Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital
Suleyman G, Perri M, Vager D, Samuel L, Zervos MJ, Alangaden G, and Tibbetts RJ. Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital. Diagn Microbiol Infect Dis 2016.
Diagnostic microbiology and infectious disease
Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 negative, susceptible isolates were isolated from a single patient who initially had a CTX-M positive, resistant strain. Isolates were clonally related, including both resistant and susceptible strains, as confirmed by pulse field gel electrophoresis (PFGE). This is the first case of a novel Salmonella outbreak at this hospital, and we believe it to be the first case of an S. Isangi serotype outbreak in the United States.
Medical Subject Headings
Anti-Bacterial Agents; Cluster Analysis; Cross Infection; Disease Outbreaks; Drug Resistance, Bacterial; Electrophoresis, Gel, Pulsed-Field; Genotype; Humans; Molecular Epidemiology; Molecular Typing; Real-Time Polymerase Chain Reaction; Salmonella Infections; Salmonella enterica; Tertiary Care Centers; United States; beta-Lactamases