Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan

Background: The epidemiology of nontyphoidal Salmonella (NTS) resistant to ciprofloxacin or ceftriaxone and its impact on patients’ clinical course are rarely reported. Methods: Children with culture-proven salmonellosis treated in a medical center in northern Taiwan in 2017 were enrolled. To trace...

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Main Authors: Yi-Jung Chang, Mi-Chi Chen, Ye Feng, Lin-Hui Su, Hsin-Chieh Li, Hsin-Ping Yang, Min-Jia Yu, Chyi-Liang Chen, Cheng-Hsun Chiu
Format: Article
Language:English
Published: Elsevier 2020-08-01
Series:Pediatrics and Neonatology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1875957220300577
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author Yi-Jung Chang
Mi-Chi Chen
Ye Feng
Lin-Hui Su
Hsin-Chieh Li
Hsin-Ping Yang
Min-Jia Yu
Chyi-Liang Chen
Cheng-Hsun Chiu
author_facet Yi-Jung Chang
Mi-Chi Chen
Ye Feng
Lin-Hui Su
Hsin-Chieh Li
Hsin-Ping Yang
Min-Jia Yu
Chyi-Liang Chen
Cheng-Hsun Chiu
author_sort Yi-Jung Chang
collection DOAJ
description Background: The epidemiology of nontyphoidal Salmonella (NTS) resistant to ciprofloxacin or ceftriaxone and its impact on patients’ clinical course are rarely reported. Methods: Children with culture-proven salmonellosis treated in a medical center in northern Taiwan in 2017 were enrolled. To trace the source of Salmonella, Salmonella isolated from food samples were collected from markets. Antimicrobial susceptibility and serotypes were determined. Results: Among the 453 isolates, 122 (26.9%) were highly antimicrobial-resistant, as defined by resistance to ciprofloxacin or ceftriaxone or both. The most prevalent highly resistant serotype was S. Anatum (66, 54.1%). Salmonella was detected in 94.1%, 66.7%, and 8.6% of examined pork, chicken, and vegetables examined, respectively. S. Anatum (6, 21.4%) and S. Derby (6, 21.4%) were the major serotypes isolated. Majority of the S. Anatum (5, 83.3%) were highly antimicrobial-resistant. More patients infected by highly resistant Salmonella required carbapenem treatment (OR = 23.5, 95% confidence interval [CI] 2.8–192.7, P < 0.001). Patients with ceftriaxone-resistant NTS infections had a significantly longer hospital stay than others (P < 0.001). Totally, 34 (7.5%) presented with invasive diseases (31 bacteremia, 1 intestinal perforation, 1 toxic megacolon and 1 septic arthritis). Risk factors for invasive disease included prolonged fever for ≧5 days and infection occurring in warmer season from May to October. The rise of ambient temperature in northern Taiwan was associated with increasing Salmonella infections. Conclusions: Retail meats were the main source of highly antimicrobial-resistant NTS in northern Taiwan. Highly antimicrobial resistance significantly impacted the clinical course and treatment of children with NTS infection.
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spelling doaj-art-a4d165e9b53f4e2ba31ad7fd38c22e8d2025-08-20T03:09:48ZengElsevierPediatrics and Neonatology1875-95722020-08-0161443243810.1016/j.pedneo.2020.03.017Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, TaiwanYi-Jung Chang0Mi-Chi Chen1Ye Feng2Lin-Hui Su3Hsin-Chieh Li4Hsin-Ping Yang5Min-Jia Yu6Chyi-Liang Chen7Cheng-Hsun Chiu8Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanDepartment of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, TaiwanSir Run Run Shaw Hospital, Hangzhou, China; Institute for Translational Medicine, Zhejiang University School of Medicine, Hangzhou, ChinaMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, TaiwanMolecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Corresponding author. Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, 5 Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyuan, Taiwan; Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Taoyuan, Taiwan; Graduate Institute of Clinical Medical Sciences, Chang Gung University College of Medicine, Taoyuan, Taiwan; Corresponding author. Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Children's Hospital, 5 Fu-Hsin Street, Kweishan, Taoyuan 333, Taiwan.Background: The epidemiology of nontyphoidal Salmonella (NTS) resistant to ciprofloxacin or ceftriaxone and its impact on patients’ clinical course are rarely reported. Methods: Children with culture-proven salmonellosis treated in a medical center in northern Taiwan in 2017 were enrolled. To trace the source of Salmonella, Salmonella isolated from food samples were collected from markets. Antimicrobial susceptibility and serotypes were determined. Results: Among the 453 isolates, 122 (26.9%) were highly antimicrobial-resistant, as defined by resistance to ciprofloxacin or ceftriaxone or both. The most prevalent highly resistant serotype was S. Anatum (66, 54.1%). Salmonella was detected in 94.1%, 66.7%, and 8.6% of examined pork, chicken, and vegetables examined, respectively. S. Anatum (6, 21.4%) and S. Derby (6, 21.4%) were the major serotypes isolated. Majority of the S. Anatum (5, 83.3%) were highly antimicrobial-resistant. More patients infected by highly resistant Salmonella required carbapenem treatment (OR = 23.5, 95% confidence interval [CI] 2.8–192.7, P < 0.001). Patients with ceftriaxone-resistant NTS infections had a significantly longer hospital stay than others (P < 0.001). Totally, 34 (7.5%) presented with invasive diseases (31 bacteremia, 1 intestinal perforation, 1 toxic megacolon and 1 septic arthritis). Risk factors for invasive disease included prolonged fever for ≧5 days and infection occurring in warmer season from May to October. The rise of ambient temperature in northern Taiwan was associated with increasing Salmonella infections. Conclusions: Retail meats were the main source of highly antimicrobial-resistant NTS in northern Taiwan. Highly antimicrobial resistance significantly impacted the clinical course and treatment of children with NTS infection.http://www.sciencedirect.com/science/article/pii/S1875957220300577nontyphoidal salmonellaserotypehighly antimicrobial resistanceinvasive salmonellosis
spellingShingle Yi-Jung Chang
Mi-Chi Chen
Ye Feng
Lin-Hui Su
Hsin-Chieh Li
Hsin-Ping Yang
Min-Jia Yu
Chyi-Liang Chen
Cheng-Hsun Chiu
Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
Pediatrics and Neonatology
nontyphoidal salmonella
serotype
highly antimicrobial resistance
invasive salmonellosis
title Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
title_full Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
title_fullStr Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
title_full_unstemmed Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
title_short Highly antimicrobial-resistant Nontyphoidal Salmonella from retail meats and clinical impact in children, Taiwan
title_sort highly antimicrobial resistant nontyphoidal salmonella from retail meats and clinical impact in children taiwan
topic nontyphoidal salmonella
serotype
highly antimicrobial resistance
invasive salmonellosis
url http://www.sciencedirect.com/science/article/pii/S1875957220300577
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