Heterogeneity of Multidrug-Resistant Salmonella enterica Isolates with Increasing Frequency of Resistance to Ciprofloxacin During a 4-Year Period in Iran.

BACKGROUND

The study was conducted to assess the trend of antimicrobial resistance among Salmonella enterica strains during a period of 4 years and to compare the effectiveness of three genotyping methods, including flagellin polymerase chain reaction (PCR)-restriction fragment length polymorphism (RFLP), enterobacterial repetitive intergenic consensus (ERIC)-PCR, and pulsed-field gel electrophoresis (PFGE), and to determine the most efficient method for S. enterica genotyping.

METHODS AND RESULTS

About 50 S. enterica isolates were isolated from 5,064 stool samples. All of the isolates harbored fliC gene, 29 of which (58%) showed diphasic characteristic with a fliC/fljB genotype. Simpson diversity index (Di) for RFLP analysis of fliC and fljB genes was calculated as 0.71 and 0.82, respectively. Strains were differentiated into 40 ERIC genotypes and 27 pulsotypes. All isolates with identical pulsotypes belonged to common serogroups which depict their correlation in a good manner. The Di calculated for ERIC-PCR and PFGE analysis was 0.99 and 0.94, respectively. The frequency of multidrug resistance (MDR) was dramatically increased from 25% in 2009-2010 to 63% in 2011-2012 with the emergence of 10% ciprofloxacin resistance in the latter period.

CONCLUSION

About 44% increase in MDR phenotype among S. enterica isolates during a 4-year period and concomitant appearance of ciprofloxacin resistance is a traumatic situation for health professionals in Iran. PFGE profiles offered a satisfactory discriminatory power, which was positively correlated with S. enterica serogrouping. The current study marks the superiority of PFGE method over other conventional molecular techniques in epidemiological investigations; however, their limitations need to be addressed for further refinement.