A new study has identified the recent emergence of a multidrug-resistant strain of Salmonella that has a high level resistance to ciprofloxacin, a common treatment for severe Salmonella infections.
The study, led by François-Xavier Weill, MD, and Simon Le Hello, PharmD, at the Pasteur Institute in France, is published in The Journal of Infectious Diseases and is now available online.
Salmonella Infection Is Public Health Issue
Salmonella infection represents a major public health problem worldwide. An estimated 1.7 million such infections occur in North America each year. More than 1.6 million cases were reported between 1999 and 2008 in 27 European countries. Although most Salmonella infections produce only mild gastroenteritis, elderly and immunocompromised patients are especially at risk for life-threatening infections. These cases are typically treated with antimicrobials called fluoroquinolones, such as ciprofloxacin.
Dr. Weill and colleagues studied information from national surveillance systems in France, England and Wales, Denmark, and the United States. The data showed that a multidrug-resistant strain of Salmonella, known as S. Kentucky, infected 489 patients in France, England and Wales, and Denmark between 2000 and 2008. In addition, researchers reported that the first infections were acquired mainly in Egypt between 2002 and 2005, while since 2006 the infections have also been acquired in various parts of Africa and the Middle East. The absence of reported international travel in approximately 10 percent of the patients suggests that infections may have also occurred in Europe through consumption of contaminated imported foods or through secondary contaminations.
Poultry May Be Spreading Salmonella Infection
In this study, multidrug-resistant S. Kentucky was isolated from chickens and turkeys from Ethiopia, Morocco, and Nigeria, suggesting that poultry is an important agent for infection. The common use of fluoroquinolones in chicken and turkey production in Nigeria and Morocco may have contributed to this rapid spread.
Importance of Global Food and Public Health Surveillance
This study highlights the importance of public health surveillance in a global food system. According to Dr. Le Hello, "We hope that this publication might stir awareness among national and international health, food, and agricultural authorities so that they take the necessary measures to control and stop the dissemination of this strain before it spreads globally, as did another multidrug-resistant strain of Salmonella, Typhimurium DT104, starting in the 1990s." The investigators from the Pasteur Institute and its international network, the Centers for Disease Control and Prevention in the U.S., the Health Protection Agency in the United Kingdom, and the Statens Serum Institute and Technical University of Denmark reported that they will continue to monitor this multidrug-resistant strain as well as help strengthen the capacities of national and regional laboratories in the surveillance of Salmonella and other major foodborne pathogens through the World Health Organization Global Foodborne Infections Network.
Results from Salmonella Study
- This study found that a multidrug-resistant strain of Salmonella, known as S. Kentucky, infected 489 patients in France, England and Wales, and Denmark between 2000 and 2008.
- Poultry appears to be a major vehicle for spreading these infections.
- International public health surveillance systems are needed to limit the spread of such multidrug-resistant organisms.
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Reference: Journal of Infection Diseases. Published Online August 2, 2011.
Simon Le Hello, Rene S. Hendriksen, Benoît Doublet, Ian Fisher, Eva Møller Nielsen, Jean M. Whichard, Brahim Bouchrif, Kayode Fashae, Sophie A. Granier, Nathalie Jourdan-Da Silva, Axel Cloeckaert, E. John Threlfall, Frederick J. Angulo, Frank M. Aarestrup, John Wain and François-Xavier Weill
Source: The Journal of Infectious Diseases