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Khan HA, Neyaz LA, Malak HA, Alshehri WA, Elbanna K, Organji SR, Asiri FH, Aldosari MS, Abulreesh HH. Diversity and antimicrobial susceptibility patterns of clinical and environmental Salmonella enterica serovars in Western Saudi Arabia. Folia Microbiol (Praha) 2024:10.1007/s12223-024-01172-1. [PMID: 38767834 DOI: 10.1007/s12223-024-01172-1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/27/2023] [Accepted: 05/13/2024] [Indexed: 05/22/2024]
Abstract
The diverse environmental distribution of Salmonella makes it a global source of human gastrointestinal infections. This study aimed to detect Salmonella spp. and explore their diversity and antimicrobial susceptibility patterns in clinical and environmental samples. Pre-enrichment, selective enrichment, and selective plating techniques were adopted for the Salmonella detection whereas the API 20E test and Vitek Compact 2 system were used to confirm the identity of isolates. Salmonella serovars were subjected to molecular confirmation by 16S rDNA gene sequencing. Disc diffusion method and Vitek 2 Compact system determined the antibiotic susceptibility of Salmonella serovars. Multiple antibiotic resistance index (MARI) was calculated to explore whether Salmonella serovars originate from areas with heavy antibiotic usage. Results depicted low Salmonella prevalence in clinical and environmental samples (3.5%). The main detected serovars included Salmonella Typhimurium, S. enteritidis, S. Infantis, S. Newlands, S. Heidelberg, S. Indian, S. Reading, and S. paratyphi C. All the detected Salmonella serovars (27) exhibited multidrug resistance to three or more antimicrobial classes. The study concludes that the overall Salmonella serovars prevalence was found to be low in environmental and clinical samples of Western Saudi Arabia (Makkah and Jeddah). However, antimicrobial susceptibility patterns of human and environmental Salmonella serovars revealed that all isolates exhibited multidrug-resistance (MDR) patterns to frequently used antibiotics, which might reflect antibiotic overuse in clinical and veterinary medicine. It would be suitable to apply and enforce rules and regulations from the One Health approach, which aim to prevent antibiotic resistance infections, enhance food safety, and improve human and animal health, given that all Salmonella spp. detected in this investigation were exhibiting MDR patterns.
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Affiliation(s)
- Hajrah A Khan
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Leena A Neyaz
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Hesham A Malak
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Wafa A Alshehri
- Department of Biology, College of Science, University of Jeddah, Jeddah, Saudi Arabia
| | - Khaled Elbanna
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Department of Agricultural Microbiology, Faculty of Agriculture, Fayoum University, Fayoum, Egypt
| | - Sameer R Organji
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia
| | - Fatimah H Asiri
- King Abdulaziz Hospital, Ministry of Health, Makkah, Saudi Arabia
| | | | - Hussein H Abulreesh
- Department of Biology, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.
- Research Laboratories Unit, Faculty of Science, Umm Al-Qura University, Makkah, 21955, Saudi Arabia.
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AL-Mohaithef M. Development, validation and reliability of a questionnaire for assessment of physician's knowledge, attitude and practices (KAPs) regarding foodborne diseases in the Kingdom of Saudi Arabia. F1000Res 2021; 10:470. [PMID: 34900229 PMCID: PMC8630547 DOI: 10.12688/f1000research.52997.2] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 09/01/2021] [Indexed: 11/20/2022] Open
Abstract
Background: The burden of foodborne illness is considered to be high across the world. Based on the Knowledge-Attitude-Practice (KAP) model, physician's awareness is essential for conducting individualized treatments, thus reducing the burden of foodborne illness. However, there have been no validated questionnaires specific to the awareness of physicians with foodborne diseases. This study aims to develop and validate a KAP questionnaire for physicians to assess their awareness about the diagnosis and management of foodborne illness. Methods The questionnaire was developed in three phases: a comprehensive literature review, face and content validity, followed by a reliability test by internal consistency. A cross-sectional study was designed in Abha, Saudi Arabia. Physicians (n=125) were opportunistically recruited from both public and private primary healthcare centers. The questionnaire's content and validity were confirmed by experts in their corresponding fields. After signing the informed consent, the study participants received the questionnaire to evaluate their KAPs on foodborne diseases. Results: A total of 160 physicians from both public and private primary health care centers were approached to enrol 125 study participants into the survey (response rate 78.13%). Of the 31 items designed for assessing the KAP of physicians on foodborne illnesses, three items were excluded after Cronbach's α analysis. In total, 29 items were included in the final set of the questionnaire. Results of different validity and reliability analyses suggest the questionnaire has a high face and content validity as well as good reliability in internal consistency and stability. Conclusions: This study introduces a newly developed questionnaire with good reliability and validity values that can assess physician's awareness of foodborne disease. The awareness questionnaire, as a study instrument, had a favourable acceptance among physicians. It is a sound method for evaluating and measuring levels of foodborne disease-related awareness among physicians in Abha, Saudi Arabia.
