Prevalence of fluoroquinolone-resistant Salmonella serotypes in Iran: a meta-analysis

Antimicrobial use regulations are associated with increased susceptibility among bovine Salmonella isolates from a U.S. surveillance system

Health authorities around the world have called to limit antimicrobial use in food-producing animals. In the United States, two recent regulatory actions have changed the use of antimicrobials in livestock, banning production uses in 2017 and restricting extra-label use of cephalosporins in 2012. This study aimed to assess the impact of the 2012 and 2017 regulations on antimicrobial use in cattle in the United States by analyzing 18,627 bovine Salmonella AMR susceptibility patterns using data from the National Antimicrobial Resistance Monitoring System (NARMS). Logistic regression was used to model the odds of being a susceptible isolate. Additionally, interval-censored accelerated failure time (AFT) models were used to analyze changes in minimum inhibitory concentrations (MICs) over time and by serotype. The most common serotypes were Montevideo (n = 3003), Anatum (n = 1394), Cerro (n = 1373), and Typhimurium (n = 1213). Susceptibility was highest for azithromycin (99 %), ciprofloxacin, gentamicin, and trimethoprim-sulfamethoxazole (all 98 %), and lowest for tetracycline (76 %), chloramphenicol (86 %), and ampicillin (85 %). Serotypes Typhimurium, Newport, and Dublin exhibited lower susceptibility compared to other serotypes. Susceptibility to all antimicrobials increased during the periods 2013-2017 and 2018-2022 compared to isolates before 2012, with a greater increase in 2018-2022. MICs decreased for most antimicrobials except for chloramphenicol and gentamicin, which showed increased median MIC for the periods 2013-2017 and 2018-2022, respectively. In conclusion, antimicrobial use restrictions appear correlated with a reduction in Salmonella AMR, although this effect cannot be untangled from the effect of time in this dataset.

Antibiotic-Resistant Salmonella Circulation in the Human Population in Campania Region (2010-2023)

Background/Objectives: A retrospective study was conducted to evaluate antibiotic resistance among Salmonella strains isolated during human infection using data from the computer database (SIGLA) of the Salmonella Typing Center (Ce.Ti.Sa) of the Istituto Zooprofilattico del Mezzogiorno (IZSM). Methods: From 2010 to 2023, the Ce.Ti.Sa laboratory tested 680 Salmonella strains against the following: amoxicillin/clavulanic acid, ampicillin, azithromycin, cefixime, cefoxitin, cefotaxime, ceftazidime, chloramphenicol, ciprofloxacin, colistin, erythromycin, gentamicin, kanamycin, meropenem, nalidixic acid, pefloxacin, streptomycin, sulfisoxazole, sulfonamides, tetracyclines, tigecycline, and trimethoprim. Results: The most common serovars were S. monophasic Typhimurium (23.2%), S. Enteritidis (16.8%), and S. Typhimurium (16.0%). Nearly all strains were resistant to azithromycin (99.4%) and showed high resistance to sulphonamides, tetracycline, streptomycin, and ampicillin. The study found that 45.8% of strains exhibited multidrug resistance. Resistance to ciprofloxacin increased over time. Serovar-specific resistance varied: S. monophasic Typhimurium was resistant to azithromycin (100.0%), tetracycline (93.0%), and ampicillin (92.4%); S. Enteritidis showed 100.0% resistance to azithromycin; S. Typhimurium had high resistance to azithromycin, streptomycin, and ampicillin; and S. Infantis was resistant to erythromycin, sulfonamides, and azithromycin. Conclusions: The study highlights a troubling prevalence of Salmonella-resistant strains, emphasizing the need for infection prevention, proper antibiotic use in humans and animals, and the development of new antibiotics.

