A large sampling study on the occurrence and characteristics of Pseudomonas aeruginosa and heterotrophic bacteria in mineral water over seasons and in different containers.

Molecular Detection of Salmonella.

Pulmonary disease caused by Mycobacterium avium complex (MAC-PD) is a chronic, recurrent disease, and its high recurrence rate after treatment makes clinical management difficult. Distinguishing whether recurrence is due to persistence of existing strains or reinfection with new strains is essential for establishing treatment strategies, preventing overuse of antimicrobials, and establishing infection control measures. According to reports, 54%-74% of MAC-PD recurrence is due to reinfection, which may be mainly related to environmental reservoirs such as household water supply. In this review, we present various clinical scenarios in which MAC-PD recurrence may occur and examine genotyping techniques as a strategy to distinguish and respond to them. From traditional methods such as IS1245-based restriction fragment length polymorphism, pulsed-field gel electrophoresis, and hsp65 and rpoB gene sequencing to high-resolution analysis techniques such as multilocus sequence testing and whole-genome sequencing, the latest molecular typing methods are comprehensively summarized. Integrating these genotype data into clinical settings, standardizing single-nucleotide polymorphism-based interpretation thresholds, and promoting the establishment of a global MAC strain database will make a substantial contribution to more accurately distinguishing the recurrence mechanisms of MAC-PD and establishing personalized treatment strategies.IMPORTANCEThe global burden of nontuberculous mycobacterial pulmonary disease (PD) is increasing, with Mycobacterium avium (MAC)-PD being the most prevalent and clinically challenging form. Its low treatment success rates, high frequency of recurrence, and persistent environmental exposure complicate both diagnosis and management. A critical clinical issue is determining whether recurrence represents true relapse, due to persistence of the original strain, or reinfection with a new strain, as this guides treatment and prevents overtreatment. Genotypic strategies capable of resolving strain-level differences can improve diagnostic accuracy, prevent misclassification, and ultimately support more informed treatment decisions. Therefore, integrating genotyping data into clinical workflows, standardizing single-nucleotide polymorphism thresholds, and establishing a global MAC strain database will not only support personalized treatment but also enhance the broader public health response to this disease.

Aim S. epidermidis SE and S. haemolyticus SH are commensal bacteria from skin microbiota. Both species are involved in device-related infections, especially hip, knee or shoulder bone and joint infections. Recently, a multidrug-resistant SE clone has been reported in prosthesis infections. The aim of this study was to report three cases of SE or SH infections treated by debridement antibiotic and implant retention (DAIR) surgery and combination of delafloxacin (DFX)/rifampicin. Method Three patients were involved. Medical characteristic of the patients, the type of surgery, and the bacteria implicated were recovered. Resistance profiles and treatment with the follow up were analyzed. Results Two males and one female aged from 51, 64 and 74 y-old were selected according to the treatment. No history of prosthetic joint infection before was reported. A DAIR procedure was performed on 1 elbow and 2 hips. BMIs were normal. ASA scores were < 3. Fever was present for 2 patients and fistula for 1. No acute blood-borne infection was reported. The median time between symptom onset and surgical procedure were 5, 22 and 55 days. During the DAIR surgery, 2/4, 3/6 and 2/5 peroperative samples were positive. Two patients were infected with SE including a mixed morphotype for 1 patient and the last one was infected with SH. All strains were methicillin-resistant and levofloxacin-resistant. Delafloxacin MICs were 0.047, 0.094 and 0.125 and 0.25 mg/L. All patients were treated by delafloxacin (450 mg*2 per day) and rifampicin (600 or 900 mg per day). No adverse event was reported. Conclusions DFX MIC should be tested according to EUCAST guidelines including if strain are levofloxacin-resistant. According to EUCAST guidelines, 2 breakpoints are available. All strains were considered susceptible and a favorable outcome was noticed for two patients after a one year follow up. However, for the third patient, the one with two S. epidermidis morphotypes, a relapse was observed 1 year after the first revised surgery revealing only the less DFX susceptible SE stain (MIC 0.25 mg/L) suggesting a selection of the strain with the higher DFX MIC leading to a treatment failure. Pulsed-field gel electrophoresis analysis confirmed the genetic link between the isolates. Therefore, DFX treatment can be a therapeutic option in bone and joint infection, even for levofloxacin-resistant strain, only if the DFX MIC is less than 0.094 mg/L (Tessier et al. Journal of Antimicrobial Chemotherapy 2024).

