Ceftriaxone-resistant Salmonella infection acquired by a child from cattle

Paul D Fey, Thomas J. Safranek, Mark Edmund Rupp, Eileen F. Dunne, Efrain Ribot, Peter Charles Iwen, Patricia A. Bradford, Frederick J. Angulo, Steven Heye Hinrichs

Research output: Contribution to journalArticle

409 Citations (Scopus)

Abstract

Background: The emergence of resistance to antimicrobial agents within the salmonellae is a worldwide problem that has been associated with the use of antibiotics in livestock. Resistance to ceftriaxone and the fluoroquinolones, which are used to treat invasive salmonella infections, is rare in the United States. We analyzed the molecular characteristics of a ceftriaxone-resistant strain of Salmonella enterica serotype typhimurium isolated from a 12-year-old boy with fever, abdominal pain, and diarrhea. Methods: We used pulsed-field gel electrophoresis and analysis of plasmids and β-lactamases to compare the ceftriaxone-resistant S. enterica serotype typhimurium from the child with four isolates of this strain obtained from cattle during a local outbreak of salmonellosis. Results: The ceftriaxone- resistant isolate from the child was indistinguishable from one of the isolates from cattle, which was also resistant to ceftriaxone. Both ceftriaxone-resistant isolates were resistant to 13 antimicrobial agents; all but one of the resistance determinants were on a conjugative plasmid of 160 kb that encoded the functional group 1 β-lactamase CMY-2. Both ceftriaxone- resistant isolates were closely related to the three other salmonella isolates obtained from cattle, all of which were susceptible to ceftriaxone. Conclusions: This study provides additional evidence that antibiotic- resistant strains of salmonella in the United States evolve primarily in livestock. Resistance to ceftriaxone, the drug of choice for invasive salmonella disease, is a public health concern, especially with respect to children, since fluoroquinolones, which can also be used to treat this disease, are not approved for use in children. (C) 2000, Massachusetts Medical Society.

Original languageEnglish (US)
Pages (from-to)1242-1249
Number of pages8
JournalNew England Journal of Medicine
Volume342
Issue number17
DOIs
StatePublished - Apr 27 2000

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Ceftriaxone
Salmonella Infections
Salmonella
Salmonella enterica
Fluoroquinolones
Livestock
Anti-Infective Agents
Plasmids
Anti-Bacterial Agents
Medical Societies
Pulsed Field Gel Electrophoresis
Abdominal Pain
Disease Outbreaks
Diarrhea
Fever
Public Health

ASJC Scopus subject areas

  • Medicine(all)

Cite this

Ceftriaxone-resistant Salmonella infection acquired by a child from cattle. / Fey, Paul D; Safranek, Thomas J.; Rupp, Mark Edmund; Dunne, Eileen F.; Ribot, Efrain; Iwen, Peter Charles; Bradford, Patricia A.; Angulo, Frederick J.; Hinrichs, Steven Heye.

In: New England Journal of Medicine, Vol. 342, No. 17, 27.04.2000, p. 1242-1249.

Research output: Contribution to journalArticle

Fey, Paul D ; Safranek, Thomas J. ; Rupp, Mark Edmund ; Dunne, Eileen F. ; Ribot, Efrain ; Iwen, Peter Charles ; Bradford, Patricia A. ; Angulo, Frederick J. ; Hinrichs, Steven Heye. / Ceftriaxone-resistant Salmonella infection acquired by a child from cattle. In: New England Journal of Medicine. 2000 ; Vol. 342, No. 17. pp. 1242-1249.
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T1 - Ceftriaxone-resistant Salmonella infection acquired by a child from cattle

AU - Fey, Paul D

AU - Safranek, Thomas J.

AU - Rupp, Mark Edmund

AU - Dunne, Eileen F.

AU - Ribot, Efrain

AU - Iwen, Peter Charles

AU - Bradford, Patricia A.

AU - Angulo, Frederick J.

AU - Hinrichs, Steven Heye

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N2 - Background: The emergence of resistance to antimicrobial agents within the salmonellae is a worldwide problem that has been associated with the use of antibiotics in livestock. Resistance to ceftriaxone and the fluoroquinolones, which are used to treat invasive salmonella infections, is rare in the United States. We analyzed the molecular characteristics of a ceftriaxone-resistant strain of Salmonella enterica serotype typhimurium isolated from a 12-year-old boy with fever, abdominal pain, and diarrhea. Methods: We used pulsed-field gel electrophoresis and analysis of plasmids and β-lactamases to compare the ceftriaxone-resistant S. enterica serotype typhimurium from the child with four isolates of this strain obtained from cattle during a local outbreak of salmonellosis. Results: The ceftriaxone- resistant isolate from the child was indistinguishable from one of the isolates from cattle, which was also resistant to ceftriaxone. Both ceftriaxone-resistant isolates were resistant to 13 antimicrobial agents; all but one of the resistance determinants were on a conjugative plasmid of 160 kb that encoded the functional group 1 β-lactamase CMY-2. Both ceftriaxone- resistant isolates were closely related to the three other salmonella isolates obtained from cattle, all of which were susceptible to ceftriaxone. Conclusions: This study provides additional evidence that antibiotic- resistant strains of salmonella in the United States evolve primarily in livestock. Resistance to ceftriaxone, the drug of choice for invasive salmonella disease, is a public health concern, especially with respect to children, since fluoroquinolones, which can also be used to treat this disease, are not approved for use in children. (C) 2000, Massachusetts Medical Society.

AB - Background: The emergence of resistance to antimicrobial agents within the salmonellae is a worldwide problem that has been associated with the use of antibiotics in livestock. Resistance to ceftriaxone and the fluoroquinolones, which are used to treat invasive salmonella infections, is rare in the United States. We analyzed the molecular characteristics of a ceftriaxone-resistant strain of Salmonella enterica serotype typhimurium isolated from a 12-year-old boy with fever, abdominal pain, and diarrhea. Methods: We used pulsed-field gel electrophoresis and analysis of plasmids and β-lactamases to compare the ceftriaxone-resistant S. enterica serotype typhimurium from the child with four isolates of this strain obtained from cattle during a local outbreak of salmonellosis. Results: The ceftriaxone- resistant isolate from the child was indistinguishable from one of the isolates from cattle, which was also resistant to ceftriaxone. Both ceftriaxone-resistant isolates were resistant to 13 antimicrobial agents; all but one of the resistance determinants were on a conjugative plasmid of 160 kb that encoded the functional group 1 β-lactamase CMY-2. Both ceftriaxone- resistant isolates were closely related to the three other salmonella isolates obtained from cattle, all of which were susceptible to ceftriaxone. Conclusions: This study provides additional evidence that antibiotic- resistant strains of salmonella in the United States evolve primarily in livestock. Resistance to ceftriaxone, the drug of choice for invasive salmonella disease, is a public health concern, especially with respect to children, since fluoroquinolones, which can also be used to treat this disease, are not approved for use in children. (C) 2000, Massachusetts Medical Society.

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