Evaluation of multi-drug resistance, virulence factors, and antimicrobial resistance genes of non-typhoidal Salmonella isolated from ruminants as a potential human health threat in Razavi Khorasan, northeastern Iran

Non-typhoidal Salmonella (NTS) is a significant foodborne pathogen that poses a threat to human health by causing infections and potentially acquiring antibiotic resistance. We evaluated thirty-five Salmonella serovars previously isolated from cattle, sheep, goats, and their retail meat in Razavi Khorasan Province, Iran. The isolates were confirmed with Salmonella polyvalent antiserum. Furthermore, PCR was used to identify the Salmonella Enteritidis, Salmonella Typhimurium, and the host-adapted serovars Salmonella Dublin and Salmonella Abortusovis. Additionally, the antimicrobial susceptibility of the serovars was evaluated using the disk diffusion method. Subsequently, the occurrence of antimicrobial resistance genes and virulence factors was evaluated using the PCR technique. Molecular typing revealed that 20 % of the isolates were S. Typhimurium, 11.4 % were S. Dublin, 8.6 % were S. Enteritidis, 5.7 % were S. Abortusovis, and 54.3 % (19 isolates) were classified as non-typed serovars. Salmonella isolates showed high susceptibility to ciprofloxacin (91.4 %), colistin (88.6 %), gentamicin (88.6 %), and cefotaxime (85.7 %) while exhibiting high resistance to others such as ampicillin (88.6 %), streptomycin (74.3 %), and tetracycline (51.4 %). The most prevalent resistance genes in non-typhoidal Salmonella (NTS) are blaTEM (91.4 %), sul1 (65.7 %), and aadA (54.3 %). Additionally, twenty-five isolates (71.4 %) showed multi-drug resistance profiles. The most frequent virulence genes are stn (100 %), iroN (100 %), and pefA (42.9 %). The current study has revealed that Salmonella serovars isolated from sheep and goats, like those from cattle, exhibit multi-drug resistance and harbor antimicrobial resistance genes. Additionally, they possess diverse virulence factors that can threaten human health by spreading diseases and developing drug resistance, leading to antibiotic treatment failure.

Antibiotic resistance patterns, characteristics of virulence and resistance genes and genotypic analysis of Salmonella serotypes recovered from different sources

The present study evaluated the Salmonella isolates obtained from various origins in Iran. Salmonella strains previously recovered and stored in the veterinary microbiology laboratory were serotyped and subjected to antibiotic susceptibility test, detection of the virulence and resistance genes by polymerase chain reaction (PCR), and genotyping by enterobacterial repetitive intergenic consensus-polymerase chain reaction (ERIC-PCR). All Salmonella isolates showed resistance to erythromycin and the most resistance rates were detected for trimethoprim (86.66%), ampicillin (75.00%), and sulfamethoxazole-trimethoprim (63.33%), respectively. In total, 86.33% of the isolates were known as multi-drug resistant and none of the isolates showed resistance to cefepime, nalidixic acid, imipenem, ceftriaxone, and polymyxin B. The virulence genes, invA, sdiA, and hilA besides the tetA resistance gene were identified in all 60 Salmonella strains. The most prevalent resistance genes were respectively tetC (70.00%), sul2 (58.33%), and ereA (55.00%). Statistical analysis revealed a significant difference between Salmonella serotypes associated with the sul1 resistance gene. In ERIC-PCR analysis, 14 distinct clusters were obtained. Statistically, there were significant relationships between the source and ERIC's genomic pattern and between the serotype of Salmonella isolates and genotypic pattern of ERIC. According to the results, Salmonella serotypes from non-human sources had considerable resistance to different antibiotics and carried significant virulence determinants and resistance genes. In addition, ERIC-PCR showed relevant results in discriminating Salmonella serotypes from other sources.

