Abstract
Salmonella is a major cause of foodborne illness in the United States, and antimicrobial-resistant strains pose a serious threat to public health. We used Bayesian hierarchical models of culture-confirmed infections during 2004–2016 from 2 Centers for Disease Control and Prevention surveillance systems to estimate changes in the national incidence of resistant nontyphoidal Salmonella infections. Extrapolating to the United States population and accounting for unreported infections, we estimated a 40% increase in the annual incidence of infections with clinically important resistance (resistance to ampicillin or ceftriaxone or nonsusceptibility to ciprofloxacin) during 2015–2016 (≈222,000 infections) compared with 2004–2008 (≈159,000 infections). Changes in the incidence of resistance varied by serotype. Serotypes I 4,[5],12:i:- and Enteritidis were responsible for two thirds of the increased incidence of clinically important resistance during 2015–2016. Ciprofloxacin-nonsusceptible infections accounted for more than half of the increase. These estimates can help in setting targets and priorities for prevention.
Highlights
Salmonella is a major cause of foodborne illness in the United States, and antimicrobial-resistant strains pose a serious threat to public health
Laboratory-Based Enteric Disease Surveillance Public health laboratories in 50 states and many local health departments receive human Salmonella isolates from clinical laboratories and report serotype information to the Centers for Disease Control and Prevention (CDC) through Laboratory-Based Enteric Disease Surveillance (LEDS) (17)
Our analysis indicates that the incidence of resistant Salmonella infections was higher in 2015–2016 than in earlier periods during 2004–2014
Summary
Salmonella is a major cause of foodborne illness in the United States, and antimicrobial-resistant strains pose a serious threat to public health. Extrapolating to the United States population and accounting for unreported infections, we estimated a 40% increase in the annual incidence of infections with clinically important resistance (resistance to ampicillin or ceftriaxone or nonsusceptibility to ciprofloxacin) during 2015–2016 (≈222,000 infections) compared with 2004– 2008 (≈159,000 infections). Ciprofloxacin-nonsusceptible infections accounted for more than half of the increase These estimates can help in setting targets and priorities for prevention. Nontyphoidal Salmonella infections cause an estimated 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths each year in the United States (1). Antimicrobial-resistant Salmonella infections can cause adverse clinical outcomes, including increased rates of hospitalization, bloodstream infection, other invasive illnesses, and death (3–7).
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