 1 mutation in gyrA (Ser83Phe) and a second mutation in parC (Ser57Phe). Mutations in the parE gene and PMQR genes were not detected in any isolate.
Conclusions.aEuro integral Salmonella Typhi with reduced susceptibility to ciprofloxacin was not distributed homogenously throughout SSA. Its prevalence was very high in Kenya, and was not observed in other study countries. Continuous monitoring of antimicrobial susceptibility is required to follow the potential spread of antimicrobial-resistant isolates throughout SSA.

• 出版日期2016-3-15
• 单位河北医科大学