Antimicrobial susceptibility and treatment of clinical cases of yersiniosis in Aotearoa | New Zealand
ABSTRACT Yersiniosis is the second most notified bacterial disease in Aotearoa | New Zealand (NZ). National clinical treatment guidelines for yersiniosis are available, but there is a lack of supporting antimicrobial susceptibility data for clinical isolates of Yersinia spp. and prescribing data for...
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| Main Authors: | , , , , , , |
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| Format: | Article |
| Language: | English |
| Published: |
American Society for Microbiology
2025-05-01
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| Series: | Microbiology Spectrum |
| Subjects: | |
| Online Access: | https://journals.asm.org/doi/10.1128/spectrum.02751-24 |
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| Summary: | ABSTRACT Yersiniosis is the second most notified bacterial disease in Aotearoa | New Zealand (NZ). National clinical treatment guidelines for yersiniosis are available, but there is a lack of supporting antimicrobial susceptibility data for clinical isolates of Yersinia spp. and prescribing data for yersiniosis cases. Data were collected through interviews with 148 consenting individuals notified with yersiniosis. Forty-three percent (n = 63) of cases indicated antimicrobial use while symptomatic with yersiniosis, including two cases with dual diagnosis (Campylobacteriosis). Children under the age of 5 were predominantly notified with Yersinia enterocolitica (YE) biotype (BT) 2/3 (87%; 27/31) and reported significantly (P = 0.008) less antimicrobial use compared to adults (aged 20–70+ years). Antimicrobial use was significantly (P = 0.006) higher for cases reporting pre-existing gastrointestinal condition(s) and with YE BT 1A (26%; 12/47) compared to YE BT 2/3 (8%; 7/86). Eighty-six percent (44/51) of cases that indicated antimicrobial use identified the commencement date. Of these, 9% (4/44), 77% (34/44), and 14% (6/44) received an antimicrobial(s) as either empirical, directed, or empirical and directed treatment, respectively. Trimethoprim-sulfamethoxazole (49% [25/51]), ciprofloxacin (16% [8/51]), and doxycycline (10% [5/51]) were the most prescribed antimicrobials. Phenotypic antimicrobial susceptibility testing demonstrated clinical Yersinia spp. were susceptible to all antimicrobials commonly prescribed for the treatment of yersiniosis. Whole-genome sequence (WGS) analysis showed very few (1–3) antimicrobial resistance (AMR) genes within the Yersinia genomes. The results support the current antimicrobial prescribing recommendation for the treatment of yersiniosis in NZ and the utility of WGS to assess for AMR profiles in Yersinia spp.IMPORTANCEThis study demonstrates that currently almost half of yersiniosis cases interviewed receive antimicrobial treatment, with most prescriptions as directed therapy after a diagnosis has been made. This study also confirms the appropriateness of current treatment guidelines for the management of yersiniosis in NZ, and that most primary care practitioners in the study areas follow these recommendations. Phenotypic testing was well correlated with the genomic assessments of antimicrobial resistance (AMR). Both types of analysis indicated a low level of AMR for Yersinia spp. in New Zealand (NZ) compared to data from overseas studies. However, ongoing surveillance given the burden of yersiniosis and high rates of treatment in NZ is paramount to ensuring timely detection of emerging multi-drug resistance and to help devise evidence-informed interventions. |
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| ISSN: | 2165-0497 |