Salmonella in the food chain within the Gulf Cooperation Council countries

Infections caused by bacteria originating from tainted food sources are a widespread concern due to their large economic impact and detrimental effects on public health. We aimed to explore literature focusing on the presence of Salmonella in the food supply chains of Gulf Cooperation Council (GCC) countries and to provide an overview of available information concerning health-related issues and the status of salmonellosis in humans in GCC countries. The reviewed evidence underscored a gap in our comprehensive understanding of the prevalence of Salmonella in the food supply of GCC countries. Molecular characterization efforts to pinpoint the sources of Salmonella in these nations were limited. Surveys targeting Salmonella in the food supply of GCC countries have been infrequent. While qualitative data indicated the presence or absence of Salmonella, there was a noticeable lack of quantitative data detailing the actual quantities of these bacteria in chicken meat supplies across GCC countries. Although reports regarding Salmonella in animal-derived foods were common, the literature highlighted in this review emphasized the persistent challenge that Salmonella pose to food safety and public health in GCC countries. Addressing this issue requires concerted efforts to enhance surveillance, improve control measures, and promote greater awareness among stakeholders in the food supply chain.

Carbapenem-resistant Enterobacterales in wastewater resources and healthy carriers: A survey in Iran

The carbapenem-resistant Enterobacterales (CRE) pose a pressing public health concern. Here, we investigated the frequency of CRE bacteria, carbapenemase-encoding genes, and the molecular epidemiology of carbapenemase-resistant Escherichia coli in wastewater resources and healthy carriers in Iran. Out of 617 Enterobacterales bacteria, 24% were carbapenem-resistant. The prevalence of CRE bacteria in livestock and poultry wastewater at 34% and hospital wastewater at 33% was significantly higher (P ≤ 0.05) than those in healthy carriers and municipal wastewater at 22 and 17%, respectively. The overall colonization rate of CRE in healthy individuals was 22%. Regarding individual Enterobacterales species, the following percentages of isolates were found to be CRE: E. coli (18%), Citrobacter spp. (24%), Klebsiella pneumoniae (28%), Proteus spp. (40%), Enterobacter spp. (25%), Yersinia spp. (17%), Hafnia spp. (31%), Providencia spp. (21%), and Serratia spp. (36%). The blaOXA-48 gene was detected in 97% of CRE isolates, while the blaNDM and blaVIM genes were detected in 24 and 3% of isolates, respectively. The B2 phylogroup was the most prominent group identified in carbapenem-resistant E. coli isolates, accounting for 80% of isolates. High prevalence of CRE with transmissible carbapenemase genes among healthy people and wastewater in Iran underscores the need for assertive measures to prevent further dissemination.

In Vitro Assessment of Antimicrobial Activity of Novel Fluoroquinolone, Levonadifloxacin (WCK 771) Against Multi-Drug-Resistant Clinical Isolates from Cancer Patients in India

Introduction: Rapid increase in antimicrobial-resistance is leading to urgent need for newer broad-spectrum antimicrobials. Therefore, we have evaluated the antimicrobial résistance spectrum of India-discovered novel antibiotics (levonadifloxacin) against clinical isolates recovered from cancer patients. Materials and Methods: The study was conducted in the microbiology department, over a period of 1 year between May 2021 and June 2022 and 374 consecutive and nonduplicate Gram-positive (GPC) and MDR Gram Negative Bacteria (GNB) isolate were analyzed from 3,880 cancer patients in study. The identification and antimicrobial sensitivities of bacterial isolates were performed according to standard laboratory protocols by using automated identification system (VITEK-2-8.01; BioMérieux, Germany). The activity of levonadifloxacin and comparator antibiotics was evaluated using disk diffusion methods as per Clinical and Laboratory Standards Institute 2022 guidelines. Results: The mean age of the patients were 51.6 ± 14.59 years with male: female ratio of 1.2:1. The prevalence of GPC was 167 (44.65%) and MDR-GNB was 207 (55.34%). The most common GPC was Staphylococcus aureus; 97 (58.08%) followed by Enterococcus species 66 (39.52%). In GNB, Escherichia coli; 93 (44.92%) was the most common followed by Klebsiella pneumoniae; 45 (21.73%). Levonadifloxacin susceptibility was present in 98.7% methicillin-resistant S. aureus and 96% methicillin-susceptible S. aureus and 77.1% Enterococcus-species. Additionally, all the fluoroquinolones-resistant S. aureus isolates were susceptible to levonadifloxacin (WCK-771) except one isolate. Also, levonadifloxacin-(WCK-771) exhibits 100% susceptibility fluoroquinolone susceptible GNB, such as E. coli, K. pneumoniae, Pseudomonas species, and Acinetobacter species. Interestingly, all fluoroquinolones-resistant Salmonella species and Stenotrophomonas maltophilla exhibited 100% susceptibility to levonadifloxacin (WCK-771). Conclusion: Levonadifloxacin (WCK-771) possesses potent activity against all the MDR Gram-positive pathogens including the coverage of susceptible Enterobacterales and MDR S. maltophilla and Burkholderia cepacia suggesting its potential utility in the management of polymicrobial infections.