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Affiliation(s)
- Mohammed AL-Mohaithef
- Department of Public Health,College of Health Sciences, Saudi Electronic University, Riyadh, post code: 11673, P.O.Box: 93499, Saudi Arabia
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AL-Mohaithef M. Development, validation and reliability of a questionnaire for assessment of physician's knowledge, attitude and practices (KAPs) regarding foodborne diseases in the Kingdom of Saudi Arabia. F1000Res 2021; 10:470. [PMID: 34900229 PMCID: PMC8630547 DOI: 10.12688/f1000research.52997.1] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Accepted: 06/04/2021] [Indexed: 11/09/2023] Open
Abstract
Background: The burden of foodborne illness is considered to be high across the world. Based on the Knowledge-Attitude-Practice (KAP) model, physician's awareness is essential for conducting individualized treatments, thus reducing the burden of foodborne illness. However, there have been no validated questionnaires specific to the awareness of physicians with foodborne diseases. This study aims to develop and validate a KAP questionnaire for physicians to assess their awareness about the diagnosis and management of foodborne illness. Methods The questionnaire was developed in three phases: a comprehensive literature review, face and content validity, followed by a reliability test by internal consistency. A cross-sectional study was designed in Abha, Saudi Arabia. Physicians (n=125) were opportunistically recruited from both public and private primary healthcare centers. The questionnaire's content and validity were confirmed by experts in their corresponding fields. After signing the informed consent, the study participants received the questionnaire to evaluate their KAPs on foodborne diseases. Results: A total of 160 physicians from both public and private primary health care centers were approached to enrol 125 study participants into the survey (response rate 78.13%). Of the 31 items designed for assessing the KAP of physicians on foodborne illnesses, three items were excluded after Cronbach's α analysis. In total, 29 items were included in the final set of the questionnaire. Results of different validity and reliability analyses suggest the questionnaire has a high face and content validity as well as good reliability in internal consistency and stability. Conclusions: This study introduces a newly developed questionnaire with good reliability and validity values that can assess physician's awareness of foodborne disease. The awareness questionnaire, as a study instrument, had a favourable acceptance among physicians. It is a sound method for evaluating and measuring levels of foodborne disease-related awareness among physicians in Abha, Saudi Arabia.
