Anvarinejad Mojtaba, Pouladfar Gholam Reza, Pourabbas Bahman, Amin Shahidi Maneli, Rafaatpour Noroddin, Dehyadegari Mohammad Ali, Abbasi Pejman, Mardaneh Jalal
Professor Alborzi Clinical Microbiology Research Center, Nemazee Hospital, Shiraz University of Medical Sciences, Shiraz, IR Iran.
Department of Microbiology, School of Medicine, Gonabad University of Medical Sciences, Gonabad, IR Iran.
Jundishapur J Microbiol. 2016 Apr 17;9(4):e26505. doi: 10.5812/jjm.26505. eCollection 2016 Apr.
Human salmonellosis continues to be a major international problem, in terms of both morbidity and economic losses. The antibiotic resistance of Salmonella is an increasing public health emergency, since infections from resistant bacteria are more difficult and costly to treat.
The aims of the present study were to investigate the isolation of Salmonella spp. with the BACTEC automated system from blood samples during 2008 - 2014 in southern Iran (Shiraz). Detection of subspecies, biogrouping, and antimicrobial susceptibility testing by the disc diffusion and agar dilution methods were performed.
A total of 19 Salmonella spp. were consecutively isolated using BACTEC from blood samples of patients between 2008 and 2014 in Shiraz, Iran. The isolates were identified as Salmonella, based on biochemical tests embedded in the API-20E system. In order to characterize the biogroups and subspecies, biochemical testing was performed. Susceptibility testing (disc diffusion and agar dilution) and extended-spectrum β-lactamase (ESBL) detection were performed according to the clinical and laboratory standards institute (CLSI) guidelines.
Of the total 19 Salmonella spp. isolates recovered by the BACTEC automated system, all belonged to the Salmonella enterica subsp. houtenae. Five isolates (26.5%) were resistant to azithromycin. Six (31.5%) isolates with the disc diffusion method and five (26.3%) with the agar dilution method displayed resistance to nalidixic acid (minimum inhibitory concentration [MIC] > 32 μg/mL). All nalidixic acid-resistant isolates were also ciprofloxacin-sensitive. All isolates were ESBL-negative. Twenty-one percent of isolates were found to be resistant to chloramphenicol (MIC ≥ 32 μg/mL), and 16% were resistant to ampicillin (MIC ≥ 32 μg/mL).
The results indicate that multidrug-resistant (MDR) strains of Salmonella are increasing in number, and fewer antibiotics may be useful for treating S. enterica infections. Routine investigation and reporting of antibiotic MICs in patients presenting with Salmonella infections is suggested.
无论是在发病率还是经济损失方面，人类沙门氏菌病仍然是一个重大的国际性问题。沙门氏菌的抗生素耐药性是一个日益严重的公共卫生紧急情况，因为耐药菌感染的治疗更加困难且成本更高。
本研究的目的是调查2008年至2014年期间在伊朗南部（设拉子）使用BACTEC自动化系统从血液样本中分离沙门氏菌属。通过纸片扩散法和琼脂稀释法进行亚种检测、生物分型以及抗菌药敏试验。
2008年至2014年期间，在伊朗设拉子，共使用BACTEC从患者血液样本中连续分离出19株沙门氏菌属。根据API-20E系统中的生化试验，将分离株鉴定为沙门氏菌。为了对生物型和亚种进行特征分析，进行了生化试验。根据临床和实验室标准协会（CLSI）指南进行药敏试验（纸片扩散法和琼脂稀释法）以及超广谱β-内酰胺酶（ESBL）检测。
通过BACTEC自动化系统回收的19株沙门氏菌属分离株均属于肠炎沙门氏菌亚种豪顿亚种。5株分离株（26.5%）对阿奇霉素耐药。纸片扩散法检测有6株（31.5%）分离株、琼脂稀释法检测有5株（26.3%）分离株对萘啶酸耐药（最低抑菌浓度[MIC]＞32μg/mL）。所有对萘啶酸耐药的分离株对环丙沙星均敏感。所有分离株ESBL均为阴性。21%的分离株对氯霉素耐药（MIC≥32μg/mL），16%的分离株对氨苄西林耐药（MIC≥32μg/mL）。
结果表明，多重耐药（MDR）沙门氏菌菌株数量在增加，可用于治疗肠炎沙门氏菌感染的抗生素可能越来越少。建议对沙门氏菌感染患者进行抗生素MIC的常规调查和报告。