Prevalence of Salmonella infection in village chickens and determination of the tetracycline resistance genes in the Salmonella isolates in the Sistan region, Iran

Recently, an increasing number of multi drug resistant Salmonella species have been emerged due to overuse of antibiotics in veterinary and human medicine which has adverse consequences on public health. The present study was conducted with the aim of investigating the prevalence of Salmonella infection in village chickens in Sistan region and determining the prevalence of the antibiotic resistance genes in Salmonella isolated from these birds. In this study, 100 chickens were randomly selected from five counties of Sistan region. A cloacal swab sample was taken from each bird and also information about age, gender, breed, proximity with other birds, proximity with waterfowl, proximity with livestock, and receiving different antibiotics especially tetracycline were obtained using a questionnaire. Conventional culture methods used for Salmonella detection and isolation. Then, amplification of invA gene by PCR was used to confirm Salmonella colonies. Finally, 27 samples were confirmed to be infected with Salmonella by both culture and PCR methods. Disk diffusion method was used to determine the sensitivity to 4 antibiotics including; tetracycline, gentamicin, cefepime, and difloxacin. The results of the present study showed that proximity to waterfowl (OR = 0.273) significantly mitigates the risk of Salmonella infection. For the isolates, the highest resistance was recorded against cefepime and the highest susceptibility was to difloxacin. The presence proportion of tetA and tetB in tetracycline resistant isolates was higher than that in susceptible ones but this difference was not statistically significant.

Prevalence of Salmonella Typhimurium and Salmonella Enteritidis isolated from poultry meat: virulence and antimicrobial-resistant genes

Salmonellosis, a zoonotic disease, is one of the leading causes of foodborne illness worldwide. It is responsible for most infections caused by consumption of contaminated food. In recent years, a significant increase in the resistance of these bacteria to common antibiotics has been observed, posing a serious threat to global public health. The aim of this study was to investigate the prevalence of virulent antibiotic-resistant Salmonella spp. strains in Iranian poultry markets. A total of 440 chicken meat samples were randomly selected from meat supply and distribution facilities in Shahrekord and tested for bacteriological contamination. After culturing and isolating the strains, identification was performed using the classical bacteriological method and PCR. To determine antibiotic resistance, a disc diffusion test was performed according to the recommendations of the French Society of Microbiology. PCR was used to detect resistance and virulence genes. Only 9% of the samples were positive for Salmonella. These were Salmonella typhimurium isolates. All Salmonella typhimurium serotypes tested positive for the rfbJ, fljB, invA and fliC genes. Resistance to TET, cotrimoxazole, NA, NIT, piperacillin/tazobactam and other antibiotics was found in 26 (72.2%), 24 (66.7%), 22 (61.1%) and 21 (58.3%) isolates, respectively. The sul1, sul2 and sul3 genes were present in 20, 12 and 4 of 24 cotrimoxazole-resistant bacteria, respectively. Chloramphenicol resistance was found in six isolates, but more isolates tested positive for the floR and cat two genes. In contrast, 2 (33%) of the cat three genes, 3 (50%) of the cmlA genes and 2 (34%) of the cmlB genes were all positive. The results of this investigation showed that Salmonella typhimurium is the most common serotype of the bacterium. This means that most of the antibiotics commonly used in the livestock and poultry industries are ineffective against most Salmonella isolates, which is important for public health.

