Article Figures & Data
Figures
- FIG 1
Monthly hospitalization incidence of nontyphoidal Salmonella. Only the eight most common sequence types are visualized. Sequence types that caused fewer than 10 incidences are grouped together as “Other.”
- FIG 2
Antimicrobial resistance in major nontyphoidal Salmonella sequence types. (A) Heat map of antimicrobial resistance phenotype of the eight most common sequence types. The left panel displays the proportion of nonsusceptibility to 7 classes of tested antimicrobial agents, including ampicillin/amoxicillin-clavulanate (AMP/AMC), ceftriaxone-ceftazidime (CRO/CAZ), imipenem (IMP), azithromycin (AZM), ciprofloxacin (CIP); trimethoprim-sulfamethoxazole (SXT), and chloramphenicol (CHL). The right panel displays the proportion of nonsusceptibility to the number of tested antimicrobial classes, including β-lactam (AMP, AMC, CRO, and CAZ), IMP, AZM, CIP, SXT, and CHL. Isolates were classified as nonsusceptible to an antimicrobial class if they were nonsusceptible to any agent of that class. The color intensity in a cell is proportional to the percentage of nonsusceptible NTS isolates to the tested antimicrobial class. The STs are arranged in decreasing order of prevalence (from top to bottom). (B) The prevalence of antimicrobial resistance determinants in the eight most common sequence types. These determinants are classified by antimicrobial classes, including 3rd-generation cephalosporin (blaCTX-M-14, blaCTX-M-15, and blaCTX-M-55), quinolone [qnrS1, qnrS2, qnrB6, qnrD1, oqxAB, patA, aac(6′)-Ib-cr, and QRDR mutations], azithromycin (ermB, ermF, ermT, mefB, and mphA), and cotrimoxazole (sul1, sul2, and sul3 plus + dfrA1, dfrA12, dfrA14, dfrA17, and dfrA5). Each bar graph denotes the proportion of isolates carrying any of these determinants, classified by antimicrobial class and sequence type.
- FIG 3
Resistance to first-line antimicrobials correlated with clinical severity. (A and B) Hospitalization duration (in days) of all 450 children infected with nontyphoidal Salmonella, classified by the number of first- and second-line antimicrobials (ciprofloxacin, ceftriaxone, azithromycin) to which the pathogen was phenotypically nonsusceptible (A), further classified by the eight most common sequence types (B). (C) Hospitalization duration of NTS infected children who received initial treatment of fluoroquinolone (CIP), 3rd-generation cephalosporin (CRO), or macrolide (AZM), stratified by the pathogen’s nonsusceptibility to the corresponding treating agent (ciprofloxacin, ceftriaxone, or azithromycin). The asterisk indicates statistical significance in the pairwise comparison (Wilcoxon signed-rank test, P < 0.05).
Tables
- TABLE 1
Demographic and clinical manifestations of diarrheal pediatric patients infected with nontyphoidal Salmonella (n = 450)
↵a Obese signifies weight-for-length Z score >3 SD in children aged <24 months; body mass index (BMI)-for-age Z score >3 SD in children aged ≥24 months. Overweight represents weight-for-length Z score >2 SD in children of age <24 months; BMI-for-age Z score >2 SD in children aged ≥24 months. Wasted signifies weight-for-length Z score less than −2 SD in children aged <24 months; BMI-for-age Z score less than −2 SD in children aged ≥24 months. Severely wasted signifies weight-for-length Z score less than −3 SD in children aged <24 months; BMI-for-age Z score less than −3 SD in children aged ≥24 months (30).
↵b All of the dehydrated cases classified as some dehydration according to Integrated Management of Childhood Illness (31).
↵c Hemoglobin level cutoff according to World Health Organization guidelines (18).
↵d Defined as “recovered” if patient had <3 passages of loose stool in the 24 hours or “improved” if patient had less episodes of diarrhea and less mucus and/or bloody in comparison to the condition of the patient at enrollment.
- TABLE 3
The performance of whole-genome sequencing in determining the antimicrobial susceptibility of nontyphoidal Salmonella
Supplemental material
- Supplemental file 1 -
Tables S1 and S2 and Fig. S1
PDF, 234K
- Supplemental file 1 -
