Prabhurajan Rajan, Kiran Rajasekharapanicker, Padmavathy Kesavaram
Research Laboratory for Oral and Systemic Health, Department of Microbiology, Sree Balaji Dental College and Hospital, Bharath Institute of Higher Education and Research (BIHER), Chennai, India.
Salem Steel Plant Hospital, Salem, India.
J Infect Dev Ctries. 2019 Sep 30;13(9):851-853. doi: 10.3855/jidc.11409.
Increasing antimicrobial resistance among non-typhoidal Salmonella (NTS) is a major public health issue especially in developing countries and is partly due to the use of antimicrobials in animal feeds as growth promoters. NTS are often associated with self-limiting acute gastroenteritis (AGE). Nevertheless, fluoroquinolones and third-generation cephalosporins are currently used in the treatment of severe diarrhoeal infections.
We report the case of a 30-year-old male who presented with clinical symptoms of moderate gastroenteritis. Stool culture and antibiotic susceptibility was performed as per standard microbiological methods. Molecular detection of bla genes was carried out by PCR.
The isolate was confirmed as S. Lindenberg by serotyping. The isolate exhibited dual resistance to fluoroquinolone and third generation cephalosporins. The isolate was an ESBL producer and harboured blaSHV. Based on the antibiotic susceptibility pattern, the patient was successfully treated with ceftriaxone-tazobactam.
Presently, there are no Indian reports on the blaSHV positive ESBL producing S. Lindenberg gastroenteritis. We report on the successful management of the first case of acute gastroenteritis caused by S. Lindenberg that exhibited dual resistance to fluoroquinolone and third generation cephalosporins. Continued surveillance of the antibiotic resistance pattern of the Non-typhoidal Salmonella serovars circulating in the geographical region is warranted.
非伤寒沙门氏菌(NTS)的抗菌耐药性不断增加是一个重大的公共卫生问题,在发展中国家尤为如此,部分原因是在动物饲料中使用抗菌药物作为生长促进剂。NTS常与自限性急性肠胃炎(AGE)相关。然而,氟喹诺酮类和第三代头孢菌素目前仍用于治疗严重腹泻感染。
我们报告了一例30岁男性患者,其表现出中度肠胃炎的临床症状。按照标准微生物学方法进行粪便培养和抗生素敏感性检测。通过聚合酶链反应(PCR)对bla基因进行分子检测。
通过血清分型确认该分离株为林登贝格沙门氏菌。该分离株对氟喹诺酮类和第三代头孢菌素表现出双重耐药性。该分离株是超广谱β-内酰胺酶(ESBL)产生菌,携带blaSHV基因。根据抗生素敏感性模式,患者使用头孢曲松-他唑巴坦成功治愈。
目前,印度尚无关于blaSHV阳性产ESBL林登贝格沙门氏菌引起肠胃炎的报道。我们报告了首例由林登贝格沙门氏菌引起的急性肠胃炎的成功治疗病例,该菌株对氟喹诺酮类和第三代头孢菌素表现出双重耐药性。有必要持续监测该地理区域内循环的非伤寒沙门氏菌血清型的抗生素耐药模式。