Current State of Knowledge Regarding WHO High Priority Pathogens-Resistance Mechanisms and Proposed Solutions through Candidates Such as Essential Oils: A Systematic Review

Combating antimicrobial resistance (AMR) is among the 10 global health issues identified by the World Health Organization (WHO) in 2021. While AMR is a naturally occurring process, the inappropriate use of antibiotics in different settings and legislative gaps has led to its rapid progression. As a result, AMR has grown into a serious global menace that impacts not only humans but also animals and, ultimately, the entire environment. Thus, effective prophylactic measures, as well as more potent and non-toxic antimicrobial agents, are pressingly needed. The antimicrobial activity of essential oils (EOs) is supported by consistent research in the field. Although EOs have been used for centuries, they are newcomers when it comes to managing infections in clinical settings; it is mainly because methodological settings are largely non-overlapping and there are insufficient data regarding EOs' in vivo activity and toxicity. This review considers the concept of AMR and its main determinants, the modality by which the issue has been globally addressed and the potential of EOs as alternative or auxiliary therapy. The focus is shifted towards the pathogenesis, mechanism of resistance and activity of several EOs against the six high priority pathogens listed by WHO in 2017, for which new therapeutic solutions are pressingly required.

Prevalence of and factors associated with postnatal depression and anxiety among parents of preterm infants: A systematic review and meta-analysis

BACKGROUND

This study aimed to determine the prevalence of and factors associated with postpartum depression and anxiety among mothers and fathers of preterm infants and to examine the relationships between maternal and paternal symptoms.

METHODS

Six electronic databases were searched to identify eligible studies reporting parental depression and anxiety within 1 year postpartum. Data were extracted for a random-effects meta-analysis to estimate the prevalence with 95 % confidence intervals (CIs). Subgroup and meta-regression analyses were conducted to analyze associations between study characteristics and prevalence estimates.

RESULTS

In total, 79 studies were included. The meta-analysis of studies on mothers generated estimates of prevalence for depression (29.2 %, 95 % CI, 21.8 %-37.9 %) and anxiety (37.7 %, 95 % CI, 24.1 %-53.6 %). The meta-analysis of fathers indicated a pooled depression prevalence of 17.4 % (95 % CI, 12.5 %-23.8 %) and an anxiety estimate of 18.3 % (95 % CI, 8.1 %-36.3 %). Assessment time points and methods as well as the geographic continent in which the study was conducted were significant moderators of depression and anxiety. Significant inter-correlations were found between mothers' and fathers' depression and anxiety symptoms (p < 0.05).

LIMITATIONS

Limited data from specific geographic continents, including Africa and Asia.

CONCLUSIONS

Prevalence of depression and anxiety among preterm infants' parents was high, highlighting the need for early psychological screening and assessment. Further research is required to improve services that focus on parents' postpartum psychological needs in the family context.

Frequency of Salmonella serotypes among children in Iran: antimicrobial susceptibility, biofilm formation, and virulence genes

BACKGROUND/SIGNIFICANCE

Salmonella gastroenteritis causes significant morbidity among pediatric patients, mainly in developing world, such as the Middle East and North Africa (MENA) region. Concurrently, data from MENA countries like Iran, regarding prevalence of Salmonella serotypes, antimicrobial susceptibility, and biofilm production is scarce.

MATERIAL & METHODS

Slide agglutination was used to determine the serogroup of 140 Salmonella isolates recovered from 4477 stool specimens collected from children with gastroenteritis, and isolates were serotyped by PCR assay. The antimicrobial susceptibility of isolates to five first line drugs was assessed by disk diffusion assay using CLSI guidelines. Semi-quantitative evaluation of biofilm production was done by microtiter plate assay followed by PCR detection of biofilm-associated virulence genes csgD, pefA, and bcsA for each isolate.

