Abstract

The National Antimicrobial Resistance Monitoring System monitors susceptibility among Enterobacteriaceae in humans in the United States. We studied isolates exhibiting decreased susceptibility to quinolones (nalidixic acid MIC >32 microg/mL or ciprofloxacin MIC > or =0.12 microg/mL) and extended-spectrum cephalosporins (ceftiofur or ceftriaxone MIC > or =2 microg/mL) during 1996-2004. Of non-Typhi Salmonella, 0.19% (27/14,043) met these criteria: 11 Senftenberg; 6 Typhimurium; 3 Newport; 2 Enteridis; and 1 each Agona, Haifa, Mbandaka, Saintpaul, and Uganda. Twenty-six isolates had gyrA mutations (11 at codon 83 only, 3 at codon 87 only, 12 at both). All Senftenberg isolates had parC mutations (S801 and T57S); 6 others had the T57S mutation. The Mbandaka isolate contained qnrB2. Eight isolates contained bla(CMY-2); 1 Senftenberg contained bla(CMY-23). One Senftenberg and 1 Typhimurium isolate contained bla(SHV-12); the Mbandaka isolate contained bla(SHV-30). Nine Senftenberg isolates contained bla(OXA-1) contained bla(OXA-9). Further studies should address patient outcomes, risk factors, and resistance dissemination prevention strategies.

Highlights

  • Oregon, and Tennessee), that participate in FoodNet, monitored antimicrobial resistance among human Campylobacter isolates [Table 1]

  • Centers for Disease Control and Prevention (CDC), Salmonella, Shigella, and E. coli O157 isolates are tested with a semi-automated system (Sensititre®, Trek Diagnostics, Westlake, OH) to determine the partial range MIC for 16 antimicrobial agents: amikacin, ampicillin, amoxicillin-clavulanic acid, cefoxitin, ceftiofur, ceftriaxone, cephalothin, chloramphenicol, ciprofloxacin, gentamicin, kanamycin, nalidixic acid, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim-sulfamethoxazole [Table 2]

  • Logistic regression analyses were performed to assess the change in antimicrobial resistance among Salmonella isolates tested in NARMS in 2002 compared to previous years for the following: 1) ceftriaxone, ciprofloxacin, and nalidixic acid resistance among non-Typhi

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Summary

Part I

In 2002, 28 health departments, representing approximately 188 million persons (65% of the United States population), participated in the National Antimicrobial Resistance Monitoring. In 2002, 2% (37/2009) of non-Typhi Salmonella isolates were resistant to nalidixic acid, 1% (16/2009) had decreased susceptibility (MIC ≥ 0.25 μg/ml) to ciprofloxacin, and. In 2002, the nine NARMS participating state health departments (California, Colorado, Connecticut, Georgia, Maryland, Minnesota, New. York, Oregon, and Tennessee), that participate in FoodNet, monitored antimicrobial resistance among human Campylobacter isolates [Table 1]. At. CDC, Salmonella, Shigella, and E. coli O157 isolates are tested with a semi-automated system (Sensititre®, Trek Diagnostics, Westlake, OH) to determine the partial range MIC for 16 antimicrobial agents: amikacin, ampicillin, amoxicillin-clavulanic acid, cefoxitin, ceftiofur, ceftriaxone, cephalothin, chloramphenicol, ciprofloxacin, gentamicin, kanamycin, nalidixic acid, streptomycin, sulfamethoxazole, tetracycline, and trimethoprim-sulfamethoxazole [Table 2]. Logistic regression analyses were performed to assess the change in antimicrobial resistance among Salmonella isolates tested in NARMS in 2002 compared to previous years for the following: 1) ceftriaxone, ciprofloxacin, and nalidixic acid resistance among non-Typhi. For Campylobacter, the baseline prevalence of resistance includes data from the first two years of surveillance: 1997 and 1998

Results
Limitations
Summary of Long Term Changes
Summary Tables and Graphs

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