Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia.
Oak Ridge Institute for Science and Education, Oak Ridge, Tennessee.
Zoonoses Public Health. 2018 Nov;65(7):838-849. doi: 10.1111/zph.12507. Epub 2018 Jul 19.
Invasive Salmonella infections in adults are commonly treated with fluoroquinolones, a critically important antimicrobial class. Historically, quinolone resistance was the result of chromosomal mutations, but plasmid-mediated quinolone resistance (PMQR) has emerged and is increasingly being reported in Enterobacteriaceae worldwide. PMQR may facilitate the spread of quinolone resistance, lead to higher-level quinolone resistance, and make infections harder to treat. To better understand the epidemiology of PMQR in non-typhoidal Salmonella causing human infections in the United States, we looked at trends in quinolone resistance among isolates submitted to the Centers for Disease Control and Prevention. We reviewed demographic, exposure and outcome information for patients with isolates having a PMQR-associated phenotype during 2008-2014 and tested isolates for quinolone resistance mechanisms. We found that PMQR is emerging among non-typhoidal Salmonella causing human infections in the United States and that international travel, reptile and amphibian exposure, and food are likely sources of human infection.
成人侵袭性沙门氏菌感染通常采用氟喹诺酮类药物治疗，这是一类极为重要的抗菌药物。历史上，喹诺酮类耐药性是由染色体突变引起的，但质粒介导的喹诺酮耐药性（PMQR）已经出现，并在全球范围内的肠杆菌科中越来越多地被报道。PMQR 可能会促进喹诺酮类耐药性的传播，导致更高水平的喹诺酮类耐药性，并使感染更难治疗。为了更好地了解美国引起人类感染的非伤寒沙门氏菌中 PMQR 的流行情况，我们研究了向疾病预防控制中心提交的分离物中喹诺酮类耐药性的趋势。我们对 2008-2014 年期间具有与 PMQR 相关表型的分离物的患者的人口统计学、暴露和结局信息进行了回顾，并对分离物进行了喹诺酮类耐药机制的检测。我们发现，PMQR 正在美国引起人类感染的非伤寒沙门氏菌中出现，国际旅行、爬行动物和两栖动物暴露以及食物可能是人类感染的来源。
