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Trends (2009-2013) in serotype distribution and antimicrobial susceptibility in Belgian human Salmonella isolates: Mind the uncommon.
[typhoid]
The
Belgian
National
Reference
Centre
for
Salmonella
received
16
,
544
human
isolates
of
Salmonella
enterica
between
January
2009
and
December
2013
.
Although
377
different
serotypes
were
identified
,
the
landscape
is
dominated
by
the
serovars
Typhimurium
(
55
%
)
and
Enteritidis
(
19
%
)
in
a
ratio
which
is
inverse
to
European
Union
averages
.
With
outbreaks
of
serotypes
Ohio
,
Stanley
and
Paratyphi
B
var
.
Java
as
prime
examples
,
twenty
serotypes
displayed
significant
fluctuations
in
this
five
-
year
period
.
Typhoid
strains
account
for
1
.
2
%
of
Belgian
salmonellosis
cases
.
Large
-scale
antibiotic
susceptibility
analyses
(
N
=
4
,
561
;
panel
of
12
antibiotics
)
showed
declining
resistance
levels
in
Enteritis
and
Typhimurium
isolates
for
8
and
3
tested
agents
,
respectively
.
Despite
low
overall
resistance
to
ciprofloxacin
(
4
.
4
%
)
and
cefotaxime
(
1
.
6
%
)
,
we
identified
clonal
lineages
of
Kentucky
and
Infantis
displaying
rising
resistance
against
these
clinically
important
drugs
.
Quinolone
resistance
is
mainly
mediated
by
serotype-
specific
mutations
in
GyrA
residues
Ser
83
and
Asp
87
(
92
.
2
%
non-wild
type
)
,
while
an
additional
ParC
_
Ser
80
Ile
mutation
leads
to
ciprofloxacin
resistance
in
95
.
5
%
Kentucky
isolates
,
which
exceeds
European
averages
.
Plasmid-mediated
quinolone
resistance
(
PMQR
)
alleles
qnrA
1
(
N
=
1
)
,
qnrS
(
N
=
9
)
,
qnrD
1
(
N
=
4
)
or
qnrB
(
N
=
4
)
were
only
found
in
3
.
0
%
of
533
isolates
resistant
to
nalidixic
acid
.
In
cefotaxime-resistant
isolates
,
we
identified
a
broad
range
of
Ambler
class
A
and
C
β-lactamases
(
e
.
g
.
,
blaSHV-
12
,
blaTEM-
52
,
blaCTX-M-
14
,
blaCTX-M-
15
)
genes
commonly
associated
with
Enterobacteriaceae
.
In
conclusion
,
resistance
to
fluoroquinolones
and
cefotaxime
remains
rare
in
human
S
.
enterica
,
but
clonal
resistant
serotypes
arise
and
continued
(
inter
)
national
surveillance
is
mandatory
to
understand
the
origin
and
routes
of
dissemination
thereof
.
Diseases
Validation
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"low overall resistance"
symptom
typhoid
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