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Affiliation(s)
- Mohammed AL-Mohaithef
- Department of Public Health,College of Health Sciences, Saudi Electronic University, Riyadh, post code: 11673, P.O.Box: 93499, Saudi Arabia
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Aljindan RY, Alkharsah KR. Pattern of increased antimicrobial resistance of Salmonella isolates in the Eastern Province of KSA. J Taibah Univ Med Sci 2020; 15:48-53. [PMID: 32110182 PMCID: PMC7033400 DOI: 10.1016/j.jtumed.2019.12.004] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2019] [Revised: 12/10/2019] [Accepted: 12/13/2019] [Indexed: 12/04/2022] Open
Abstract
OBJECTIVES The antimicrobial resistance of Salmonella species is increasing worldwide. This study was conducted to determine the pattern of antimicrobial susceptibility of Salmonella species in a tertiary hospital from 2011 to 2018. METHODS In this retrospective study, the medical records of all patients with Salmonella infections were reviewed. The clinical, demographic, and microbiological data of the selected patients were analysed. RESULTS A total of 752 patients were included. The resistance of Salmonella species to antimicrobial drugs increased from 24.6% in 2011 to 37.8% in 2018 (p = 0.002). By 2018 all Salmonella isolates were completely resistant to cefalotin, cefuroxime, and cefoxitin, while we found some susceptibility to other cephalosporins and ciprofloxacin. The most commonly isolated Salmonella serogroups were groups D (36.5%), C (23.5%), and B (11.7%). CONCLUSIONS The incidence of resistance of Salmonella to antibiotics is on the rise. The results of this study highlight the need for an active monitoring system of antibiotic usage in humans and domestic animals.
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Affiliation(s)
- Reem Y. Aljindan
- Department of Microbiology, College of Medicine, Imam Abdulrahman Bin Faisal University (IAU), Dammam, KSA
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Al Kraiem AA, Zeng Y, Huo X, Yang K, Al Kraiem F, Qin J, Cui Y, Kan B, Yan M, Yang G, Chen T. Identification of Salmonella Bredeney Resistant to Third-Generation Cephalosporins in Saudi Arabia. Front Cell Infect Microbiol 2019; 9:390. [PMID: 31824867 PMCID: PMC6879462 DOI: 10.3389/fcimb.2019.00390] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2019] [Accepted: 10/30/2019] [Indexed: 11/23/2022] Open
Abstract
The rapidly increasing prevalence and spread of antibiotic-resistant Salmonella worldwide have become a thorny problem that poses a serious threat to human health. It is speculated that antibiotic abuse, frequent traveling, and mass gatherings accelerate this threat. To explore this hypothesis, we investigated 13 Salmonella isolates from Medina, Saudi Arabia and 15 from China as the control group using typical methods of serotype identification, antibiotic resistance tests, pulsed-field gel electrophoresis (PFGE), and multi-locus sequence typing (MLST). Our results indicated that the isolates from China showed greater serotype diversity and a higher antimicrobial resistance rate, which was consistent with results from other studies in China. In contrast, the Saudi Arabian isolates were mainly identified as Serovar Bredeney and were resistant to a limited number of antibiotics. Interestingly, two of the Bredeney isolates was resistant to third-generation cephalosporins but sensitive to all other tested antibiotics. To confirm the results and understand the underlying molecular mechanisms of these isolates, whole-genome sequencing (WGS) was performed. We discovered that several cephalosporin resistance-associated genes were shared with other strains, but one gene (LEN-23) was unique. Therefore, to the best of our knowledge, we concluded that this study is the first to report the emergence of Salmonella Bredeney resistant to third-generation cephalosporins in Saudi Arabia.
