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Journal of Clinical Microbiology, October 1999, p. 3425-3425, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
Emergence and Spread of an Atypical Salmonella
enterica subsp. enterica Serotype 4,5,12:i:
Strain
in Spain
M. Aurora
Echeita*
Ana
Aladueña,
Susana
Cruchaga, and
Miguel A.
Usera
Sección de EnterobacteriasServicio de BacteriologíaC.N.M. Instituto de Salud Carlos III28220 Majadahonda, Madrid, Spain
Received 11 June 1999/Returned for modification 22 June
1999/Accepted 29 June 1999
 |
TEXT |
Salmonella sp. serotyping is a very useful
epidemiological tool to detect outbreaks in the developed world
(5, 10). The Spanish National Salmonella
Reference Laboratory routinely serotypes Salmonella sp.
strains from most Spanish Autonomous Communities (AACC) for
epidemiological surveillance (8, 9). In August of 1997 an
atypical Salmonella enterica subsp. enterica
serotype 4,5,12:i:
strain was detected. This strain either could be a monophasic strain of serotype Typhimurium (4,5,12:i:1,2) or serotype Lagos (4,5,12:i:1,5) or could represent a new serotype (7). The incidence of this serotype rapidly increased, and this serotype became the fourth most frequently encountered Salmonella sp.
serotype in Spain during the second semester of 1997 (2.2% annual
incidence). The aim of this study was to establish the incidence and
possible origin of this serotype and to provide further characterization.
A total of 7,146 and 774 Salmonella sp. strains were
isolated from human and food samples, respectively, in 1998 and the
first quarter of 1999 in Spain. They were assigned to a serotype by the
slide agglutination method with commercial antiserum (Sanofi Diagnostic
Pasteur, Paris, France) and antiserum we had induced. Furthermore, the
specific identification of phase 2 antigens of the H1 antigenic complex
was performed by the multiplex PCR method of Echeita et al.
(4). Antimicrobial resistance was determined by the disc
diffusion method according to National Committee for Clinical
Laboratory Standards criteria (6). The following
antimicrobials were tested: ampicillin (A), chloramphenicol (C),
sulfamethoxazole (Su), gentamicin (G), ciprofloxacin, kanamycin,
streptomycin (S), cephalothin, nalidixic acid, cefotaxime,
tetracycline (T), and co-trimoxazole (SxT). Phage susceptibility was
studied by using a set of Salmonella serotype Typhimurium
international phages (Laboratory of Enteric Pathogens, London, United
Kingdom) according to the method of Anderson et al. (1).
Only Salmonella serotype 4,5,12:i: strains which were
detected by the slide agglutination method were selected for further studies. All selected strains were H:1,2 and H:1,5 negative by the
multiplex PCR method. All of these strains were lysed only by the
additional Salmonella serotype Typhimurium phage 10 (phage type [PT] U302). The most frequent resistance pattern was ACSuGSTSxT.
Two hundred and eighty-eight (3.7%) strains of Salmonella
serotype 4,5,12:i: with PT U302 and an ACSuGSTSxT multidrug
resistance pattern were considered for the incidence study. Two hundred
and seventy-one (3.8%) and 17 (2.2%) strains were isolated from human and food samples, respectively. Food strains were isolated from pork or
pork products. Fourteen of 17 AACC were implicated. The distribution of
these human strains was similar to that obtained when analyzing the
total number of Salmonella spp. from humans in Spain for
such characteristics as patient sex and age and date of isolation.
Salmonella serotype 4,5,12:i: has been only sporadically
isolated over the past few years in Spain (10 strains in the period 1993 to 1996) (3).
The annual incidence of this strain has increased during the period of
this study, and this strain has become the fourth and ninth most common
serotype isolated from humans and food, respectively. Now this
serotype is affecting most Spanish AACC.
This report documents the first isolation of this strain with the
multidrug resistance pattern described above. The resistance to
gentamicin, a very active antimicrobial against most
Salmonella spp. (2), is interesting. It can be
concluded that an atypical, gentamicin-resistant Salmonella
serotype 4,5,12:i: strain has emerged and spread to humans in Spain,
probably with contaminated pork as the source.
| |
FOOTNOTES |
*
Fax: 34-915097966
E-mail: aecheita{at}isciii.es
| |
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Journal of Clinical Microbiology, October 1999, p. 3425-3425, Vol. 37, No. 10
0095-1137/99/$04.00+0
Copyright © 1999, American Society for Microbiology. All rights reserved.
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