Antimicrobial Resistance in Bacteria Isolated from Foods in Cuba.

INTRODUCTION Antimicrobial drug resistance constitutes a health risk of increasing concern worldwide. One of the most common av-enues for the acquisition of clinically-relevant antimicrobial resistance can be traced back to the food supply, where resistance is acquired through the ingestion of antimicrobial resistant microorganisms pres-ent in food. Antimicrobial resistance constitutes a health risk, leading to production losses and negative consequences for livelihood and food safety. OBJECTIVE Determine whether resistant bacteria are present in foods in Cuba. METHODS A descriptive observational study was conducted in theMicrobiology Laboratory of Cuba's National Institute of Hygiene, Epi-demiology and Microbiology from September 2004 through Decem-ber 2018. Researchers analyzed 1178 bacterial isolates from food samples. The isolates were identifi ed as Escherichia coli, Salmonella, Vibrio cholerae and coagulase-positive Staphylococcus. The antimi-crobial susceptibility study was performed using the Bauer-Kirby disk diffusion method, following procedures outlined by the Clinical and Laboratory Standards Institute. The data were analyzed using WHO-NET version 5.6. RESULTS Of the total isolates, 62.1% were resistant to at least one antibiotic. Within each group, >50% of isolates showed some type of resistance. E. coli and V. cholerae exceeded 50% resistance to tetracycline and ampicillin, respectively. Staphylococcus showed the highest resistance to penicillin, and Salmonella to tetracycline, nali-dixic acid and ampicillin. The highest percentages of non-susceptible microorganisms were identifi ed in meats and meat products. CONCLUSIONS These results serve as an alert to the dangers of acquiring antibiotic-resistant bacteria from food and demonstrate the need to establish a surveillance system and institute measures bacte-rial control in food products.KEYWORDS Microbial drug resistance, bacteria, food, foodborne disease, Cuba.

Resistencia antimicrobiana en bacterias aisladas de pescados y mariscos / Antimicrobial resistance in bacteria isolated in fish and shellfish

RESUMEN Introducción: El alarmante incremento de la resistencia bacteriana frente a los antibióticos constituye uno de los mayores problemas en Salud Pública. Las bacterias de ambientes acuáticos pueden transferir genes de resistencia antimicrobiana a otras bacterias, incluyendo las patógenas para el hombre, lo cual constituye un riesgo. Objetivo: Determinar la resistencia a los antimicrobianos en aislamientos bacterianos de pescados y mariscos. Materiales y métodos: Se analizaron 154 aislamientos bacterianos en pescados y mariscos en el Laboratorio de Microbiología del Instituto Nacional de Higiene Epidemiología y Microbiología. La susceptibilidad antimicrobiana, se determinó mediante el método de difusión con discos (Bauer-Kirby), según la normativa del Clinical and Laboratory Standards Institute. El análisis de los resultados se realizó mediante el programa WHONET 5.6. Resultados: Se Identificó resistencia en dos cepas de Salmonella y seis de E. coli, la resistencia se expresó con mayor frecuencia para para la ampicilina y la tetraciclina. En Staphylococcus se determinó un patrón de multirresistencia para el cloranfenicol, la eritromicina y la tetraciclina. Vibrio cholerae fue el género con mayor aislamiento en pescados y mariscos, las cepas resistentes fueron más frecuentes en ostiones y pescados de aguas dulces. Conclusiones: Se determinaron los mayores porcentajes de resistencia para la ampicilina y la tetraciclina en el total de los microorganismos estudiados. El ostión se consideró el producto de mayor riesgo de diseminación de bacterias resistentes a los antimicrobianos.