RESULTS

Nearly 94% of Salmonella isolates were recovered from ≤ 5-year-old patients, and 99% of isolates were non-typhoidal. While we found extensive diversity among Salmonella isolates, serogroup D (46%) predominated, and Salmonella Enteritidis (41%) was the most common serotype that showed the highest antimicrobial susceptibility rate (> 96%). For the first time in Iran, S. Newport serotype from human specimens was isolated. Most isolates were sensitive to all test antimicrobials, but 35% of isolates were not-typed (NT) that showed the highest resistance with 48% being resistant to ≥ 1 test antimicrobial. Majority of isolates made weak (or no) biofilm, and we found a weak association between antimicrobial susceptibility, biofilm production, or virulence genes csgD, pefA, and bcsA.

CONCLUSIONS

The most effective measure that may control pediatric salmonellosis outbreaks is raising awareness of parents of preschoolers about food safety. Isolation of highly diverse Salmonella serotypes, including many commonly isolated from animals, indicates widespread contamination of the food chain. Majority of serotypes were sensitive to first-line antimicrobials, thus presently, pediatric Salmonella infections in this region may be controlled by conventional antimicrobials. However, despite the current trend, an imminent emergence of resistant Salmonella strains is foreseen, since various serotypes resistant to > 1 antimicrobial agent are typically associated with animals. Our results warrant further investigation that includes correlation analysis of clinical data regarding treatment outcomes, and serotype attributes like virulence genes.

Molecular Characterization of Quinolone Resistance Determinants in Non-Typhoidal Salmonella Strains Isolated in Tehran, Iran

Background: Quinolone resistant Salmonella serotypes have been reported in recent years and have become increasingly widespread worldwide. Objectives: We evaluated the molecular mechanism of quinolone resistance in non-typhoidal Salmonella strains isolated from clinical samples in Tehran, Iran. Methods: The present study included the Salmonella isolates originated from hospitalized individuals and outpatients in Tehran, Iran. Serotyping of nalidixic acid-resistant Salmonella isolates was done by slide agglutination method. Then, the quinolone resistance-determining region (QRDR) of topoisomerase gene gyrA and the plasmid-mediated quinolone resistance (PMQR) determinants were detected using the polymerase chain reaction (PCR) method. Restriction fragment length polymorphism (RFLP) analysis was also employed to determine the possible mutation in the gyrA gene of those strains. Mutant strains were detected by enzymatic digestion, and their PCR products were sequenced immediately. Results: Amongst 141 isolates, 60% showed nalidixic acid resistance, whereas none of them were ciprofloxacin-resistant. The commonly prevalent serotypes were S. Enteritidis and S. Infantis. Of 85 nalidixic acid-resistant strains, 17 (20%) isolates harbored the qnrS gene. However, PCR analysis of the quinolone-resistant strains did not detect qnrA and qnrB genes. PCR-RFLP and sequencing analysis of the QRDRs of the gyrA gene indicated that 16 (18.8%) isolates had mutant patterns, and the most common point mutation was serine to phenylalanine at position 83. Conclusions: Our results demonstrated that point mutations in gyrA and the existence of plasmid-mediated gene qnrS were important mechanisms of quinolone resistance in non-typhoidal Salmonella strains isolated from human origin. Other alternative mechanisms of resistance, such as alterations in the expression of efflux pumps, should be studied to provide greater insight into the molecular mechanism of quinolone-resistant non-typhoidal Salmonella isolates.

Prevalence and drug resistance patterns of Gram-negative enteric bacterial pathogens from diarrheic patients in Ethiopia: A systematic review and meta-analysis

Background

Diarrhoea is the leading cause of morbidity and mortality in the world particularly in developing countries and among vulnerable groups of the population. Gram-negative enteric bacterial pathogens (GNEBPs) are a group of organisms that reside mainly in the intestine and induce diarrhoea. Antimicrobial agents are usually the part of their treatment regimen. The therapeutic effect of antimicrobials is hindered by the emergence and spread of drug-resistant strains. The information regarding the prevalence and antimicrobial resistance patterns of GNEBPs in Ethiopia is limited and found in a scattered form.

Objectives

This study was designed to determine the pooled prevalence and drug resistance patterns of GNEBPs by meta-analysis of data from diarrhoeic patients in Ethiopia.

