Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults.
<h4>Background</h4>Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007-December...
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Public Library of Science (PLoS)
2012-01-01
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| Series: | PLoS Neglected Tropical Diseases |
| Online Access: | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001933&type=printable |
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| author | Erika R Vlieghe Thong Phe Birgit De Smet Chhun H Veng Chun Kham Sophie Bertrand Raymond Vanhoof Lut Lynen Willy E Peetermans Jan A Jacobs |
| author_facet | Erika R Vlieghe Thong Phe Birgit De Smet Chhun H Veng Chun Kham Sophie Bertrand Raymond Vanhoof Lut Lynen Willy E Peetermans Jan A Jacobs |
| author_sort | Erika R Vlieghe |
| collection | DOAJ |
| description | <h4>Background</h4>Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007-December 2010).<h4>Methodology</h4>Blood was cultured as part of a microbiological prospective surveillance study. Identification of Salmonella isolates was performed by conventional methods and serotyping. Antibiotic susceptibilities were assessed using disk diffusion, MicroScan and E-test macromethod. Clonal relationships were assessed by Pulsed Field Gel Electrophoresis; PCR and sequencing for detection of mutations in Gyrase and Topoisomerase IV and presence of qnr genes.<h4>Principal findings</h4>Seventy-two Salmonella isolates grew from 58 patients (mean age 34.2 years, range 8-71). Twenty isolates were identified as Salmonella Typhi, 2 as Salmonella Paratyphi A, 37 as Salmonella Choleraesuis and 13 as other non-typhoid Salmonella spp. Infection with human immunodeficiency virus (HIV) was present in 21 of 24 (87.5%) patients with S. Choleraesuis BSI. Five patients (8.7%) had at least one recurrent infection, all with S. Choleraesuis; five patients died. Overall, multi drug resistance (i.e., co-resistance to ampicillin, sulphamethoxazole-trimethoprim and chloramphenicol) was high (42/59 isolates, 71.2%). S. Typhi displayed high rates of decreased ciprofloxacin susceptibility (18/20 isolates, 90.0%), while azithromycin resistance was very common in S. Choleraesuis (17/24 isolates, 70.8%). Two S. Choleraesuis isolates were extended spectrum beta-lactamase producer.<h4>Conclusions and significance</h4>Resistance rates in Salmonella spp. in Cambodia are alarming, in particular for azithromycin and ciprofloxacin. This warrants nationwide surveillance and revision of treatment guidelines. |
| format | Article |
| id | doaj-art-fac534a7a3164639bc55e0e427098bbd |
| institution | OA Journals |
| issn | 1935-2727 1935-2735 |
| language | English |
| publishDate | 2012-01-01 |
| publisher | Public Library of Science (PLoS) |
| record_format | Article |
| series | PLoS Neglected Tropical Diseases |
| spelling | doaj-art-fac534a7a3164639bc55e0e427098bbd2025-08-20T02:15:25ZengPublic Library of Science (PLoS)PLoS Neglected Tropical Diseases1935-27271935-27352012-01-01612e193310.1371/journal.pntd.0001933Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults.Erika R VliegheThong PheBirgit De SmetChhun H VengChun KhamSophie BertrandRaymond VanhoofLut LynenWilly E PeetermansJan A Jacobs<h4>Background</h4>Salmonella enterica is a frequent cause of bloodstream infection (BSI) in Asia but few data are available from Cambodia. We describe Salmonella BSI isolates recovered from patients presenting at Sihanouk Hospital Centre of Hope, Phnom Penh, Cambodia (July 2007-December 2010).<h4>Methodology</h4>Blood was cultured as part of a microbiological prospective surveillance study. Identification of Salmonella isolates was performed by conventional methods and serotyping. Antibiotic susceptibilities were assessed using disk diffusion, MicroScan and E-test macromethod. Clonal relationships were assessed by Pulsed Field Gel Electrophoresis; PCR and sequencing for detection of mutations in Gyrase and Topoisomerase IV and presence of qnr genes.<h4>Principal findings</h4>Seventy-two Salmonella isolates grew from 58 patients (mean age 34.2 years, range 8-71). Twenty isolates were identified as Salmonella Typhi, 2 as Salmonella Paratyphi A, 37 as Salmonella Choleraesuis and 13 as other non-typhoid Salmonella spp. Infection with human immunodeficiency virus (HIV) was present in 21 of 24 (87.5%) patients with S. Choleraesuis BSI. Five patients (8.7%) had at least one recurrent infection, all with S. Choleraesuis; five patients died. Overall, multi drug resistance (i.e., co-resistance to ampicillin, sulphamethoxazole-trimethoprim and chloramphenicol) was high (42/59 isolates, 71.2%). S. Typhi displayed high rates of decreased ciprofloxacin susceptibility (18/20 isolates, 90.0%), while azithromycin resistance was very common in S. Choleraesuis (17/24 isolates, 70.8%). Two S. Choleraesuis isolates were extended spectrum beta-lactamase producer.<h4>Conclusions and significance</h4>Resistance rates in Salmonella spp. in Cambodia are alarming, in particular for azithromycin and ciprofloxacin. This warrants nationwide surveillance and revision of treatment guidelines.https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001933&type=printable |
| spellingShingle | Erika R Vlieghe Thong Phe Birgit De Smet Chhun H Veng Chun Kham Sophie Bertrand Raymond Vanhoof Lut Lynen Willy E Peetermans Jan A Jacobs Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. PLoS Neglected Tropical Diseases |
| title | Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. |
| title_full | Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. |
| title_fullStr | Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. |
| title_full_unstemmed | Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. |
| title_short | Azithromycin and ciprofloxacin resistance in Salmonella bloodstream infections in Cambodian adults. |
| title_sort | azithromycin and ciprofloxacin resistance in salmonella bloodstream infections in cambodian adults |
| url | https://journals.plos.org/plosntds/article/file?id=10.1371/journal.pntd.0001933&type=printable |
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