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Emergence and spread in Taiwan of multidrug-resistant serotypes of nontyphoidal Salmonella

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Abstract

Purpose

Antimicrobial resistance of nontyphoidal Salmonella (NTS) is a threat to public health worldwide.

Methods

A study on longitudinally collected NTS isolates from a medical center in Taiwan from 2011 to 2019 was undertaken. The multidrug resistance (MDR) and extensively drug resistance (XDR) phenotypes were determined according to internationally used definitions. Molecular serotyping was performed on the resistant NTS.

Results

Notably 16.1% (870/5412) of the isolates were MDR, while XDR accounted for 2.1% (111/5412). Both MDR and XDR NTS have increased significantly from 2011 to 2019, especially from 2015 to 2017 (MDR from 9.6% in 2015 to 23.1% 2017; XDR from 1.4% in 2016 to 4.7% in 2017). S. Anatum was the commonest NTS serotype expressing MDR and XDR, in 256/559 (45.8%) and 81/111 (73.0%) of the isolates, respectively, followed by S. Typhimurium and S. Goldcoast. Children < 18 years old contributed to 69.0% of all MDR cases and 64.0% of all XDR cases; majority of them aged less than 5 years.

Conclusions

Increasing MDR and XDR NTS is a threat to public health. MDR and XDR NTS usually caused gastroenteritis in children < 5 years old. Multiple NTS serotypes expressing MDR and XDR indicate multiple food vehicles involved in the transmission. Proper food hygiene practice should never be over-reinforced.

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Abbreviations

ACSSuT:

Ampicillin, chloramphenicol and trimethoprim/sulfamethoxazole

CGMH:

Chang Gung Memorial Hospital

CLSI:

Clinical and Laboratory Standard Institute

EMB:

Eosin Methylene Blue agar

MALDI-TOF MS:

Matrix-assisted laser desorption ionization time-of-flight mass spectrometry

MDR:

Multidrug resistance

NHIRD:

Taiwan National Health Insurance Research Database

NTS:

Nontyphoidal Salmonella

PDR:

Pan-drug resistance

TMP-SMX:

Trimethoprim-sulfamethoxazole

XDR:

Extensively drug resistance

XLD:

Xylose Lysine Deoxycholate agar

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Funding

This study was supported by grants from Chang Gung Memorial Hospital (CMRPG3L0541‒3) Taiwan.

Author information

Author notes

  1. Wah-Tin Tiew and·Rajendra P. Janapatla have contributed equally.

Authors and Affiliations

  1. Division of Pediatric Infectious Diseases, Department of Pediatrics, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyüan, Taiwan

    Wah-Tin Tiew, Yi-Jung Chang, Yi-Ching Chen & Cheng-Hsun Chiu

  2. Division of Pediatric Infectious Diseases, Ministry of Health, Putrajaya, Malaysia

    Wah-Tin Tiew

  3. Molecular Infectious Disease Research Center, Chang Gung Memorial Hospital, Chang Gung University College of Medicine, Taoyüan, Taiwan

    Rajendra P. Janapatla, Hsin-Ping Yang, Lin-Hui Su, Chyi-Liang Chen & Cheng-Hsun Chiu

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  1. Wah-Tin Tiew
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Contributions

Conceived and designed study: W-TT, RPJ, C-HC. Performed data collection: W-TT, RPJ, Y-JC, Y-CC, H-PY, L-HS, C-LC. Analyzed data: W-TT, RPJ, Y-JC, Y-CC, H-PY, L-HS, C-LC, C-HC. Wrote the paper: W-TT, RPJ, C-HC.

Corresponding author

Correspondence to Cheng-Hsun Chiu.

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Conflict of interest

The authors declared that no competing interests relevant to this article.

Ethical approval and consent to participate

The study was approved by the Institutional Review Board of CGMH (201601804B0, 201702155B0, 201802237B0 and 202100813B0).

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Tiew, WT., Janapatla, R.P., Chang, YJ. et al. Emergence and spread in Taiwan of multidrug-resistant serotypes of nontyphoidal Salmonella. Infection 50, 475–482 (2022). https://doi.org/10.1007/s15010-021-01736-0

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  • DOI: https://doi.org/10.1007/s15010-021-01736-0

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