ABSTRACT Introduction: The alarming increase of antibiotics resistance in bacteria is one of the greatest problems in Public Health. Bacteria in aquatic environments can transfer antimicrobial resistance genes to other bacteria, including pathogenic bacteria for humans, which is a health risk. Objective: To determine the antimicrobial resistance in bacterial isolates from fish and shellfish. Materials and methods: A total of 154 bacterial isolates were analyzed in fish and shellfish in the microbiology laboratory of the National Institute of Hygiene, Epidemiology and Microbiology. Antimicrobial susceptibility was determined by the Kirby- Bauer disc diffusion method according to the regulations of the Clinical and Laboratory Standards Institute. The analysis of the results was carried out by the WHONET 5.6 program. Results: Resistance was identified in two strains of Salmonella and six ones of Escherichia coli, the resistance to ampicillin and tetracycline was higher. A multiresistance pattern was identified in multiresistant staphylococcus to chloramphenicol, erythromycin and tetracycline. Vibrio cholerae was the most frequent genus found in fish and shellfish; resistant strains were more frequent in oysters and freshwater fish. Conclusions: The highest percentages of resistance were determined for ampicillin and tetracycline in the total of microorganisms studied. The oyster was considered the greatest risk product of dissemination of antimicrobial-resistant bacteria.

Serovariedades y patrones de susceptibilidad a los antimicrobianos de cepas de Salmonella aisladas de alimentos en Cuba / Serotypes and antimicrobial susceptibility patterns of Salmonella strains isolated from food in Cuba

The serotypes of 178 isolates of Salmonella enterica taken from food in different regions of Cuba between January 2008 and December 2009 were identified, and the antimicrobial susceptibility pattern of 100 selected isolates was determined by stratasampling. A total of 20 Salmonella serotypes were identified, with a predominance of S. Enteritidis (23%), S. Agona (13.5%), and S. London (11.2%). Of all the strains, 75%were resistant or presented intermediate resistance to at least one of the drugs tested, in the following order: tetracycline (70.7%), ampicillin (22.7%), and nalidixic acid (14.7%). Ten different resistance patterns were identified. The most frequent patternscorresponded to strains that were either drug-resistant or had intermediate resistance (89.3%). Three strains (identified as S. Infantis, S. Derby, and S. Enteritidis) were multiresistant, and one of them, S. Enteritidis, was not sensitive to either nalidixic acid or ciprofloxacin. To control salmonellosis, the importance of maximizing integrated health surveillance is emphasized.

Se describen los serotipos de 178 cepas de Salmonella enterica aisladas de alimentos en diferentes regiones de Cuba entre enero de 2008 y diciembre de 2009, y el patrón de susceptibilidada los antimicrobianos de 100 aislados seleccionados mediante muestreo por estratos. Se identificaron 20 serovariedades de Salmonella entre las que predominaron S. Enteritidis (23%);S. Agona (13,5%) y S. London (11,2%). Del total, 75% de las cepas fueron resistentes o presentaronresistencia intermedia a al menos uno de los fármacos probados, en el siguiente orden, según su frecuencia: tetraciclina (70,7%); ampicilina (22,7%) y ácido nalidíxico (14,7%). Seidentificaron 10 patrones de resistencia diferentes y predominaron las cepas resistentes o con resistencia intermedia a un fármaco (89,3%). Tres cepas (S. Infantis, S. Derby y S. Enteritidis)fueron multirresistentes y una, de S. Enteritidis, dio un resultado no sensible al ácido nalidíxico y la ciprofloxacina. Se destaca la necesidad de extremar la vigilancia sanitaria integrada en el país para el control de la salmonelosis.

[Serotypes and antimicrobial susceptibility patterns of Salmonella strains isolated from food in Cuba]. / Serovariedades y patrones de susceptibilidad a los antimicrobianos de cepas de Salmonella aisladas de alimentos en Cuba.

The serotypes of 178 isolates of Salmonella enterica taken from food in different regions of Cuba between January 2008 and December 2009 were identified, and the antimicrobial susceptibility pattern of 100 selected isolates was determined by strata sampling. A total of 20 Salmonella serotypes were identified, with a predominance of S. Enteritidis (23%), S. Agona (13.5%), and S. London (11.2%). Of all the strains, 75% were resistant or presented intermediate resistance to at least one of the drugs tested, in the following order: tetracycline (70.7%), ampicillin (22.7%), and nalidixic acid (14.7%). Ten different resistance patterns were identified. The most frequent patterns corresponded to strains that were either drug-resistant or had intermediate resistance (89.3%). Three strains (identified as S. Infantis, S. Derby, and S. Enteritidis) were multiresistant, and one of them, S. Enteritidis, was not sensitive to either nalidixic acid or ciprofloxacin. To control salmonellosis, the importance of maximizing integrated health surveillance is emphasized.