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Affiliation(s)
- Ayman Ahmad Al Kraiem
- Department of Clinical Immunology, Tongji Medical College, Tongji Hospital, Huazhong University of Sciences and Technology, Wuhan, China.,Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China.,Department of Biology, College of Science, Taibah University, Medina, Saudi Arabia
| | - Yingchun Zeng
- Hubei Provincial Center for Disease Control and Prevention (CDC), Wuhan, China
| | - Xixiang Huo
- Hubei Provincial Center for Disease Control and Prevention (CDC), Wuhan, China
| | - Kun Yang
- Department of Clinical Immunology, Tongji Medical College, Tongji Hospital, Huazhong University of Sciences and Technology, Wuhan, China.,Department of Pathogen Biology and Immunology, Shihezi University School of Medicine, Shihezi, China
| | - Fahd Al Kraiem
- Pilgrims City Hospital, Ministry of Health, Medina, Saudi Arabia
| | - Jingliang Qin
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China.,School of Basic Medical Sciences, Anhui Medical University, Hefei, China
| | - Yujun Cui
- State Key Laboratory of Pathogen and Biosecurity, Beijing Institute of Microbiology and Epidemiology, Beijing, China
| | - Biao Kan
- Chinese Center for Disease Control and Prevention, National Institute for Communicable Diseases Control and Prevention, Beijing, China
| | - Meiying Yan
- Chinese Center for Disease Control and Prevention, National Institute for Communicable Diseases Control and Prevention, Beijing, China
| | - Guang Yang
- Department of Biomedical Engineering, College of Life Science and Technology, Huazhong University of Science and Technology, Wuhan, China
| | - Tie Chen
- Department of Clinical Immunology, Tongji Medical College, Tongji Hospital, Huazhong University of Sciences and Technology, Wuhan, China
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Moghnieh RA, Kanafani ZA, Tabaja HZ, Sharara SL, Awad LS, Kanj SS. Epidemiology of common resistant bacterial pathogens in the countries of the Arab League. THE LANCET. INFECTIOUS DISEASES 2018; 18:e379-e394. [PMID: 30292478 DOI: 10.1016/s1473-3099(18)30414-6] [Citation(s) in RCA: 72] [Impact Index Per Article: 12.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/07/2017] [Revised: 06/03/2018] [Accepted: 06/18/2018] [Indexed: 12/12/2022]
Abstract
No uniformly organised collection of data regarding antimicrobial resistance has occurred in the countries of the Arab League. 19 countries of the Arab League have published data for antimicrobial susceptibility for the WHO priority organisms, and seven of 14 of these organisms are included in this Review (Escherichia coli, Klebsiella spp, Pseudomonas aeruginosa, Acinetobacter baumannii, Salmonella spp, Staphylococcus aureus, and Streptococcus pneumoniae). Although E coli and Klebsiella spp resistance to third-generation cephalosporins is common in all countries, with prevalence reaching more than 50% in Egypt and Syria, carbapenem resistance is emerging, albeit with a prevalence of less than 10%. Conversely, a large amount of carbapenem resistance has been reported for P aeruginosa and A baumannii across the Arab League, reaching 50% and 88% of isolates in some countries. As for Salmonella spp, the prevalence of fluoroquinolone resistance has exceeded 30% in several areas. With regards to the Gram-positive pathogens, the prevalence of meticillin resistance in S aureus is reported to be between 20% and 30% in most countries, but exceeds 60% in Egypt and Iraq. The prevalence of penicillin non-susceptibility among pneumococci has reached more than 20% in Algeria, Egypt, Morocco, Saudi Arabia, and Tunisia. These findings highlight the need for structured national plans in the region to target infection prevention and antimicrobial stewardship.
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Affiliation(s)
- Rima A Moghnieh
- Division of Infectious Diseases, Department of Internal Medicine, Makassed General Hospital, Beirut, Lebanon
| | - Zeina A Kanafani
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Hussam Z Tabaja
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon
| | - Sima L Sharara
- Faculty of Medicine, American University of Beirut, Beirut, Lebanon
| | - Lyn S Awad
- Pharmacy Department, Makassed General Hospital, Beirut, Lebanon
| | - Souha S Kanj
- Division of Infectious Diseases, Department of Internal Medicine, American University of Beirut, Beirut, Lebanon.
