Nontyphoidal Salmonella from human clinical cases, asymptomatic children, and raw retail meats in Yucatan, Mexico.

BACKGROUND: We report the results of a 3-year Salmonella surveillance study of persons with diarrhea; asymptomatic children; and retail pork, poultry, and beef in Yucatan, Mexico. METHODS: Isolates were characterized according to serotype, antimicrobial susceptibility, and genetic relatedness with pulsed-field gel electrophoresis. RESULTS: Salmonella Typhimurium was the most common serotype found in ill humans (21.8% of isolates), followed by Salmonella Agona (21% of isolates). Salmonella Enteritidis was a minor serotype (4.2% of isolates). Asymptomatic children carried S. Agona (12.1% of isolates), Salmonella Meleagridis (11.6% of isolates), Salmonella Anatum (8% of isolates) and S. Enteritidis (5.8% of isolates). A high percentage of retail meat samples contained Salmonella; it was most commonly found in pork (58.1% of samples), followed by beef (54% of samples) and poultry (39.7% of samples). Resistance to oral drugs used for the treatment of salmonellosis was observed for ampicillin (14.6% of isolates were resistant), chloramphenicol (14.0% of isolates), and trimethoprim-sulfamethoxazole (19.7% of isolates). Resistance to ceftriaxone emerged in 2002 and was limited to the serotype S. Typhimurium. Twenty-seven percent of the isolates were resistant to nalidixic acid, and none were resistant to ciprofloxacin. Multidrug resistance was most common among isolates of serotypes S. Typhimurium and S. Anatum. Pulsed-field gel electrophoresis showed that strains found in retail meats were genetically identical to strains found in both asymptomatic children and ill patients. CONCLUSIONS: Our study found a high prevalence of Salmonella in retail meats and persons with enteric infection; many of these isolates were resistant to clinically important antimicrobials. A random selection of isolates from people and retail meat showed genetic relatedness, which suggests that, in Yucatan, considerable transfer of Salmonella occurs through the food chain.

Rapid and widespread dissemination of multidrug-resistant blaCMY-2 Salmonella Typhimurium in Mexico.

OBJECTIVES: We describe the emergence and dissemination of multidrug-resistant (MDR) Salmonella Typhimurium in humans, retail meat and food animals from Yucatan, Mexico. METHODS: Salmonella Typhimurium isolates were collected through an active surveillance system and tested for susceptibility to 12 antimicrobial agents. Isolates that were non-susceptible to ceftriaxone were tested with 10 additional antimicrobials and assayed by PCR for the presence of CMY, CTX-M, SHV, TEM and OXA beta-lactamase genes. Plasmid-borne phenotypes were identified by transfer to susceptible Escherichia coli. Isolates from humans, retail meat and food animals were compared by PFGE to determine genetic relatedness. RESULTS: MDR Salmonella Typhimurium containing a plasmid-mediated blaCMY-2 AmpC beta-lactamase rose from 0% (0/27) during 2000 and 2001 to 75% (63/84) in 2004 and 2005 (P<0.0001). MDR blaCMY-2 Salmonella Typhimurium (n=115) was most common in ill children (44.3%) and pork or swine intestine (36.5%). In several cities, MDR blaCMY-2 Salmonella Typhimurium from retail meat or swine intestine exhibited PFGE patterns and antibiograms indistinguishable from those in strains recovered from hospitalized children. The CMY gene was transferred to E. coli by electroporation, along with resistance to three to six other antimicrobials. Children with MDR blaCMY-2 Salmonella Typhimurium infection (n=39) had a higher frequency of systemic infection (13% versus 0%), mortality (8% versus 0%) and hospital re-admission due to protracted diarrhoea (28% versus 17%) than children with non-MDR-Salmonella Typhimurium (n=24), although the difference was not statistically significant. CONCLUSIONS: The rapid and widespread dissemination of MDR blaCMY-2 Salmonella Typhimurium in Mexico calls for urgent interventions to contain this potentially fatal pathogen.