Antimicrobial susceptibility and genomic profiling of Salmonella enterica from bloodstream infections at a tertiary referral hospital in Lusaka, Zambia, 2018–2019

Yamba, Kaunda; Kapesa, Christine; Mpabalwani, Evans; Hachaambwa, Lottie; Smith, Anthony M.; Young, Andrea Liezl; Gally, David L.; Mainda, Geoffrey; Mukuma, Mercy; Samutela, Mulemba Tillika; Kalonda, Annie; Mwansa, James; Muma, John Bwalya

doi:10.1016/j.ijregi.2022.04.003

Cited by 8 publications

(3 citation statements)

References 54 publications

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“…Serotypes such as Salmonella Typhi (54%) and S. Paratyphi A (46%) were identified in the present study. Similar results were reported in a study conducted by Yamba at al [23], according to which S. typhi was 66.7% and S. paratyphi A was 33.3%. Another study by Dilip et al [24] reported S. typhi and S. paratyphi A in 54% and 46% respectively.…”

Section: Discussionsupporting

confidence: 91%

Susceptibility to Fluoroquinolones among Salmonella Enterica Serovars in Blood Culture

Saad¹,

Khan²,

Rehman³

et al. 2022

PJMHS

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Background and Aim: Enteric fever is a severe bloodstream infection contributing to higher rate of morbidity and mortality around the globe caused by S. Typhi and Paratyphi A. Fecal-oral route is the prevalent transmission route of enteric fever that manifests with various clinical outcomes such as nausea, fever, transient rash, chills, hepatosplenomegaly, abdominal discomfort, and malaise. Assessment of susceptibility to fluoroquinolones in Salmonella enterica serovars in blood cultures was the prime objective of the current study. Methodology: This cross-sectional study was carried out on 326 suspected enteric fever patients attending the outpatient department of HBS Dental and General Hospital, Islamabad for the duration from July 2021 to June 2022. Prior to study conduction, ethical approval for the study was taken and each individual signed the written informed consent. BACTEC culture bottles were used for the incubation of blood. Standard procedures were followed to identify the bacterial growth in the obtained isolates from the vials. Salmonella enterica serotyping of identified isolates was done. Salmonella Typhi and Salmonella Paratyphi isolation and identification were processed. All the isolates were then subjected to Kirby-Bauer disc diffusion method for antibiotic susceptibility test. Clinical Laboratory Standards Institute guidelines were used for the interpretation of results. All the data from laboratory analysis were analyzed in SPSS version 25. Results: Of the total 326 suspected enteric fever patients, the incidence of positive Salmonella enterica was found in 28 (8.6%), out of which Salmonella Typhi and Salmonella Paratyphi A were 15 (54%) and 13 (46%) respectively. Salmonella enterica growth was not observed in patients with age>51 years. However, patients of age group 11-20 years and 21-30 years showed higher proportion of Salmonella enterica growth. Male patients had higher Salmonella enterica growth than females. All the isolates of Salmonella enterica exhibited resistance to ampicillin and nalidixic but sensitivity to chloramphenicol and ceftriaxone. The Salmonella Paratyphi A and Salmonella Typhi isolates presented reduced susceptibility to ofloxacin and ciprofloxacin. Conclusion: The present study found that reduced susceptibility and higher level of resistance to fluoroquinolones are the major reasons for not considering the fluoroquinolones as a treatment option for Salmonella infections. Ceftriaxone is still the better drug choice in Salmonella Typhi and Paratyphi A. Keywords: Fluoroquinolones, Salmonella Typhi, Salmonella Paratyphi, Enterica serovars, Blood culture

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Section: Discussionsupporting

confidence: 91%

Susceptibility to Fluoroquinolones among Salmonella Enterica Serovars in Blood Culture

Saad¹,

Khan²,

Rehman³

et al. 2022

PJMHS

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“…Over forty acquired AMR genes have been identified, including point mutations (two in gyrA, one in parC (both gyrA and parC are resistant to quinolone), nfsA (resistance to nitrofurantoin) and transposons [ 102 ]. The use of WGS for the detection of AMR in Africa despite financial constraints is gradually increasing [ 65 , 103 – 105 ]…”