Wastewaters are considered as hotspot for multidrug resistant bacteria and genes, especially for extended spectrum beta lactamase producing Escherichia coli (ESBL-EC), which pose significant public health concern. Conventional wastewater treatment plants (WWTPs) are not designed to remove such resistant bacteria before discharge. This study, therefore, aimed to evaluate and compare the performance of two municipal WWTPs in eliminating ESBL-EC in Hatay province, Türkiye. The isolates were further characterized by antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE) and resistance gene analysis. A total of 24 wastewater samples [influent (n = 12) and effluent (n = 12)] were collected from both conventional and advanced biological WWTP. A total of 66 ESBL-EC were isolated and confirmed as ESBL producer. The abundance of ESBL-EC was significantly more prevalent in the influent water samples (mean 3.86 ± 0.11 log cfu/ml), when compared to the effluent wastewater samples (mean 2.20 ± 0.27 log cfu/ml). According to the PFGE results (cut-off > 85%), 16 isolates were clonally related, whereas 49 isolates were singletons and one isolate could not be evaluated. Besides beta-lactam antibiotics, the isolates were highly resistant to tetracycline (63.63%) and fluoroquinolones (43.93%). The blaCTX-M gene was the most frequently detected gene in the isolates (86.36%), among which the blaCTX-M-15 type (86.36%) was the most frequently detected. At least two disinfectant resistance genes were also detected in each of the isolates. Even though both WWTP were found to be effective in reducing ESBL-EC counts, not well enough to complete elimination, showing the potential public health risk.

Comparative evaluation of MALDI-TOF MS and PFGE for typing and transmission analysis of Corynebacterium striatum in an ICU setting.

With the large-scale use of antibiotics, the detection rate and mortality of carbapenem resistant Escherichia coli (CR-EC) have gradually increased. This study investigated the molecular characteristics and prevalence of CR-EC in order to supplement the isolated data of CR-EC in Hangzhou, China. The minimal inhibitory concentration was determined by microbroth dilution method. The drug resistance genes were detected by polymerase chain reaction. The transferability of plasmid was verified by the conjugation test and genetic homology was detected by pulsed-field gel electrophoresis. The whole genome was sequenced (WGS) using the Illumina MiSeq technology. A total of 8 non-duplicated CR-EC isolates were collected, and all exhibited a multidrug-resistant phenotype. Two different New Delhi metallo-β-lactamase (NDM) variants, blaNDM-5 and blaNDM-13, were found with detection rates of 62.5% and 12.5%, respectively. The success rate of conjugation was 100% (6/6). Homology analysis showed that there was no widespread cloning outbreak of CR-EC, and blaNDM-5-ST410 was prevalent in the local area as a dominant group. WGS also indicated the rate of occurrence of resistance genes carrying resistance for more types of antibiotics, as well as exposed potential virulence risks. This was a survey on the prevalence and molecular characteristics of CR-EC in Hangzhou. blaNDM-like production combined with extended spectrum beta-lactamase (ESBLs) and/or AmpC was the main resistance mechanism of CR-EC in this area. The dominant blaNDM-5-ST410 requires enhanced attention. The horizontal transformation of plasmids, complex drug resistance, and potential virulence risks also need close attention.

Relatively little is known about Pseudomonas aeruginosa lineages during early infection in individuals with cystic fibrosis (CF). The Early Pseudomonas Infection Control Clinical Trial (EPIC-CT), which treated individuals with CF and newly detected P. aeruginosa infections, presents an ideal opportunity to study this phenomenon. We performed whole-genome sequencing on 572 P. aeruginosa isolates from 190 EPIC-CT subjects. We identified 203 P. aeruginosa lineages causing newly detected infections near the time of enrollment of these subjects. Twelve subjects were initially infected with more than one P. aeruginosa lineage, and 20 subjects had different PA lineages detected during the follow-up period of the EPIC-CT. Of the 203 lineages causing initial infections, 144 were not detected again by culture and 59 were detected again despite antibiotic therapy. Multilocus sequence typing was as accurate as whole genome single nucleotide variant (SNV) typing in discriminating lineages, but pulsed-field gel electrophoresis inaccurately classified 17 genetically related isolates as distinct. Although subjects were infected for a relatively short time, 23 P. aeruginosa genes acquired nonsynonymous SNVs in at least 2 subjects. Of these, 14 had been previously identified as pathoadaptive, confirming that such mutations can emerge early in CF infections. Our study demonstrates the complexity of early P. aeruginosa infections in people with CF and the potential of these complexities to confound interpretation of antibiotic efficacy studies.

