Resistance to third-generation cephalosporins in human non-typhoidal Salmonella enterica isolates from England and Wales, 2010–12

Objectives To identify the mechanism(s) underlying cefotaxime resistance in 118 of 21 641 (0.55%) non-typhoidal Salmonella enterica isolates collected from humans throughout England and Wales from January 2010 to September 2012. Methods Non-duplicate isolates (n = 118) resistant to cefotaxime (MICs...

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Bibliographic Details
Published in:Journal of antimicrobial chemotherapy 2014-04, Vol.69 (4), p.977-981
Main Authors: Burke, Liam, Hopkins, Katie L., Meunier, Daniele, de Pinna, Elizabeth, Fitzgerald-Hughes, Deirdre, Humphreys, Hilary, Woodford, Neil
Format: Article
Language:English
Subjects:
Alleles
Animals
Anti-Bacterial Agents - pharmacology
Bacteria
Bacterial infections
Bacterial Proteins - genetics
beta-Lactam Resistance
beta-Lactamases - genetics
Cefotaxime - pharmacology
Cephalosporins - pharmacology
DNA, Bacterial - chemistry
DNA, Bacterial - genetics
Drug resistance
England - epidemiology
Genes
Humans
Microbial Sensitivity Tests
Prevalence
Salmonella enterica
Salmonella enterica - drug effects
Salmonella enterica - isolation & purification
Salmonella Infections - epidemiology
Salmonella Infections - microbiology
Salmonella Infections, Animal - epidemiology
Salmonella Infections, Animal - microbiology
Sequence Analysis, DNA
Wales - epidemiology
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Summary:Objectives To identify the mechanism(s) underlying cefotaxime resistance in 118 of 21 641 (0.55%) non-typhoidal Salmonella enterica isolates collected from humans throughout England and Wales from January 2010 to September 2012. Methods Non-duplicate isolates (n = 118) resistant to cefotaxime (MICs >1 mg/L) were screened by PCR for genes encoding CTX-M extended-spectrum β-lactamases (ESBLs) and associated ISEcp1-like elements, and for genes encoding acquired AmpC, SHV, TEM, VEB, PER and GES β-lactamases. Sequencing was used to identify specific alleles in selected isolates. Carbapenem resistance was sought by ertapenem disc screening. Results Seventy-nine isolates (0.37% of all referred S. enterica) produced ESBLs, 37 isolates (0.17%) produced CMY-type AmpC enzymes, and 1 isolate had both enzyme types; the mechanism of cefotaxime resistance in 3 isolates could not be identified. Group 1 CTX-M genes were identified in 57 isolates belonging to 22 serotypes, with CTX-M-1 (n = 11), -15 (n = 9) and -55/57 (n = 8) the most prevalent alleles among the 29 (51%) investigated. CTX-M-2 (n = 5), -14 (n = 5), -8 (n = 1) and -65 (n = 1) were also identified. TEM-52 was identified in two isolates and SHV-12 in seven isolates. There was no evidence of carbapenem resistance. ESBL and AmpC genes were detected in both domestically acquired and travel-associated salmonellae. Eighty-nine isolates (75%) were multidrug resistant (resistant to at least three antimicrobial classes) and 42 (36%) had decreased susceptibility to ciprofloxacin (MICs 0.25–1 mg/L), with a further 13 (11%) isolates resistant (MICs >1 mg/L). Conclusions The prevalence of CTX-M and acquired AmpC genes in human non-typhoidal S. enterica from England and Wales is still low, but has increased from 0.03% in 2001–03 to 0.49% in 2010–12. Resistance to third-generation cephalosporins requires monitoring as it may reduce therapeutic options.
ISSN:0305-7453
1460-2091
DOI:10.1093/jac/dkt469