Section: Molecular Methods Of Amr Detectionmentioning

confidence: 99%

Combating the menace of antimicrobial resistance in Africa: a review on stewardship, surveillance and diagnostic strategies

et al. 2022

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The emergence of antibiotic-resistant pathogens has threatened not only our ability to deal with common infectious diseases but also the management of life-threatening complications. Antimicrobial resistance (AMR) remains a significant threat in both industrialized and developing countries alike. In Africa, though, poor clinical care, indiscriminate antibiotic use, lack of robust AMR surveillance programs, lack of proper regulations and the burden of communicable diseases are factors aggravating the problem of AMR. In order to effectively address the challenge of AMR, antimicrobial stewardship programs, solid AMR surveillance systems to monitor the trend of resistance, as well as robust, affordable and rapid diagnostic tools which generate data that informs decision-making, have been demonstrated to be effective. However, we have identified a significant knowledge gap in the area of the application of fast and affordable diagnostic tools, surveillance, and stewardship programs in Africa. Therefore, we set out to provide up-to-date information in these areas. We discussed available hospital-based stewardship initiatives in addition to the role of governmental and non-governmental organizations. Finally, we have reviewed the application of various phenotypic and molecular AMR detection tools in both research and routine laboratory settings in Africa, deployment challenges and the efficiency of these methods.

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“…These discrepancies observed in the two bacterial species ( K. pneumoniae and S. pseudintermedius ) were not pursued. However, potential antimicrobial mechanisms without resistance gene expression include activation of multidrug efflux pumps or decreased outer membrane permeability [ 53 ], which should be further explored for fluoroquinolone resistance. Moreover, databases can differ essentially in the number and type of genes and resistance determinants they comprise [ 54 ], so there is the possibility that quinolone-resistant determinants were not found due to the database data used.…”

Section: Discussionmentioning

confidence: 99%

Occurrence of Multidrug-Resistant Bacteria Resulting from the Selective Pressure of Antibiotics: A Comprehensive Analysis of ESBL K. pneumoniae and MRSP Isolated in a Dog with Rhinorrhea

Rodrigues

Ribeiro-Almeida

Ribeiro

et al. 2023

Veterinary Sciences

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Because of public health concerns, much greater scrutiny is now placed on antibiotic use in pets, especially for antimicrobial agents that have human analogs. Therefore, this study aimed to characterize the phenotypic and genotypic profiles of multidrug-resistant bacteria isolated from nasal swabs samples taken from a one-year-old male Serra da Estrela dog with rhinorrhea that was treated with amikacin. An extended-spectrum β-lactamases (ESBL) Klebsiella pneumoniae was isolated in the first sample taken from the left nasal cavity of the dog. Seven days later, methicillin-resistant (MRSP) Staphylococcus pseudintermedius was also isolated. Nevertheless, no alterations to the therapeutic protocol were performed. Once the inhibitory action of the antibiotic disappeared, the competitive advantage of the amikacin-resistant MRSP was lost, and only commensal flora was observed on both nasal cavities. The genotypic profile of extended-spectrum β-lactamase (ESBL)-producing Klebsiella pneumoniae revealed the same characteristics and close relation to other strains, mainly from Estonia, Slovakia and Romania. Regarding MRSP isolates, although resistance to aminoglycosides was present in the first MRSP, the second isolate carried aac(6′)-aph(2″), which enhanced its resistance to amikacin. However, the veterinary action was focused on the treatment of the primary agent (ESBL K. pneumoniae), and the antibiotic applied was according to its phenotypic profile, which may have led to the resolution of the infectious process. Therefore, this study highlights the importance of targeted therapy, proper clinical practice and laboratory-hospital communication to safeguard animal, human and environmental health.

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Antimicrobial susceptibility and genomic profiling of Salmonella enterica from bloodstream infections at a tertiary referral hospital in Lusaka, Zambia, 2018–2019

Cited by 8 publications

References 54 publications

Susceptibility to Fluoroquinolones among Salmonella Enterica Serovars in Blood Culture

Susceptibility to Fluoroquinolones among Salmonella Enterica Serovars in Blood Culture

Combating the menace of antimicrobial resistance in Africa: a review on stewardship, surveillance and diagnostic strategies

Occurrence of Multidrug-Resistant Bacteria Resulting from the Selective Pressure of Antibiotics: A Comprehensive Analysis of ESBL K. pneumoniae and MRSP Isolated in a Dog with Rhinorrhea

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