Antimicrobial resistance in Salmonella infections associated with foreign travel
Abstract number: O49
Al-Mashhadani M., Hewson R., Vivancos R., Keenan A., Beeching N., Wain J., Parry C.
Objectives: Non-typhoidal Salmonella (NTS) causes gastroenteritis and can lead to serious invasive illness and death. Many cases of NTS go untreated as they cause a mild illness. In more serious cases treatment is required and the fluoroquinolones are often the drug of choice. Isolates with decreased susceptibility to ciprofloxacin (DCS), which is usually associated with resistance to nalidixic acid (NA), are on the increase. It has been suggested that foreign travel is a risk factor for the acquisition of Salmonella enterica isolates with NA resistance and DCS. This study aims to investigate the link between foreign travel and NA resistant/DCS isolates in Liverpool.
Methods: NTS strains from 2003 onwards were characterised for resistance to NA and DCS. A database containing all Salmonella strains detected by the Microbiology Service at a Liverpool Teaching Hospital from 2003 was merged with statutory notification of diseases data that contains the travel history (validated through an enhanced questionnaire) to investigate the link between NA resistance, DCS and foreign travel.
Results: 433 unique NTS strains were isolated. NA susceptibility DCS information was available for 371 (85.6%) and 364 (84.1%) of cases respectively. NA resistance was found in 82 (22.1%) and DCS in 84/364 (23.1%) of the isolates. Approximately one fifth of cases of salmonellosis had travelled abroad during the incubation period. Significantly higher levels of NA resistance (travel 38.4% vs no travel 18.1%; RR 2.12, 95% CI 1.453.09) and DCS (travel 37.5% vs no travel 19.5%; RR 1.92, 95% CI 1.322.81) were found in isolates associated with foreign travel.
Conclusions: Foreign travel is a significant risk factor for the acquisition of Salmonella isolates with NA resistance and DCS. Antibiotic resistance can lead to delays in effective treatment and result in complications. Public health authorities need to engage with the travel industry in order to improve surveillance and prevention of travel related gastrointestinal infections.
|Session name:||Abstracts 20th European Congress of Clinical Microbiology and Infectious Diseases|
|Location:||Vienna, Austria, 10 - 13 April 2010|
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