Emergence of multidrug-resistant Salmonella enterica serotype typhimurium DT104 infections in the United States
Emergence of multidrug-resistant Salmonella enterica serotype typhimurium DT104 infections in the United States
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DOI：
10.1056/nejm199805073381901
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发表时间：
1998-05-07
影响因子：
158.5
通讯作者：
Angulo, FJ
中科院分区：
文献类型：
--
作者：
Glynn, MK;Bopp, C;Angulo, FJ
背景耐药沙门氏菌菌株已成为一个世界性的健康问题。肠沙门氏菌血清型鼠伤寒沙门氏菌的一种独特菌株，称为确定型104（DT 104），对氨苄青霉素、氯霉素、链霉素、磺胺类药物和四环素具有抗性，并且已成为欧洲特别是英国人类和动物疾病的主要原因。我们分析了1979年至1996年期间由地方和州卫生部门以及公共卫生实验室在全国调查沙门氏菌抗菌药物耐药性时收集的数据。结果鼠伤寒沙门氏菌的流行率从1979-1980年的0.6%上升到1996年的34%。1994-1995年，在46个监测点中的36个（78%）的样本中发现了此类分离株。39的43个鼠伤寒沙门氏菌菌株的5种药物的耐药模式，在1994-1995年和1996年确定的噬菌体型DT 104或密切相关的噬菌体type.Conclusions多重耐药鼠伤寒沙门氏菌DT 104已成为一种广泛的病原体在美国。在农场动物中更谨慎地使用抗菌药物和在农场进行更有效的疾病预防是必要的，以减少多重耐药鼠伤寒DT 104的传播，并减缓这种和其他沙门氏菌菌株对其他药物的耐药性。（C）1998年，马萨诸塞州医学会。
Background Strains of salmonella that are resistant to antimicrobial agents have become a worldwide health problem. A distinct strain of Salmonella enterica serotype typhimurium, known as definitive type 104 (DT104), is resistant to ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline and has become a major cause of illness in humans and animals in Europe, especially the United Kingdom.Methods To characterize typhimurium DT104 infections in the United States, we analyzed data collected by local and state health departments and public health laboratories between 1979 and 1996 in national surveys of the antimicrobial-drug resistance of salmonella. Selected typhimurium isolates with the five-drug pattern of resistance were phage typed.Results The prevalence of typhimurium isolates with the five-drug pattern of resistance increased from 0.6 percent in 1979-1980 to 34 percent in 1996. In 1994-1995, such isolates were identified in samples from 36 of the 46 surveillance sites (78 percent). Thirty-nine of 43 typhimurium isolates with the five-drug pattern of resistance identified in 1994-1995 and 1996 were phage type DT104 or a closely related phage type.Conclusions Multidrug-resistant typhimurium DT104 has become a widespread pathogen in the United States. More prudent use of antimicrobial agents in farm animals and more effective disease prevention on farms are necessary to reduce the dissemination of multidrug-resistant typhimurium DT104 and to slow the emergence of resistance to additional agents in this and other strains of salmonella. (C)1998, Massachusetts Medical Society.