DNA copy number research is impeded by limited methodology to determine true DNA copy numbers accurately and precisely. Human alpha defensin 1-3 (DEFA1A3) is a multiallelic gene with DNA copy numbers generally ranging from 2 to 12 copies per diploid genome. In this study, we developed a digital droplet PCR (ddPCR) protocol using DEFA1A3 as a model locus. We compared these results to DNA copy numbers determined by pulsed field gel electrophoresis (PFGE), which is considered a gold standard in CNV identification, on 40 DNA samples from a clinical study cohort. Taqman real-time quantitative PCR (qPCR) was also compared, being the other major available low cost, high-throughput system. The copy number measurements of 40 genomic samples were highly concordant between ddPCR and PFGE, while copy number by qPCR correlated only weakly with PFGE copy number. In conclusion, ddPCR is a low-cost, high-throughput technique with accurate resolution of CNV at both low and high DNA copy numbers. This makes it an ideal model to adapt for CNV testing in clinical practice.

Salmonella enterica subsp. enterica serovar Mbandaka (S. Mbandaka) represents an emerging public health threat due to its remarkable genomic adaptability, involvement in multinational foodborne outbreaks, and the ability to establish persistent infections. Here, we report the first documented isolation of a carbapenem-resistant S. Mbandaka strain, a significant public health concern given the critical role of carbapenems in treating multidrug-resistant infections. Five clonal S. Mbandaka isolates were obtained from a single patient, with three isolates (SM_F22R, SM_F28R, and SM_B30R) exhibiting carbapenem resistance mediated by the blaNDM-1. The comprehensive genomic analysis uncovered a 1,220 kb chromosomal inversion mediated by IS26 through intramolecular replicative transposition (in trans), generating the SM_F28R and SM_B30R variants. Using S1 pulsed-field gel electrophoresis, Southern blotting, and conjugation experiments, we demonstrated the transfer of blaNDM-1: chromosomal localization in SM_F22R and plasmid-borne (IncC-type) carriage in SM_F28R and SM_B30R. Notably, the region carrying blaNDM-1 in both locations was flanked by IS26 and completely identical, indicating that IS26 may facilitate the transfer of blaNDM-1 between the chromosome and plasmid. Additionally, we detected the amplification of mph(A) on the chromosome and blaNDM-1 on the IncC plasmid. The expression level of blaNDM-1 in SM_F22R was lower than that in SM_F28R and SM_B30R, consistent with SM_F22R exhibiting lower carbapenem resistance compared to SM_F28R and SM_B30R. This study reported the IS26-mediated transfer of blaNDM-1 between the chromosome and a plasmid in S. Mbandaka, highlighting the critical role of transposable elements in disseminating carbapenem resistance.IMPORTANCEAs a clinically significant foodborne pathogen, carbapenem-resistant Salmonella presents a significant therapeutic challenge due to its extensive antibiotic resistance. While blaNDM-1 is conventionally plasmid-borne, our study elucidates its transfer between chromosomes and a conjugative IncC plasmid in Salmonella. Our findings demonstrate the pivotal involvement of IS26 and ISCR1 mobile genetic elements in orchestrating genomic rearrangements while concurrently mediating the horizontal transfer and subsequent amplification of antimicrobial resistance determinants. This study provides an important theoretical basis for an in-depth analysis of the horizontal transfer mechanism of bacterial resistance genes.

