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[Salmonella montevideo from a hospital outbreak with different antibiograms determined by a plasmid]
Abstract:
From May to June 1984 an outbreak of Salmonella montevideo occurred in the neonatal ward of a district's hospital. 26 babies were involved and mild forms of disease were observed in the most cases. The infants were hospitalized from different reasons and treated chemotherapeutically prior to the nosocomial infection. The Salmonella montevideo strains isolated from the faeces of the infants showed five different antibiograms. In all strains the multiple drug resistance was determined by a single plasmid belonging to the incompatibility group C and with a molecular weight of 110 Md or 100 Md in the threefold resistant strains. These plasmids were found also in the faecal flora (E. coli and Klebsiella) of all patients. It is suggested that a transfer of the plasmids from E. coli or Klebsiella to Salmonella montevideo occurred under in vivo condition, since distinct patients excreted susceptible as well as resistant Salmonellae. This example shows the necessity to include antibiogram and plasmid analysis as epidemiological markers.
Insights
A 1984 neonatal ward outbreak revealed Salmonella montevideo strains with multiple drug resistance due to plasmids. These plasmids transferred between bacteria in vivo, highlighting the need for plasmid analysis in epidemiology.
Area of Science:
- * Clinical microbiology and infectious disease epidemiology.
- * Bacterial genetics and molecular epidemiology.
Context:
- * An outbreak of Salmonella montevideo occurred in a hospital's neonatal ward between May and June 1984.
- * Twenty-six infants were affected, most with mild illness, and had prior chemotherapeutic treatment.
- * Salmonella montevideo strains exhibited diverse antibiograms and multiple drug resistance.
Purpose:
- * To investigate the genetic basis of multiple drug resistance in Salmonella montevideo during a nosocomial outbreak.
- * To determine the origin and transfer mechanisms of drug resistance plasmids in neonatal patients.
Summary:
- * Multiple drug resistance in Salmonella montevideo strains was linked to single plasmids (incompatibility group C, 100-110 Md).
- * Identical plasmids were detected in fecal flora (E. coli, Klebsiella) of the affected infants.
- * Evidence suggests in vivo plasmid transfer from E. coli or Klebsiella to Salmonella montevideo.
Impact:
- * Demonstrates the critical role of plasmid analysis alongside antibiograms as epidemiological markers for tracking infectious outbreaks.
- * Underscores the potential for horizontal gene transfer of antibiotic resistance in clinical settings.
- * Informs strategies for infection control and antibiotic stewardship in neonatal intensive care units.