Varma Jay K, Molbak Kåre, Barrett Timothy J, Beebe James L, Jones Timothy F, Rabatsky-Ehr Therese, Smith Kirk E, Vugia Duc J, Chang Hwa-Gan H, Angulo Frederick J
Epidemic Intelligence Service, Epidemiology Program Office, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA.
J Infect Dis. 2005 Feb 15;191(4):554-61. doi: 10.1086/427263. Epub 2005 Jan 7.
Nontyphoidal Salmonella is a leading cause of foodborne illness. Few studies have explored the health consequences of antimicrobial-resistant Salmonella.
The National Antimicrobial Resistance Monitoring System (NARMS) performs susceptibility testing on nontyphoidal Salmonella isolates. The Foodborne Diseases Active Surveillance Network (FoodNet) ascertains outcomes for patients with culture-confirmed Salmonella infection, in 9 states, each of which participates in NARMS. We analyzed the frequency of bloodstream infection and hospitalization among patients with resistant infections. Isolates defined as resistant to a clinically important agent were resistant to 1 or more of the following agents: ampicillin, ceftriaxone, ciprofloxacin, gentamicin, and/or trimethoprim-sulfamethoxazole.
During 1996-2001, NARMS received 7370 serotyped, nontyphoidal Salmonella isolates from blood or stool. Bloodstream infection occurred more frequently among patients infected with an isolate resistant to > or =1 clinically important agent (adjusted odds ratio [OR], 1.6; 95% confidence interval [CI], 1.2-2.1), compared with patients with pansusceptible infection. During 1996-2001, FoodNet staff ascertained outcomes for 1415 patients who had isolates tested in NARMS. Hospitalization with bloodstream infection occurred more frequently among patients infected with an isolate resistant to > or =1 clinically important agent (adjusted OR, 3.1; 95% CI, 1.4-6.6), compared with patients with pansusceptible infection.
Patients with antimicrobial-resistant nontyphoidal Salmonella infection were more likely to have bloodstream infection and to be hospitalized than were patients with pansusceptible infection. Mitigation of antimicrobial resistance in Salmonella will likely benefit human health.
非伤寒沙门氏菌是食源性疾病的主要病因。很少有研究探讨耐抗菌药物沙门氏菌对健康的影响。
国家抗菌药物耐药监测系统（NARMS）对非伤寒沙门氏菌分离株进行药敏试验。食源性疾病主动监测网络（FoodNet）确定9个参与NARMS的州中经培养确诊的沙门氏菌感染患者的转归。我们分析了耐药感染患者中血流感染和住院的频率。定义为对一种临床重要药物耐药的分离株对以下一种或多种药物耐药：氨苄西林、头孢曲松、环丙沙星、庆大霉素和/或甲氧苄啶-磺胺甲恶唑。
1996 - 2001年期间，NARMS收到7370株来自血液或粪便的血清型非伤寒沙门氏菌分离株。与全敏感感染患者相比，感染对≥1种临床重要药物耐药的分离株的患者血流感染更为常见（校正比值比[OR]，1.6；95%置信区间[CI]，1.2 - 2.1）。1996 - 2001年期间，FoodNet工作人员确定了1415例在NARMS进行分离株检测的患者的转归。与全敏感感染患者相比，感染对≥1种临床重要药物耐药的分离株的患者因血流感染住院更为常见（校正OR，3.1；95% CI，1.4 - 6.6）。
与全敏感感染患者相比，耐抗菌药物的非伤寒沙门氏菌感染患者更易发生血流感染和住院。减轻沙门氏菌的抗菌药物耐药性可能有益于人类健康。