Vancomycin-resistant Enterococcus faecium (VREfm) is an important nosocomial pathogen. The recent emergence of the highly virulent clonal complex 17 (CC17) is posing a challenge for both therapeutic interventions and hospital infection control measures. Hence, prompt discrimination of CC17 VREfm from unrelated and less-virulent VREfm strains is essential for preventing its spread in hospitals and beyond. Between January 2022 and November 2024, 340 VREfm primary isolates have been identified in our lab and underwent genotyping by pulsed-field gel electrophoresis (PFGE) to survey a potential outbreak in the Tyrol region. In addition, whole-genome sequencing (WGS) was performed on a selected subset (n = 40). To curtail the lengthy time-to-result (TTR) of these methods, a novel typing protocol using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS) was established, validated, and optimized for rapid sample processing. PFGE and WGS showed that 61.2% of isolates (n = 208) belonged to a specific VREfm cluster identified as CC17 sequence type (ST) 80 vanA VREfm. A comprehensive MALDI-TOF MS analysis identified a distinct peak pattern specific to this lineage. This phenotypic characterization was used as a novel typing method with excellent performance (sensitivity: 1.00 [0.98-1.00], specificity: 0.89 [0.70-0.97]) and demonstrated a short TTR of 1 day after the cultural growth of VREfm. A rapid and novel MALDI-TOF MS-based typing approach for a specific CC17/ST80 vanA VREfm cluster was developed and enabled real-life application in routine diagnostics to assure accurate infection prevention and control measures. Future outbreak investigations may benefit from adopting this cost- and labor-efficient approach.IMPORTANCEThis study addresses the urgent need for faster ways to detect problematic hospital bacteria. A highly transmissible strain of Enterococcus faecium (CC17) has been spreading in healthcare settings, making infections harder to treat and control. Traditional methods to identify and track outbreaks are accurate but slow and resource-intensive, delaying critical infection control actions. By developing and validating a new method using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry, the researchers demonstrated that this strain can be identified quickly, reliably, and at lower cost. Importantly, the new approach delivers results within a day, compared to the lengthy turnaround times of existing methods. This rapid detection tool provides hospitals with a practical solution to respond to outbreaks more effectively, prevent further spread, and protect vulnerable patients. The findings highlight a valuable step forward in strengthening hospital infection control and improving patient safety.

Analysis of an outbreak of echinocandin-resistant clonal Candida parapsilosis complex harbouring ERG11Y132F and FKS1S656P mutations.

Prevalence of Salmonella spp. isolated from seagulls and pigeons in Barcelona, Spain and its genetic relatedness with Salmonella human clinical isolates.

PurposeThe objective of this study was to investigate the molecular characteristics and risk factors of bloodstream infection (BSI) caused by extended-spectrum beta-lactamase producing Klebsiella pneumoniae (ESBL-Kpn).MethodsBacterial species were identified using the matrix-assisted laser desorption ionization time-of-flight mass spectrometry (MALDI-TOF MS) (Bruker Daltonik GmbH, Bremen, Germany), while antimicrobial susceptibilities were assessed using the MicroScan WalkAway 96 Plus system (Siemens, Germany) and the microbroth dilution method. Polymerase chain reaction (PCR) was employed to detect common extended-spectrum beta-lactamase resistance genes (blaSHV, blaTEM, blaCTX-M). Multilocus sequence typing (MLST), pulsed-field gel electrophoresis (PFGE), capsular serotyping, and serum resistance tests were utilized to analyze the molecular characteristics among the isolated strains. Additionally, a logistic regression analysis was conducted to identify the risk factors associated with BSI caused by ESBL-Kpn.ResultsA total of 371 Klebsiella pneumoniae (K. pneumoniae) strains were isolated from blood samples collected at the Affiliated Hospital of Southwest Medical University between January 2020 and June 2023, among which 45 were confirmed to produce ESBL. Twenty-eight STs were identified, with ST15 being predominant. Most strains exhibited resistance to multiple antibiotics, with blaCTX-M-15 as the predominant ESBL resistance genes. Nine strains (n=9, 20%) of bacteria exhibited high serum resistance, and 27 strains matched capsular serotypes predominantly K17. Multivariate analysis indicated that transferred patients, prior use of cephalosporin antibiotics, and prolonged hospital stay were independent risk factors for ESBL-Kpn BSI.ConclusionBSI caused by ESBL-Kpn exhibit high resistance rates. The newly identified ST6835 and ST6837 indicate the emergence and spread of novel clones in Southwest China, highlighting the imperative for enhanced surveillance of ESBL-producing strains.

