Jacob Jobin John, Solaimalai Dhanalakshmi, Muthuirulandi Sethuvel Dhiviya Prabaa, Rachel Tanya, Jeslin Praveena, Anandan Shalini, Veeraraghavan Balaji
Department of Clinical Microbiology, Christian Medical College and Hospital, Vellore, Tamil Nadu 632004 India.
Gut Pathog. 2020 Oct 23;12:49. doi: 10.1186/s13099-020-00388-z. eCollection 2020.
The steady increase in the proportion of Non-typhoidal (NTS) infections in humans represents a major health problem worldwide. The current study investigated the serovar distribution and antimicrobial susceptibility trends of NTS isolated from faecal samples during the period 2000-2018.
Faecal specimens of patients were cultured according to standard lab protocol. The isolates were serotyped and antimicrobial susceptibility testing (AST) were performed according to CLSI guidelines.
A total of 1436 NTS isolates were obtained from faeces samples mostly comprising of Typhimurium (27.3%), Weltevreden (13%), Bareilly (11%), Newport (4.2%), . Cholerasuis (4%), Infantis (3.4%), and . Enteritidis (2.4%). Resistance to nalidixic acid (26%) was most common among the tested NTS, followed by ampicillin (18.5%), cotrimoxazole (13.5%), ciprofloxacin (12%), ceftriaxone (6.3%) and chloramphenicol (3.6%). Multidrug resistance was observed in 5% of NTS isolates with the highest rate (10.52%) in 2014. The incidence of NTS infection was maximum in children < 5 years of age with an average 19.3% of the total affected patients during the time period.
Based on this study, the faecal NTS isolates have high resistance rates against first line antimicrobial agents except chloramphenicol. The gradual but consistent increase in resistance to fluoroquinolones, third generation cephalosporins and macrolide may restrict future treatment options. Hence periodic monitoring of NTS infections, serotype distribution and antimicrobial resistance trend is recommended.
人类非伤寒沙门氏菌（NTS）感染比例稳步上升，这是全球范围内的一个主要健康问题。本研究调查了2000年至2018年期间从粪便样本中分离出的NTS的血清型分布和抗菌药物敏感性趋势。
按照标准实验室规程对患者的粪便标本进行培养。根据临床和实验室标准协会（CLSI）指南对分离株进行血清分型和抗菌药物敏感性测试（AST）。
共从粪便样本中获得1436株NTS分离株，主要包括鼠伤寒沙门氏菌（27.3%）、韦尔特弗里登沙门氏菌（13%）、巴雷利沙门氏菌（11%）、纽波特沙门氏菌（4.2%）、猪霍乱沙门氏菌（4%）、婴儿沙门氏菌（3.4%）和肠炎沙门氏菌（2.4%）。在检测的NTS中，对萘啶酸的耐药率（26%）最为常见，其次是氨苄西林（18.5%）、复方新诺明（13.5%）、环丙沙星（12%）、头孢曲松（6.3%）和氯霉素（3.6%）。5%的NTS分离株观察到多重耐药，2014年的发生率最高（10.52%）。NTS感染的发生率在5岁以下儿童中最高，在此期间平均占所有受影响患者总数的19.3%。
基于本研究，除氯霉素外，粪便NTS分离株对一线抗菌药物具有较高的耐药率。对氟喹诺酮类、第三代头孢菌素和大环内酯类药物耐药性的逐渐但持续增加可能会限制未来的治疗选择。因此，建议定期监测NTS感染、血清型分布和抗菌药物耐药趋势。
