M'ikanatha Nkuchia M, Yin Xin, Boktor Sameh W, Dettinger Lisa A, Tewari Deepanker
Division of Infectious Disease Epidemiology, Pennsylvania Department of Health, Harrisburg, Pennsylvania, USA.
Center for Clinical Epidemiology and Biostatistics, University of Pennsylvania School of Medicine, Philadelphia, Pennsylvania, USA.
Open Forum Infect Dis. 2021 Apr 26;8(8):ofab213. doi: 10.1093/ofid/ofab213. eCollection 2021 Aug.
Antimicrobial resistance in foodborne pathogens, including nontyphoidal (NTS), is a public health concern. Pennsylvania conducts integrated surveillance for antimicrobial resistance in NTS from human and animal sources.
During 2015-2017, clinical laboratories submitted 4478 NTS isolates from humans and 96 isolates were found in 2520 retail meat samples. One hundred nine clinical isolates that shared pulsed-field gel electrophoresis patterns with meat isolates and all strains from meat samples were tested for susceptibility to antimicrobial agents. Six clinical and 96 NTS isolates from meat sources (total 102) were analyzed by whole-genome sequencing (WGS).
Twenty-eight (25.7%) of the 109 clinical NTS and 21 (21.9%) of strains from meat sources had resistance to ≥3 antimicrobial drug classes (multidrug resistance). Sixteen of the 102 (15.7%) isolates analyzed by WGS had resistance mechanisms that confer resistance to expanded-spectrum cephalosporins, such as ceftriaxone. We identified in 2 Infantis isolates from clinical and 3 Infantis isolates from meat sources. These 5 -positive Infantis strains carried ≥5 additional resistance genes plus a D87Y mutation in gyrA that encodes fluoroquinolone resistance. WGS showed that isolates from patients and meat samples were within ≤10 and ≤5 alleles for Infantis and Reading, respectively.
A significant proportion of NTS isolates from human and animal sources were multidrug resistant and 16% had genetic mechanisms that confer resistant to ceftriaxone. These results emphasize need for integrated surveillance in healthcare and agricultural settings.
包括非伤寒沙门氏菌（NTS）在内的食源性病原体中的抗菌药物耐药性是一个公共卫生问题。宾夕法尼亚州对来自人类和动物源的NTS抗菌药物耐药性进行综合监测。
在2015 - 2017年期间，临床实验室提交了4478株来自人类的NTS分离株，在2520份零售肉类样本中发现了96株。对109株与肉类分离株具有相同脉冲场凝胶电泳图谱的临床分离株以及所有肉类样本中的菌株进行了抗菌药物敏感性测试。通过全基因组测序（WGS）分析了6株临床分离株和96株来自肉类来源的NTS分离株（共102株）。
109株临床NTS中有28株（25.7%）以及肉类来源的菌株中有21株（21.9%）对≥3类抗菌药物具有耐药性（多重耐药）。在通过WGS分析的102株分离株中，有16株（15.7%）具有赋予对扩展谱头孢菌素（如头孢曲松）耐药性的耐药机制。我们在2株临床婴儿沙门氏菌分离株和3株肉类来源的婴儿沙门氏菌分离株中鉴定出了[具体物质未给出]。这5株[具体物质未给出]阳性的婴儿沙门氏菌菌株携带≥5个额外的耐药基因，外加gyrA中一个编码氟喹诺酮耐药性的D87Y突变。WGS显示，来自患者和肉类样本的婴儿沙门氏菌分离株分别在≤10个和≤5个等位基因范围内，雷丁沙门氏菌也类似。
来自人类和动物源的很大一部分NTS分离株具有多重耐药性，16%具有赋予对头孢曲松耐药性的遗传机制。这些结果强调了在医疗保健和农业环境中进行综合监测的必要性。