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El-Tayeb MA, Ibrahim ASS, Al-Salamah AA, Almaary KS, Elbadawi YB. Prevalence, serotyping and antimicrobials resistance mechanism of Salmonella enterica isolated from clinical and environmental samples in Saudi Arabia. Braz J Microbiol 2017; 48:499-508. [PMID: 28245965 PMCID: PMC5498448 DOI: 10.1016/j.bjm.2016.09.021] [Citation(s) in RCA: 26] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/20/2016] [Accepted: 09/18/2016] [Indexed: 11/26/2022] Open
Abstract
Salmonella is recognized as a common foodborne pathogen, causing major health problems in Saudi Arabia. Herein, we report epidemiology, antimicrobial susceptibility and the genetic basis of resistance among S. enterica strains isolated in Saudi Arabia. Isolation of Salmonella spp. from clinical and environmental samples resulted in isolation of 33 strains identified as S. enterica based on their biochemical characteristics and 16S-rDNA sequences. S. enterica serovar Enteritidis showed highest prevalence (39.4%), followed by S. Paratyphi (21.2%), S. Typhimurium (15.2%), S. Typhi and S. Arizona (12.1%), respectively. Most isolates were resistant to 1st and 2nd generation cephalosporin; and aminoglycosides. Moreover, several S. enterica isolates exhibited resistance to the first-line antibiotics used for Salmonellosis treatment including ampicillin, trimethoprim–sulfamethoxazole and chloramphenicol. In addition, the results revealed the emergence of two S. enterica isolates showing resistance to third-generation cephalosporin. Analysis of resistance determinants in S. enterica strains (n = 33) revealed that the resistance to β-lactam antibiotics, trimethoprim–sulfamethoxazole, chloramphenicol, and tetracycline, was attributed to the presence of carb-like, dfrA1, floR, tetA gene, respectively. On the other hand, fluoroquinolone resistance was related to the presence of mutations in gyrA and parC genes. These findings improve the information about foodborne Salmonella in Saudi Arabia, alarming the emergence of multi-drug resistant S. enterica strains, and provide useful data about the resistance mechanisms.
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Affiliation(s)
- Mohamed A El-Tayeb
- King Saud University, College of Science, Department of Botany and Microbiology, Riyadh, Saudi Arabia
| | - Abdelnasser S S Ibrahim
- King Saud University, College of Science, Department of Botany and Microbiology, Riyadh, Saudi Arabia; National Research Center, Pharmaceutical Industries Research Division, Department of Chemistry of Natural and Microbial Products, Cairo, Egypt.
| | - Ali A Al-Salamah
- King Saud University, College of Science, Department of Botany and Microbiology, Riyadh, Saudi Arabia
| | - Khalid S Almaary
- King Saud University, College of Science, Department of Botany and Microbiology, Riyadh, Saudi Arabia
| | - Yahya B Elbadawi
- King Saud University, College of Science, Department of Botany and Microbiology, Riyadh, Saudi Arabia
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Garaween G, Somily A, Raji A, Braun S, Al-Kattan W, Shibl A, Ehricht R, Senok A. Serogenotyping and emergence of extended-spectrum β-lactamase genes in non-typhoidal Salmonella: first report from Saudi Arabia. J Med Microbiol 2016; 65:1343-1346. [PMID: 27655242 DOI: 10.1099/jmm.0.000355] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Affiliation(s)
- Ghada Garaween
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ali Somily
- Department of Pathology and Laboratory Medicine, College of Medicine, King Khalid University Hospital and King Saud University, Riyadh, Saudi Arabia
| | - Adeola Raji
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Sascha Braun
- Alere Technologies GmbH, Löbstedter Straße 103-105, D-07749 Jena, Germany
- InfectoGnostics Research Campus, Jena, Germany
| | - Wael Al-Kattan
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Atef Shibl
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
| | - Ralf Ehricht
- Alere Technologies GmbH, Löbstedter Straße 103-105, D-07749 Jena, Germany
- InfectoGnostics Research Campus, Jena, Germany
| | - Abiola Senok
- College of Medicine, Mohammed Bin Rashid University of Medicine and Health Sciences, Dubai, UAE
- College of Medicine, Alfaisal University, Riyadh, Saudi Arabia
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Abstract
Salmonellosis is a disease that represents a major public health concern in both developing and developed countries. The aim of this article is to evaluate the public health burden of Salmonella illness in Lebanon. The current scope of the Salmonella infection problem was assessed in relation to disease incidence and distribution with respect to age, gender and district. Factors that provide a better understanding of the magnitude of the problem were explored and highlighted. Data reported to the Epidemiologic Surveillance Department at the Lebanese Ministry of Public Health between 2001 and 2013 was reviewed. Information obtained was compared to information reported regionally and globally. The estimated true incidence was derived using multipliers from the CDC and Jordan. A literature review of all published data from Lebanon about Salmonella susceptibility/resistance patterns and its serious clinical complications was conducted. The estimated incidence was 13·34 cases/100 000 individuals, most cases occurred in the 20-39 years age group with no significant gender variation. Poor and less developed districts of Lebanon had the highest number of cases and the peak incidence was in summer. Reflecting on the projected incidence derived from the use of multipliers indicates a major discrepancy between what is reported and what is estimated. We conclude that data about Salmonella infection in Lebanon and many Middle Eastern and developing countries lack crucial information and are not necessarily representative of the true incidence, prevalence and burden of illness.
