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 Salmonella enterica  
Samantha Go
Bio 113, Dr. Ruscetti, Fall 2010

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  Salmonella enterica  


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Salmonella is the leading cause of food-borne illness, with an estimated
annual 1.4 million infections in the United States alone. Most occur as a result
of eating contaminated food, particularly those of animal origin. Antimicrobial
agents are not essential for the treatment of most salmonella infections, but
they can be lifesaving in cases of severe infection.
Use of ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole
is now limited because of increasing antimicrobial resistance to these agents.
Fluoroquinolones, such as ciprofloxacin, which work by targeting the bacteria¶s
DNA gyrase A, are commonly used.
The use of antimicrobial agents creates selection pressures that favor
the survival of antibiotic-resistant pathogens. Overuse of antibiotics has dire
implications, evidenced by emerging resistance to fluoroquinolones. As a ³last   Total quarterly numbers of S. enterica ser choleraesuis isolates from the fourth
resort´ drug, resistance to it would result in no effective method of treating quarter of 1996 through the third quarter of 2001 (bars) and the percentage of these
isolates that were resistant to ciprofloxacin (curve).
those particular Salmonella infections.  ! Lanes 1, 8, and 14 show S. enterica ser. Newport controls; lanes 2 through 7 and 9
through 11 show isolates from the Oregon patients; lane 12 shows the environmental isolate from
‡In March 2000 there was a dramatic and rapid increase in the incidence of a foam mattress; lane 13 shows the isolate obtained in 1995 from the New York patient.
ciprofloxacin resistance in S. enterica serotype choleraesuis
â  ‡In the third quarter of 2001, the rate of resistance reached a high of 60% ‡The four control isolates had different patterns on pulsed-field gel
electrophoresis and were sensitive to ciprofloxacin
  Salmonella enterica   

   Salmonella enterica   
    ‡All isolates associated with the outbreak had similar patterns on pulsed-field

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gel electrophoresis, which were also similar to the sample of S. enterica
serotype Schwarzengrund isolated from the New York patient.


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number of isolates

*MIC denotes minimal inhibitory concentration, MIC90 the lowest antibiotic concentration 

that inhibited the growth of 90% of the organisms.
The amino acids at codons 83 and 87 were found on comparison with the sequences of the ‡The 9 ciprofloxacin-resistant isolates had the same two point mutations in the
gene for DNA gyrase A (gyrA) from Escherichia coli. region of gyrA that determines quinolone resistance, whereas the control
Á The amino acids at codons 83 and 87 were the same as those of gyrA from E. coli.
isolates had the wild-type sequence
‡The quinolone-resistance-determining region of the gene for DNA gyrase A ‡The two point mutations were identical to those seen in the New York patient
  Isolates were collected from Chang Gung Memorial Hospital and Chang
Gung Children's Hospital from 1991 through 2000. was PCR-amplified and sequenced
‡The base substitutions Ser83Phe and Asp87Asn were identified in all
ciprofloxacin-resistant isolates
‡Before 1991, most S. enterica serotype choleraesuis isolates were susceptible
to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole. ‡Most susceptible strains had a single amino acid change, either Ser83Phe or ‡The most common mutations (Ser83Phe and Asp87Asn) associated with
‡By 2000, resistance to at least one of the three antibiotics was found in Asp87Asn, indicating that the two mutations are equally important in permitting fluoroquinolone resistance in S. enterica ser. choleraesuis are the same mutations
approximately 90% of the isolates, and 78% of the isolates were resistant to all S. enterica ser. choleraesuis to attain resistance to ciprofloxacin responsible for fluoroquinolone resistance in S. enterica ser. Schwarzengrund
three antibiotics.
‡Certain antibiotics are critical to human medicine because they are effective
‡There were no reports of resistance to ciprofloxacin in S. enterica serotype Figure 3 and Table 2 show isolates from a 1997 Oregon outbreak of against pathogens that are resistant to other antibiotics. Fluoroquinolones are
choleraesuis through 1999. fluoroquinolone-resistant salmonella infection, caused by S. enterica ser. among the few remaining antibiotics to which Salmonella is still sensitive, so the
Schwarzengrund. The four control isolates of S. enterica ser. Schwarzengrund emergence of fluoroquinolone-resistant S. enterica serotypes is potentially a
Figure 2 shows the total quarterly numbers of S. enterica serotype were collected in Oregon between 1995 and 1998 but not associated with the serious problem.
choleraesuis isolates from Chang Gung Memorial Hospital and Chang Gung outbreak. Comparisons were made to the only previous isolate of ‡In order to prevent widespread Salmonella antimicrobial resistance, clinicians
Children¶s Hospital in Taiwan. Ciprofloxacin was not available in these fluoroquinolone-resistant salmonella in the US, a sample of S. enterica ser. should be advised to use antimicrobial agents judiciously per the indications
hospitals before October 1996. Schwarzengrund isolated in New York in 1995. outlined in the standard of care.

‡Chiu CH, Wu TL, Su LH, et al. (2002) The emergence in Taiwan of fluoroquinolone resistance in Salmonella enterica serotype choleraesuis. New England Journal of Medicine 346:6, 413-419.
‡Molbak K, Baggesen D, Aarestrup F, et al. (1999) An outbreak of multidrug-resistant, quinolone-resistant Salmonella enterica serotype typhimurium DT104. New England Journal of Medicine 341:19, 1420-1425.
‡Olsen SJ, DeBess EE, McGivern TE, et al. A nosocomial outbreak of fluoroquinolone-resistant Salmonella infection. (2001) New England Journal of Medicine 344:21 , 1572-1579.
‡Waltner-Toews, David. Food, Sex, and Salmonella: Why Our Food Is Making Us Sick. Vancouver: Greystone, 2008. Print.
‡White DG, Zhao S, Sudler R, et al. (2001) The isolation of antibiotic-resistant Salmonella from ground meats. New England Journal of Medicine 345:16, 1147-1154.