Isolation of multidrug-resistant Salmonella in Singapore

Abstract

Multidrug-resistant Salmonella is a well-recognised problem worldwide, especially in developing countries such as India, where non-typhoidal Salmonella infections and enteric fever are endemic. Antimicrobial resistance, particularly to fluoroquinolones, is common and leads to the frequent use of alternative agents, such as azithromycin. We herein describe the first reported case of azithromycin-resistant Salmonella gastroenteritis in a Singaporean patient.

A review of Salmonella enterica with particular focus on the pathogenicity and virulence factors, host specificity and antimicrobial resistance including multidrug resistance

“…Consequently, this lead to an increased perception of the need for adoption of surveillance systems to ensure food safety – identification of foods involved in foodborne outbreaks – due to its economic importance; because the identification of only one contaminated food product may lead to discarding of tonnes of foods resulting in economic losses to the production sector and international trade restrictions [179]. Salmonellosis is one of the most frequently reported foodborne disease outbreaks worldwide but mainly common in developing countries such as India, Asia and Africa [23,54,180]. Salmonellosis poses public health threats due to its high endemicity, difficulty in adopting control measures, and because of its significant morbidity and mortality rates.…”

“…In recent years, the development of antimicrobial resistance (AMR) among foodborne pathogens such as Salmonella have been associated with an increased number of human deaths, longer duration of hospital stay, and high costs of treatment due to therapy failure. Several clones of multidrug-resistant (MDR) Salmonella have emerged during the late 1990s and early 2000s and since then, their prevalence both in humans, domestic animals and other wildlife species have expanded globally [9,[15][16][17][18][19][20][21][22][23][24][25]. Recently, the increasing prevalence of MDR Salmonella such as resistance towards clinically important antimicrobials like fluoroquinolones and third-generation cephalosporins has become an emerging problem worldwide [16,18,[26][27][28][29][30][31][32][33].…”

A macrophage-based screen identifies antibacterial compounds selective for intracellular Salmonella Typhimurium

“…Tm can invade into phagocytes for systemic spread through the reticuloendothelial system 11 . Salmonella infections are commonly treated with fluoroquinolones, cephalosporins, or macrolides 12 , although cephalosporins do not penetrate phagocytic cells 13 . Unfortunately, resistance to these antibiotic classes is increasing worldwide 14,15 .…”

The burden of typhoid fever in Klang Valley, Malaysia, 2011–2015

“…A separate study in Bangladesh reported a prevalence of Salmonella typhi isolates expressing high-level of resistance to ciprofloxacin of 90.6% [ 27 ], with 43% showing resistance to co-trimoxazole and chloramphenicol, and 40% to ampicillin and nalidixic acid [ 19 ]. After the MDR Salmonella arose toward first-line antibiotics and became the major problem in several countries worldwide, fluoroquinolones (ciprofloxacin) was chosen for patient treatment and had a high cure rate among the carriers [ 28 – 30 ]. Ceftriaxone, a third-generation cephalosporin, and azithromycin (a macrolide) are now used as other options (second-line antibiotics) to treat typhoid fever when first-line drugs and fluoroquinolone cannot be used [ 31 , 32 ].…”

“…Only the medical doctor can prescribe the antibiotic, and pharmacies will release the antibiotic according to the prescribed form. A case report by Phoon et al in 2015 in Singapore reported Salmonella resistance to azithromycin for the first time to ciprofloxacin and ceftriaxone [ 28 ]. The development of resistance is likely due to misuse, overuse and inappropriate prescribing procedures [ 27 , 30 ].…”