Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan

Background: Enteric fever caused by Salmonella enterica serovar Typhi has not been adequately explored in Jordan. Methodology: In this study we investigated antibiotic resistance patterns and resistance determinants coupled with fingerprint methods of forty-eight isolates of S. Typhi obtained from 1...

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Main Authors: Tarek M. Al-Sanouri, Bianca Paglietti, Aktham Haddadin, Manuela Murgia, Donatella Bacciu, Mahammad Youssef, Salvatore Rubino
Format: Article
Language:English
Published: The Journal of Infection in Developing Countries 2008-08-01
Series:Journal of Infection in Developing Countries
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Online Access:https://jidc.org/index.php/journal/article/view/225
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author Tarek M. Al-Sanouri
Bianca Paglietti
Aktham Haddadin
Manuela Murgia
Donatella Bacciu
Mahammad Youssef
Salvatore Rubino
author_facet Tarek M. Al-Sanouri
Bianca Paglietti
Aktham Haddadin
Manuela Murgia
Donatella Bacciu
Mahammad Youssef
Salvatore Rubino
author_sort Tarek M. Al-Sanouri
collection DOAJ
description Background: Enteric fever caused by Salmonella enterica serovar Typhi has not been adequately explored in Jordan. Methodology: In this study we investigated antibiotic resistance patterns and resistance determinants coupled with fingerprint methods of forty-eight isolates of S. Typhi obtained from 113 patients with suspected enteric fever admitted at six governmental hospitals in different directorates in Jordan. Twenty-four isolates were from an outbreak of typhoid fever that occurred between October 2004 and January 2005, and another twenty-four were from sporadic cases from 2005. Results: All isolates of S. Typhi were resistant to streptomycin. A multidrug resistant (MDR) pattern of ampicillin, chloramphenicol, co-trimoxazole with tetracycline and streptomycin (R-type ACCoTS) was found in 58% of the epidemic strains causing the outbreak and in 98% of the strains from sporadic cases. MDR isolates harbored a single IncHI1 plasmid containing a class 1 integron (dfrA7). Plasmid conjugation studies demonstrated a genetic transfer of resistance (ACCoT). S. Typhi isolates were all sensitive to fluoroquinolones and cefotaxime, the alternative drugs recommended for treatment of typhoid fever. The genomic analysis using PFGE showed: a) the outbreak was caused by an introduced circulating clone with/without an MDR plasmid, and b) isolates from the sporadic cases from 2005 are the same MDR clone that persisted and spread in the country. Conclusion: The emergence of MDR S. Typhi strains is a majorn important public health issue in Jordan. This study should guide selection of effective antibiotic therapy for the treatment of typhoid and monitoring of the spread of MDR of S. Typhi.
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spelling doaj-art-c1dd187eb0864936a55b73cc9ec2a5122025-08-20T02:27:18ZengThe Journal of Infection in Developing CountriesJournal of Infection in Developing Countries1972-26802008-08-0120410.3855/jidc.225Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from JordanTarek M. Al-Sanouri0Bianca Paglietti1Aktham Haddadin2Manuela Murgia3Donatella Bacciu4Mahammad Youssef5Salvatore Rubino6Central Laboratory, Ministry of Health, AmmanDepartment of Biomedical Sciences, University of SassariCentral Laboratory, Ministry of Health, AmmanDepartment of Biomedical Sciences, University of SassariDepartment of Biomedical Sciences, University of SassariWHO/Lyon Office for National Epidemic Preparedness and Response (EPR), LyonDepartment of Biomedical Sciences, University of SassariBackground: Enteric fever caused by Salmonella enterica serovar Typhi has not been adequately explored in Jordan. Methodology: In this study we investigated antibiotic resistance patterns and resistance determinants coupled with fingerprint methods of forty-eight isolates of S. Typhi obtained from 113 patients with suspected enteric fever admitted at six governmental hospitals in different directorates in Jordan. Twenty-four isolates were from an outbreak of typhoid fever that occurred between October 2004 and January 2005, and another twenty-four were from sporadic cases from 2005. Results: All isolates of S. Typhi were resistant to streptomycin. A multidrug resistant (MDR) pattern of ampicillin, chloramphenicol, co-trimoxazole with tetracycline and streptomycin (R-type ACCoTS) was found in 58% of the epidemic strains causing the outbreak and in 98% of the strains from sporadic cases. MDR isolates harbored a single IncHI1 plasmid containing a class 1 integron (dfrA7). Plasmid conjugation studies demonstrated a genetic transfer of resistance (ACCoT). S. Typhi isolates were all sensitive to fluoroquinolones and cefotaxime, the alternative drugs recommended for treatment of typhoid fever. The genomic analysis using PFGE showed: a) the outbreak was caused by an introduced circulating clone with/without an MDR plasmid, and b) isolates from the sporadic cases from 2005 are the same MDR clone that persisted and spread in the country. Conclusion: The emergence of MDR S. Typhi strains is a majorn important public health issue in Jordan. This study should guide selection of effective antibiotic therapy for the treatment of typhoid and monitoring of the spread of MDR of S. Typhi.https://jidc.org/index.php/journal/article/view/225Salmonella enterica serovar Typhimulti-drug resistance plasmidintegronsJordan
spellingShingle Tarek M. Al-Sanouri
Bianca Paglietti
Aktham Haddadin
Manuela Murgia
Donatella Bacciu
Mahammad Youssef
Salvatore Rubino
Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
Journal of Infection in Developing Countries
Salmonella enterica serovar Typhi
multi-drug resistance plasmid
integrons
Jordan
title Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
title_full Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
title_fullStr Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
title_full_unstemmed Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
title_short Emergence of plasmid-mediated multidrug resistance in epidemic and non-epidemic strains of Salmonella enterica serotype Typhi from Jordan
title_sort emergence of plasmid mediated multidrug resistance in epidemic and non epidemic strains of salmonella enterica serotype typhi from jordan
topic Salmonella enterica serovar Typhi
multi-drug resistance plasmid
integrons
Jordan
url https://jidc.org/index.php/journal/article/view/225
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