This study aimed to evaluate the antimicrobial susceptibility and clonal relatedness of Klebsiella pneumoniae isolates recovered from the milk of cows with mastitis in a large-scale study that clinical severity was scored. A total of 48K. pneumoniae complex isolates were subjected to in vitro antimicrobial susceptibility tests (AST), PCR for carbapenemase-encoding genes, and molecular typing by pulsed-field gel electrophoresis (PFGE). Thirteen isolates, selected by PFGE type and AST results were subjected to whole-genome sequencing (WGS) for the identification of sequence types (STs) and the detection of antimicrobial resistance genes and virulence-encoding genes. A total of 39 different PFGE restriction profiles were identified. Thirteen different STs, including two novel STs, were identified among the 13 sequenced strains. The blaCTX-M-8, qnrE1, aadA2, cmlA4, dfrA15, sul1, tetA, and tetB genes were identified. Two isolates presented the yersiniabactin-encoding gene ybtAEPQSTUX. Klebsiella pneumoniae isolates from the milk of cows with mastitis clinically scored revealed high genetic diversity, according to both PFGE and MLST analysis, as well as harboring resistance genes commonly found in human clinical isolates.

Group B streptococcus (GBS) is a uropathogen capable of causing urinary tract infections (UTIs), although its role in male patients is not well characterized. This study aimed to investigate the capsule serotypes and clonal relationships of GBS strains isolated from male patients with urinary symptoms. A total of 69 GBS isolates from male patients admitted to Adana City Hospital were analyzed. Capsule serotypes were determined by multiplex PCR (Thermo Fisher Scientific, USA), and clonal relationships were assessed using pulsed-field gel electrophoresis (PFGE) (Bio-Rad, USA). The most common capsule serotypes identified were Ib (n = 28; 40.6%), V (n = 23; 33.3%), and III (n = 18; 26.1%). All isolates were susceptible to ampicillin and vancomycin. Resistance rates were 69.5% for ciprofloxacin, 30.4% for erythromycin, 24.6% for clindamycin, and 11.5% for tetracycline. PFGE analysis revealed that two isolates from different patients, collected on separate dates, were 100% identical, indicating possible clonal spread. In conclusion, although GBS-related UTIs are uncommon in male patients, the data obtained in this study provide valuable insights for future epidemiological research on GBS in this population.

Macrophages, the central players of innate immunity, control invading microbes by encapsulating them inside the phagosome, a nutrient-poor, reactive oxidant species-rich organelle. Nevertheless, some microbes, including the opportunistic yeast pathogen Candida glabrata, noted for its karyotype diversity, rapid evolution of antifungal drug resistance, and lack of meiosis, can survive and even replicate inside macrophages. However, it is not fully understood how C. glabrata responds to macrophage engulfment, and it is unknown how this presumably DNA-damaging environment influences the pathogen’s genome stability. In this study, we used comparative transcriptomics to identify amino acid starvation and DNA damage as conditions eliciting C. glabrata responses most similar to macrophage engulfment. Consistent with this, we found that C. glabrata intra-macrophage survival and replication require master regulator of amino acid biosynthesis GCN4 and functional DNA double-strand break repair. Furthermore, comet assays provided the first direct evidence for increased DNA breaks in intra-macrophage yeast, and pulse-field gel electrophoresis showed that chromosomal alterations occur frequently in macrophage-passaged C. glabrata. Interestingly, these alterations could not be resolved by long read DNA sequencing, suggesting that they involved highly complex repetitive regions. Finally, we identified several point mutations emerging during macrophage passaging and showed that among them, a frameshift in RME1 (repressor of meiosis in Saccharomyces cerevisiae), increased C. glabrata intra-macrophage fitness. Together, these analyses point to amino acid deprivation, reveal elevated DNA breakage and chromosome instability, and raise intriguing questions about the role of meiotic gene orthologs in C. glabrata persisting and replicating within macrophages.

