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CDC estimates 6,200 drug-resistant Salmonella cases per year
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Approximately 6,200 culture-confirmed cases of drug-resistant Salmonella infections occur each year in the U.S., according to estimates from the CDC recently published in Emerging Infectious Diseases.
“Antimicrobial drug-resistant Salmonella is a serious threat to public health,” Felicita Medalla, MD, MS, of the CDC, and colleagues wrote. “Adverse clinical outcomes (eg, increased rates of hospitalization, bloodstream infection, invasive illness and death) have been associated with resistant infections, and treatment failures have been reported for infections with reduced susceptibility to ciprofloxacin. Estimates of the incidence of resistant Salmonella infections are needed to inform policy decisions.”
Medalla and colleagues used data from the CDC, the Prevention National Antimicrobial Resistance Monitoring System and the Laboratory-based Enteric Disease Surveillance for the years 2004 to 2012 to create Bayesian hierarchical models of drug-resistant nontyphoidal Salmonella. The researchers identified three mutually exclusive categories of resistance: ceftriaxone and ampicillin resistant; ampicillin resistant but ceftriaxone and ciprofloxacin susceptible; and ciprofloxacin non-susceptible but ceftriaxone susceptible. They used U.S. census population data to estimate incidence.
Researchers identified 369,254 culture-confirmed Salmonella infections. The Enteritidis isolate was the most common (19%), followed by Typhimurium (18%), Newport (11%) and Heidelberg (4%), they wrote. All other serotypes made up 48% of isolates, and another 13% had not been fully serotyped. Overall resistance was 12% (n = 2,320).
The overall incidence of ampicillin-only resistance was 1.07/100,000 person-years (95% credible interval, 0.86-1.32), while for ceftriaxone and ciprofloxacin resistance it was 0.51/100,000 person-years (95% CrI, 0.35-0.7) and for ciprofloxacin non-susceptibility it was 0.35/100,000 person-years (95% CrI, 0.24-0.51).
Study limitations included that the disease is likely underreported and that diseases may often be reported in the state where they were diagnosed rather than where patients live.
“National incidence estimates of resistant Salmonella infections are needed to track progress to support the U.S. President’s Executive Order to combat antibiotic-resistant bacteria,” the researchers wrote. “Such estimates help define the magnitude of the resistance problem, target prevention efforts and assess whether control measures are working. Further development of these methods can be used to assess progress from control measures.” – by Andy Polhamus
Disclosure: All researchers are employees of the CDC.
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