WHO Collaborating Centre for Antimicrobial Resistance in Foodborne Pathogens and EU Community Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Copenhagen V, Denmark.
Pediatr Infect Dis J. 2009 Sep;28(9):814-8. doi: 10.1097/INF.0b013e3181a3aeac.
Multidrug-resistant Salmonella serovar Concord infections have been reported from children adopted from Ethiopia. We interviewed patients, characterized the isolates, and gathered information about adoptions from Ethiopia to assess public health implications.
Information about Salmonella Concord cases and adoptions were provided from Austria, Denmark, England (and Wales), Ireland, the Netherlands and the United States. Patients from Denmark and the United States were interviewed to determine the orphanages of origin; orphanages in Ethiopia were visited. Isolates were subtyped by pulsed-field gel electrophoresis and antimicrobial susceptibility; specific antimicrobial resistance genes were characterized.
Salmonella Concord was isolated from 78 persons from 2003 to 2007. Adoption status was known for 44 patients <or=3 years of age; 98% were adopted from Ethiopia. The children adopted from Ethiopia were from several orphanages; visited orphanages had poor hygiene and sanitation and frequent use of antimicrobial agents. The number of children adopted from Ethiopia in the participating countries increased 527% from 221 in 2003 to 1385 in 2007. Sixty-four Salmonella Concord isolates yielded 53 pulsed-field gel electrophoresis patterns including 6 patterns with >2 indistinguishable isolates; one isolate from an Ethiopia adoptee. Antimicrobial susceptibility was performed on 43 isolates; 81% were multidrug-resistant (>or=3 agents). Multidrug-resistant isolates were from Ethiopian adoptees and were resistant to third and fourth generation cephalosporins and 14% had decreased susceptibility to ciprofloxacin.
Improved hygiene and sanitation and more appropriate use of antimicrobial agents are needed in orphanages in Ethiopia. Culturing of stool specimens of children adopted from Ethiopia and appropriate hygiene may prevent further disease transmission.
从埃塞俄比亚收养的儿童中报告了耐多药沙门氏菌血清型 concord 感染病例。我们采访了患者，对分离株进行了特征描述，并收集了有关从埃塞俄比亚收养的信息，以评估其对公共卫生的影响。
从奥地利、丹麦、英格兰（和威尔士）、爱尔兰、荷兰和美国提供了有关沙门氏菌 concord 病例和收养的信息。对来自丹麦和美国的患者进行了访谈，以确定其孤儿院的来源；访问了埃塞俄比亚的孤儿院。通过脉冲场凝胶电泳和抗菌药物敏感性对分离株进行了亚型分析；对特定的抗菌药物耐药基因进行了特征描述。
从 2003 年至 2007 年期间从 78 人分离出沙门氏菌 concord。对 44 名年龄<或=3 岁的患者的收养情况进行了了解；98%的患者是从埃塞俄比亚收养的。从埃塞俄比亚收养的儿童来自多个孤儿院；探访过的孤儿院卫生和环境卫生条件差，经常使用抗菌药物。参与国家从埃塞俄比亚收养的儿童人数从 2003 年的 221 人增加到 2007 年的 1385 人，增加了 527%。64 株沙门氏菌 concord 分离株产生了 53 种脉冲场凝胶电泳图谱，其中 6 种图谱有>2 个不可区分的分离株；一个分离株来自埃塞俄比亚收养的儿童。对 43 株分离株进行了抗菌药物敏感性检测；81%为多重耐药（>或=3 种药物）。多重耐药分离株来自埃塞俄比亚收养的儿童，对第三代和第四代头孢菌素耐药，14%对环丙沙星的敏感性降低。
需要改善埃塞俄比亚孤儿院的卫生和环境卫生条件，并更恰当地使用抗菌药物。对从埃塞俄比亚收养的儿童进行粪便标本培养和适当的卫生措施可能有助于防止进一步的疾病传播。