Method

A comprehensive literature search was conducted through internet searches using Google Scholar, PubMed, Science Direct, HINARI databases, and reference lists of previous studies. Published articles were included in the study based on priorly set inclusion and exclusion criteria. Results were presented in the forest plot, tables, and figures with a 95% confidence interval (CI). The inconsistency index (I²) test statistics was used to assess heterogeneity across studies. The pooled prevalence estimate of GNEBPs and their drug resistance patterns were computed by a random-effects model. Software for Statistics and Data Science (STATA) version 14 statistical software was used for the analysis.

Result

After removing those articles which did not fulfil the inclusion criteria, 43 studies were included in the analysis. Studies were conducted in 8 regions of the country and most of the published articles were from the Amhara region (30.23%) followed by Oromia (18.60%) and Southern Nations, Nationalities, and Peoples’ region (SNNP) (18.60%). The pooled prevalence of GNEBPs was 15.81% (CI = 13.33–18.29). The funnel plot indicated the presence of publication bias. The pooled prevalence of GNEBPs in Addis Ababa, Amhara, SNNP, and Oromia regions were 20.08, 16.67, 12.12, and 11.61%, respectively. The pooled prevalence was 14.91, 18.03, and 13.46% among studies conducted from 2006–2010, 2011–2015, and 2016–2021, respectively and it was the highest (20.35%) in children having age less than or equal to 15 years. The pooled prevalence of Escherichia coli, Campylobacter spp., Shigella spp., and Salmonella enterica were 19.79, 10.76, 6.24, and 5.06%, respectively. Large proportions (60–90%) of the isolates were resistant to ampicillin, amoxicillin, tetracycline, and trimethoprim-sulphamethoxazole. The pooled prevalence of multidrug resistance (MDR) was 70.56% (CI = 64.56–76.77%) and MDR in Campylobacter spp., Shigella spp., E. coli, and S. enterica. were 80.78, 79.08, 78.20, and 59.46%, respectively.

Conclusion

The pooled estimate showed a high burden of GNEBPs infections and a high proportion of drug resistance characters to commonly used antimicrobial agents in Ethiopia. Therefore, performing drug susceptibility tests, establishing an antimicrobial surveillance system and confirmation by molecular techniques are needed.

Antimicrobial Resistance and Whole-Genome Characterisation of High-Level Ciprofloxacin-Resistant Salmonella Enterica Serovar Kentucky ST 198 Strains Isolated from Human in Poland

BACKGROUND

Salmonella Kentucky belongs to zoonotic serotypes that demonstrate that the high antimicrobial resistance and multidrug resistance (including fluoroquinolones) is an emerging problem. To the best of our knowledge, clinical S. Kentucky strains isolated in Poland remain undescribed.

METHODS

Eighteen clinical S. Kentucky strains collected in the years 2018-2019 in Poland were investigated. All the strains were tested for susceptibility to 11 antimicrobials using the disc diffusion and E-test methods. Whole genome sequences were analysed for antimicrobial resistance genes, mutations, the presence and structure of SGI1-K (Salmonella Genomic Island and the genetic relationship of the isolates.

RESULTS

Sixteen of 18 isolates (88.9%) were assigned as ST198 and were found to be high-level resistant to ampicillin (>256 mg/L) and quinolones (nalidixic acid MIC ≥ 1024 mg/L, ciprofloxacin MIC range 6-16 mg/L). All the 16 strains revealed three mutations in QRDR of GyrA and ParC. The substitutions of Ser83 → Phe and Asp87 → Tyr of the GyrA subunit and Ser80→Ile of the ParC subunit were the most common. One S. Kentucky isolate had qnrS1 in addition to the QRDR mutations. Five of the ST198 strains, grouped in cluster A, had multiple resistant determinants like blaTEM1-B, aac(6')-Iaa, sul1 or tetA, mostly in SGI1 K. Seven strains, grouped in cluster B, had shorter SGI1-K with deletions of many regions and with few resistance genes detected.

CONCLUSION

The results of this study demonstrated that a significant part of S. Kentucky isolates from humans in Poland belonged to ST198 and were high-level resistant to ampicillin and quinolones.