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Chang YC, Scaria J, Ibraham M, Doiphode S, Chang YF, Sultan A, Mohammed HO. Distribution and factors associated with Salmonella enterica genotypes in a diverse population of humans and animals in Qatar using multi-locus sequence typing (MLST). J Infect Public Health 2015; 9:315-23. [PMID: 26631436 DOI: 10.1016/j.jiph.2015.10.013] [Citation(s) in RCA: 10] [Impact Index Per Article: 1.1] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/27/2015] [Revised: 10/08/2015] [Accepted: 10/11/2015] [Indexed: 12/26/2022] Open
Abstract
Salmonella enterica is one of the most commonly reported causes of bacterial foodborne illness around the world. Understanding the sources of this pathogen and the associated factors that exacerbate its risk to humans will help in developing risk mitigation strategies. The genetic relatedness among Salmonella isolates recovered from human gastroenteritis cases and food animals in Qatar were investigated in the hope of shedding light on these sources, their possible transmission routes, and any associated factors. A repeat cross-sectional study was conducted in which the samples and associated data were collected from both populations (gastroenteritis cases and animals). Salmonella isolates were initially analyzed using multi-locus sequence typing (MLST) to investigate the genetic diversity and clonality. The relatedness among the isolates was assessed using the minimum spanning tree (MST). Twenty-seven different sequence types (STs) were identified in this study; among them, seven were novel, including ST1695, ST1696, ST1697, ST1698, ST1699, ST1702, and ST1703. The pattern of overall ST distribution was diverse; in particular, it was revealed that ST11 and ST19 were the most common sequence types, presenting 29.5% and 11.5% within the whole population. In addition, 20 eBurst Groups (eBGs) were identified in our data, which indicates that ST11 and ST19 belonged to eBG4 and eBG1, respectively. In addition, the potential association between the putative risk factors and eBGs were evaluated. There was no significant clustering of these eBGs by season; however, a significant association was identified in terms of nationality in that Qataris were six times more likely to present with eBG1 compared to non-Qataris. In the MST analysis, four major clusters were presented, namely, ST11, ST19, ST16, and ST31. The linkages between the clusters alluded to a possible transmission route. The results of the study have provided insight into the ST distributions of S. enterica and their possible zoonotic associations in Qatar.
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Affiliation(s)
- Yu C Chang
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Schurman Hall, Ithaca, NY 14853, USA.
| | - Joy Scaria
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Schurman Hall, Ithaca, NY 14853, USA.
| | | | - Sanjay Doiphode
- Hamad Medical Corporation, Bin Omran Area, Doha 3050, Qatar.
| | - Yung-Fu Chang
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Schurman Hall, Ithaca, NY 14853, USA.
| | - Ali Sultan
- Weill Cornell Medical College-Qatar, Education City, Al Luqta Street, Ar-Rayyan, P.O. Box 24144, Doha, Qatar.
| | - Hussni O Mohammed
- Department of Population Medicine and Diagnostic Sciences, College of Veterinary Medicine, Cornell University, Schurman Hall, Ithaca, NY 14853, USA.
