cResistance to extended-spectrum -lactams in Salmonella, in particular, in serotypes such as Salmonella enterica serovar Enteritidis that are frequently associated with clinical infections, is a serious public health concern. In this study, phenotypic characterization of 433 clinical S. Enteritidis strains obtained from a nationwide collection of the Chinese Center for Disease Control and Prevention during the period from 2005 to 2010 depicted a trend of increasing resistance to ceftriaxone from 2008 onwards. Seventeen (4%) of the strains were found to be resistant to ceftriaxone, 7% were found to be resistant to ciprofloxacin, and 0.7% were found to be resistant to both ciprofloxacin and ceftriaxone. Most of the ceftriaxone-resistant S. Enteritidis strains (15/17) were genetically unrelated and originated from Henan Province. The complete sequence of an IncI1 plasmid, pSE115, which belonged to a novel sequence type, was obtained. This 87,255-bp IncI1 plasmid was found to harbor a bla CTX-M-14 gene in a novel multidrug resistance region (MRR) within the tra locus. Although the majority of strains were also found to contain conjugative IncI1 plasmids with a size similar to that of pSE115 (ϳ90 kb) and harbor a variety of bla CTX-M group 1 and group 9 elements, the novel MRR site at the tra locus in pSE115 was not detectable in the other IncI1 plasmids. The findings from this study show that cephalosporin resistance in S. Enteritidis strains collected in China was mainly due to the dissemination of IncI1 plasmids carrying bla CTX-M , resembling the situation in which IncI1 plasmids serve as major vectors of bla CTX-M variants in other members of the Enterobacteriaceae.
Foodborne salmonellosis is a serious public health problem worldwide and the leading cause of foodborne illnesses in many countries, including the United States and China. Salmonella enterica subsp. enterica serovar Enteritidis is the most common serotype that causes human infections in China (1). In the United States, S. Enteritidis has become the most clinically prevalent serotype since 2008, accounting for ϳ17% of all salmonellosis cases (2). In other countries, the prevalence of S. Enteritidis is even higher, reaching Ͼ50% in European countries and Hong Kong (1, 3-5). Most importantly, S. Enteritidis is commonly associated with outbreaks of foodborne illness and is sometimes associated with invasive Salmonella infections worldwide (6). Although antimicrobials are usually not required for the treatment of salmonellosis due to the self-limiting nature of this disease, they can be lifesaving in patients with invasive infections, which normally occur in children, the elderly, and immunocompromised patients (7).Ceftriaxone and ciprofloxacin are the key drugs of choice for the treatment of invasive Salmonella infections in humans (8).Resistance to ceftriaxone or other extended-spectrum -lactams is usually due to the production of extended-spectrum -lactamases (ESBLs), among which the CTX-M-type ESBLs are largely responsible for cephalosporin resista...