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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
Diseases presenting
"broad range"
symptom
acute rheumatic fever
congenital toxoplasmosis
cowden syndrome
cystinuria
dystrophic epidermolysis bullosa
gm1 gangliosidosis
hereditary cerebral hemorrhage with amyloidosis
kallmann syndrome
neuralgic amyotrophy
severe combined immunodeficiency
typhoid
waldenström macroglobulinemia
well-differentiated liposarcoma
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