Antimicrobial efficacy of Cecropin A (1-7)- Melittin and Lactoferricin (17-30) against multi-drug resistant Salmonella Enteritidis

The present study evaluated intracellular antibacterial efficacy of two short-chain cationic antimicrobial peptides (AMPs) namely, Cecropin A (1-7)-Melittin and lactoferricin (17-30) against three field strains of multi-drug resistant Salmonella Enteritidis. Initially, antimicrobial ability of both the AMPs was evaluated for their minimum inhibitory concentration (MIC) and minimum bactericidal concentration (MBC) against multi-drug resistant S. Enteritidis strains. Besides, the AMPs were evaluated for its in vitro stability (high-end temperatures, proteases, physiological concentrations of cationic salts and pH) and safety (haemolytic assay in sheep erythrocytes; cytotoxicity assay in murine macrophage RAW 264.7 cell line and human epithelioma HEp-2 cell line and beneficial gut lactobacilli). Later, a time-kill assay was performed to assess the intracellular antibacterial activity of Cecropin A (1-7)-Melittin and lactoferricin (17-30) against multi-drug resistant S. Enteritidis in RAW 264.7 and HEp-2 cells. The observed MBC values of Cecropin A (1-7)-Melittin and lactoferricin (17-30) against multi-drug resistant S. Enteritidis (128 μM; 256 μM) were generally twice or four-fold greater than the MIC values (64 μM). Further, both the AMPs were found variably stable after exposure at high-end temperatures (70 °C and 90 °C), protease treatment (trypsin, proteinase K, lysozyme), higher concentration of physiological salts (150 mM NaCl and 2 mM MgCl₂) and hydrogen ion concentrations (pH 4.0 to 8.0). Both the AMPs were found non-haemolytic on sheep erythrocytes, revealed minimal cytotoxicity in RAW 264.7 and HEp-2 cells, and was tested safe against beneficial gut lactobacilli (L. acidophilus and L. rhamnosus). Intracellular bacteriostatic effect with both cationic AMPs against multi-drug resistant S. Enteritidis was evident in RAW 264.7 cells; however, in both the cell lines, the significant bactericidal effect was not observed (P > 0.05) with both cationic AMPs understudy against multi-drug resistant S. Enteritidis. Based on the results of the present study, both the cationic AMPs understudy may not be useful for the intracellular elimination of multi-drug resistant S. Enteritidis; hence, further studies such as conjugation of these AMPs with either cell-penetrating peptides (CPP) and/or nanoparticles (NPs) are warranted.

Antibiotic resistance profiles of Salmonella serotypes isolated from animals in Iran: a meta-analysis

BACKGROUND

Salmonella infection (salmonellosis) is a zoonotic bacterial disease. Widespread use of antibiotics in livestock and poultry production for different purposes such as treatment and growth promotion has led to the emergence of antibiotic-resistant Salmonella, causing treatment of Salmonella infections more difficult with each passing year.

AIMS

To determine the antibiotic resistance prevalence of Salmonella serotypes isolated from animals in different provinces of Iran.

METHODS

To find eligible articles, we searched the international and national electronic databases using appropriate keywords in English and Persian.

RESULTS

After applying predefined criteria, 54 articles reporting antibiotic resistance profiles of Salmonella serotypes were included. Salmonella isolates were mostly resistant against nalidixic acid (67%), tetracycline (66.9%), and streptomycin (49.6%), followed by trimethoprim/sulfamethoxazole (41.6%) and kanamycin (23.6%). The highest sensitivity was observed against imipenem, meropenem, and cefepime with 1.7%, 1.4%, and 1.9% of all isolates being resistant, respectively.

CONCLUSION

Results revealed that the prevalence of resistant isolates to nalidixic acid, tetracycline and streptomycin is high and their use must be restricted. In addition, resistance to other antibiotics such as chloramphenicol, ampicillin, cephalothin, cefixime, and enrofloxacin is at an alarming level that calls for attention in the future infection control and antibiotic stewardship programs.