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Abstract
Control of typhoid fever relies on clinical information, diagnosis, and an understanding for the epidemiology of the disease. Despite the breadth of work done so far, much is not known about the biology of this human-adapted bacterial pathogen and the complexity of the disease in endemic areas, especially those in Africa. The main barriers to control are vaccines that are not immunogenic in very young children and the development of multidrug resistance, which threatens efficacy of antimicrobial chemotherapy. Clinicians, microbiologists, and epidemiologists worldwide need to be familiar with shifting trends in enteric fever. This knowledge is crucial, both to control the disease and to manage cases. Additionally, salmonella serovars that cause human infection can change over time and location. In areas of Asia, multidrug-resistant Salmonella enterica serovar Typhi (S Typhi) has been the main cause of enteric fever, but now S Typhi is being displaced by infections with drug-resistant S enterica serovar Paratyphi A. New conjugate vaccines are imminent and new treatments have been promised, but the engagement of local medical and public health institutions in endemic areas is needed to allow surveillance and to implement control measures.
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Affiliation(s)
- John Wain
- Norwich Medical School, University of East Anglia, Norwich, UK.
| | - Rene S Hendriksen
- National Food Institute, Technical University of Denmark, WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, Kongens Lyngby, Denmark
| | - Matthew L Mikoleit
- National Enteric Reference Laboratory Team, Enteric Diseases Laboratory Branch, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Karen H Keddy
- Centre for Enteric Diseases, National Institute for Communicable Diseases, Division in the National Health Laboratory Service (NHLS), Johannesburg, South Africa; Faculty of Health Sciences, University of the Witwatersrand, Johannesburg, South Africa
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Schmidt JW, Agga GE, Bosilevac JM, Brichta-Harhay DM, Shackelford SD, Wang R, Wheeler TL, Arthur TM. Occurrence of Antimicrobial-Resistant Escherichia coli and Salmonella enterica in the Beef Cattle Production and Processing Continuum. Appl Environ Microbiol 2015; 81:713-25. [PMID: 25398858 PMCID: PMC4277590 DOI: 10.1128/aem.03079-14] [Citation(s) in RCA: 64] [Impact Index Per Article: 7.1] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/22/2014] [Accepted: 11/06/2014] [Indexed: 01/22/2023] Open
Abstract
Specific concerns have been raised that third-generation cephalosporin-resistant (3GC(r)) Escherichia coli, trimethoprim-sulfamethoxazole-resistant (COT(r)) E. coli, 3GC(r) Salmonella enterica, and nalidixic acid-resistant (NAL(r)) S. enterica may be present in cattle production environments, persist through beef processing, and contaminate final products. The prevalences and concentrations of these organisms were determined in feces and hides (at feedlot and processing plant), pre-evisceration carcasses, and final carcasses from three lots of fed cattle (n = 184). The prevalences and concentrations were further determined for strip loins from 103 of the carcasses. 3GC(r) Salmonella was detected on 7.6% of hides during processing and was not detected on the final carcasses or strip loins. NAL(r) S. enterica was detected on only one hide. 3GC(r) E. coli and COT(r) E. coli were detected on 100.0% of hides during processing. Concentrations of 3GC(r) E. coli and COT(r) E. coli on hides were correlated with pre-evisceration carcass contamination. 3GC(r) E. coli and COT(r) E. coli were each detected on only 0.5% of final carcasses and were not detected on strip loins. Five hundred and 42 isolates were screened for extraintestinal pathogenic E. coli (ExPEC) virulence-associated markers. Only two COT(r) E. coli isolates from hides were ExPEC, indicating that fed cattle products are not a significant source of ExPEC causing human urinary tract infections. The very low prevalences of these organisms on final carcasses and their absence on strip loins demonstrate that current sanitary dressing procedures and processing interventions are effective against antimicrobial-resistant bacteria.
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Affiliation(s)
- John W Schmidt
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Getahun E Agga
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Joseph M Bosilevac
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Dayna M Brichta-Harhay
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Steven D Shackelford
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Rong Wang
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Tommy L Wheeler
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
| | - Terrance M Arthur
- U.S. Department of Agriculture, Agricultural Research Service, Roman L. Hruska U.S. Meat Animal Research Center, Clay Center, Nebraska, USA
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