New Delhi metallo-β-lactamase 1 (NDM-1), a member of the B-type metallo-β-lactamase (MBL) family, emerged as a major focus in resistance research, raising serious concerns about the treatment of bacterial infections over the past decade. Kluyvera ascorbata, generally considered a bacterium of low pathogenicity and rarely associated with severe infections, has nonetheless demonstrated significant resistance to a broad spectrum of antibiotics in recent studies. In this study, we successfully isolated a K. ascorbata strain harboring the antibiotic-resistant genes blaNDM-1 and blaCTX-M-77 from a fecal sample of a patient with diarrhea in China. The strain was accurately identified using matrix-assisted laser desorption/ionization time-of-flight mass spectrometry (MALDI-TOF MS). Additionally, the minimum inhibitory concentration (MIC) of the strain against various antimicrobial agents was determined using agar dilution and microdilution method. The results indicated that the strain exhibited resistance to all tested antimicrobial agents. The blaNDM-1 resistance gene was located on an IncFIA (HI1), IncR plasmid, as revealed by whole-genome sequencing. A detailed analysis of the plasmid’s size, number, and location was conducted using S1-nuclease pulsed-field gel electrophoresis (S1-PFGE), Southern blotting, and conjugation experiments. These experiments successfully demonstrated the transfer of the plasmid carrying blaNDM-1 into the recipient bacterium Escherichia coli EC600. These findings underscore the urgent need for continuous surveillance of the blaNDM-1-carrying plasmid in clinical isolate of K. ascorbata to prevent and contain its further dissemination in China.

Objective: To understand the etiological surveillance and drug resistance characteristics of Legionella pneumophila (LP) from the aqueous environment of public places in Shanghai, from 2011 to 2020, and provide evidence for surveillance of the disease. Methods: Environmental water samples were systematically collected from public venues in urban and suburban districts of Shanghai for LP surveillance. All the identified LP isolates underwent a series of testings including serotyping, pulsed field gel electrophoresis (PFGE), sequence-based typing, and antimicrobial susceptibility testing. χ2 test or Cochran-Armitage trend tests were used for statistical analysis and for temporal resistance patterns. Results: Among 6 263 water samples, the LP-positive rate was 20.93% (1 311/6 263). The positivity rate decreased from 24.98% (287/1 149) in 2011-2012 to 20.02% (1 024/5 114) in 2013-2020 (χ2=13.92, P<0.001), with the highest monthly positivity observed from June to August (23.79%, 745/3 132). A total of 1 365 LP strains were isolated, of which 912 were further characterized, including 10 serotypes, 149 PFGE patterns, and 33 sequence types (ST). The predominant serotype was Lp1 (86.84%, 792/912), and the dominant ST was ST752 (29.50%, 269/912). ST clustering revealed two major clonal groups CG1 and CG2, accounting for 91.12% (831/912) of the isolates. The 190 LPs involved in the drug sensitivity test showed three resistance profiles: azithromycin resistance (31.05%, 59/190), ciprofloxacin resistance (0.53%, 1/190) and azithromycin+ciprofloxacin resistance (0.53%, 1/190). Azithromycin-resistant strains were predominantly ST1 (64.41%, 38/59). The antimicrobial resistance rate showed a significant decline, from 48.65% (18/37) in 2011-2012 to 28.10% (43/153) in 2013-2020 (χ2=9.38, P=0.002). Conclusions: Compared to from 2011 to 2012, both the positivity rate and antimicrobial resistance prevalence of LP in public aqueous environments of Shanghai exhibited an overall decline from 2013 to 2020. The predominant types of LP were serotype Lp1 and sequence type ST752, with notable high-level resistance to azithromycin. Measures as enhancing the enforcement of water safety regulations and prioritizing surveillance of azithromycin resistance in LP were recommended to mitigate public health risks.

Aquatic environments are potential reservoirs for the persistence and spread of pathogenic bacteria. This study investigated the prevalence of Salmonella spp. in stream environments and their relationship with clinical isolates in Republic of Korea. A total of 4582 water samples were collected from 94 streams. We identified these isolates using MALDI–TOF MS and the Kauffmann–White scheme. Polymerase chain reaction and sequencing were performed to identify the resistance genes. Whole genome sequencing analysis and pulsed-field gel electrophoresis (PFGE) were performed to investigate genetic relatedness. In total, 110 Salmonella isolates showing 23 serotypes were isolated from the streams. S. Typhimurium (20.9%) was the most common, followed by S. Livingstone (17.3%), S. Infantis (10.9%), S. Othmarschen (6.4%), S. I. 4,[5],12:i:- (5.5%), and S. Thompson (5.5%). PFGE patterns of eight serotypes were identical or closely related to the stream and clinical strains. The sequence types of S. Mbandaka and S. Livingstone isolates from streams were identical to those of the clinical specimens as ST413 and ST543, respectively. Salmonella strains are highly prevalent in streams and are closely related to the isolates obtained from patients. Therefore, the continuous monitoring of stream environments is required to control the spread of Salmonella.