The Emergence of Reduced Ciprofloxacin Susceptibility in<i>Salmonella enterica</i>Causing Bloodstream Infections in Rural Ghana

Eibach, Daniel; Al‐Emran, Hassan M.; Dekker, Denise; Krumkamp, Ralf; Adu‐Sarkodie, Yaw; Espinoza, Ligia María Cruz; Ehmen, Christa; Boahen, Kennedy Gyau; Heisig, Peter; Im, Justin; Jaeger, Anna; Kalckreuth, Vera von; Pak, Gi Deok; Panzner, Ursula; Park, Se Eun; Reinhardt, Alexander; Sarpong, Nimako; Schütt-Gerowitt, Heidi; Wierzba, Thomas F.; Marks, Florian; May, Jürgen

doi:10.1093/cid/civ757

Cited by 35 publications

(44 citation statements)

References 33 publications

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“… 41 Low MDR and/or reduced fluoroquinolone susceptibility has also been documented in West African countries, such as Senegal and Ghana. 41 , 42 Our findings are also consistent with MDR S. Typhi isolates reported in several sites in sub-Saharan Africa, and reduced susceptibility to ciprofloxacin identified in S. Typhi from Kibera, Kenya, and Pietermaritzburg, South Africa in recent time. 3 …”

Section: Discussionsupporting

confidence: 88%

Typhoid Fever: Tracking the Trend in Nigeria

Akinyemi

Oyefolu

Mutiu

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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Abstract.Typhoid fever continues to pose a serious health challenge in developing countries. A reliable database on positive blood cultures is essential for prompt interventions. To generate reliable data on Salmonella enterica serovar Typhi (S. Typhi)–positive blood culture trends in typhoidal Salmonella in Nigeria alongside changing contextual factors and antimicrobial resistance patterns, a retrospective cohort study was conducted in two hospitals in Lagos between 1993 and 2015. Medical records of typhoid patients were reviewed for positive culture and antibiogram, using standard procedures and analyzed. Additional data were retrieved from a previous study in seven facilities in Abuja and three hospitals in Kano from 2008 to 2017 and 2013 to 2017, respectively. A declining trend in percent positivity of S. Typhi was observed in Abuja with more erratic trends in Lagos and Kano. In Lagos, more than 80% of the isolates from the entire study period exhibited multiple drug resistance with a generally increasing trend. Of the chosen contextual factors, improvements were recorded in female literacy, access to improved water supply, diarrheal mortality in children younger than 5 years, gross domestic product, and poverty while access to improved sanitation facilities decreased over time nationally. Typhoid fever still poses a serious health challenge in Nigeria and in antibiotic resistance, and is a major health security issue. A combined approach that includes the use of typhoid vaccines, improvements in sanitation, and safe water supply is essential.

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Section: Discussionsupporting

confidence: 88%

Typhoid Fever: Tracking the Trend in Nigeria

Akinyemi

Oyefolu

Mutiu

et al. 2018

The American Journal of Tropical Medicine and Hygiene

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“…The fluoroquinolone resistance rate in this study is comparable to rates in other countries such as Palestine (15%), Philippines (14.9%), and Finland (21.3%) while it is higher than that in USA (2.4%), Hong Kong (7.1%), Sri Lanka (8%), and Ghana (6.6%). 1 , 4 , 5 , 19 - 21 In addition, it is lower than fluoroquinolone resistance rates in other countries such as Taiwan (48.1%), Thailand (46.2%), Romania (60%), and Korea (36.5%). 3 , 5 , 18 Plasmid mediated quinolone resistance genes, qnrB and qnrS , were detected in 8 strains while fluoroquinolone resistance mechanisms could not be identified in 21 strains.…”

Section: Discussionmentioning

confidence: 91%

“… 10 , 23 Plasmid mediated quinolone resistance genes can also be encoded with other antimicrobial resistance determinants such as ESBL limiting the therapeutic options. 1 , 4 …”

Section: Discussionmentioning

confidence: 99%

“… 1 - 3 Although most cases of salmonellosis are uncomplicated it can be very serious and life-threatening in infants, elderly, and immuocompromised patients and may require antibiotic treatment. 1 , 4 Fluoroquinolones and cephalosporins are the drugs of choice for invasive salmonellosis treatment. 1 , 5 …”

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confidence: 99%

“… 11 - 13 According to literature, these β-lactamases can be co-harbored on plasmids along with PMQR genes. 1 , 4 There are few reports of Salmonella infections and antibiotic resistance in Saudi Arabia. 14 , 15 In addition, there are no reports delineating the molecular mechanisms of fluoroquinolones and/or β-lactam resistance in Salmonella strains from Saudi hospitals.…”

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confidence: 99%

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First description of plasmid mediated quinolone resistance genes in salmonella isolates from Saudi hospitals

Aljindan

Hussein

Khoudair

et al. 2018

SMJ

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Objectives:To detect resistance genes to fluoroquinolones and β-lactams in Salmonella strains from a Saudi hospital.Methods:From October 2015 to December 2016, a total of 149 Salmonella strains were collected from stool specimens from patients admitted to King Fahad Hospital of the University, AlKhobar, Saudi Arabia using CHROMagar Salmonella. The organism identification and antimicrobial susceptibility testing were performed using Vitek 2 system. Strain serogrouping was performed using Wellcolex color Salmonella kit. Fluoroquinolone resistance genes, extended-spectrum β-lactamases (ESBLs), and AmpC β-lactamase were determined using polymerase chain reaction (PCR). Enterobacterial repetitive intergenic consensus sequence-based PCR (ERIC-PCR) was used to determine clonal relatedness.Results:The resistance rates to cefotaxime were 1.3% and ciprofloxacin 19.5%. Plasmid mediated quinolone resistance (PMQR) genes, qnrB and qnrS, were detected in 8 strains, qnrB (n=5) and qnrS (n=3), respectively. No ESBLs, AmpC, or mutations in the topoisomerases were detected. Salmonella isolates formed 7 clusters with similarity.Conclusions:This study reveals the emergence of fluoroquinolone resistant Salmonella in the region imposing public health concerns.

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