Antimicrobial Resistance in Invasive Non-typhoid Salmonella from the Democratic Republic of the Congo Emergence of Decreased Fluoroquinolone Susceptibility and Extended-spectrum Beta Lactamases.docVIP

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Antimicrobial Resistance in Invasive Non-typhoid Salmonella from the Democratic Republic of the Congo Emergence of Decreased Fluoroquinolone Susceptibility and Extended-spectrum Beta Lactamases.doc

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Antimicrobial Resistance in Invasive Non-typhoid Salmonella from the Democratic Republic of the Congo Emergence of Decreased Fluoroquinolone Susceptibility and Extended-spectrum Beta Lactamases

AntimicrobialResistanceinInvasiveNon-typhoid SalmonellafromtheDemocraticRepublicoftheCongo: EmergenceofDecreasedFluoroquinoloneSusceptibility andExtended-spectrumBetaLactamases OctavieLunguya1,2,VeerleLejon3,4,Marie-FrancePhoba1,2,SophieBertrand5,RaymondVanhoof5, YouriGlupczynski6,JanVerhaegen7,Jean-JacquesMuyembe-Tamfum1,2,JanJacobs3* 1NationalInstituteforBiomedicalResearch,Kinshasa, DemocraticRepublicoftheCongo,2UniversityHospitalofKinshasa,Kinshasa, DemocraticRepublicoftheCongo, 3Department ofClinical Sciences, Institute ofTropicalMedicine,Antwerp,Belgium, 4Institut de Recherche pour leDe′veloppement,UMR177 IRD-CIRADINTERTRYP, CampusInternationaldeBaillarguet,Montpellier,France,5InstituteofPublicHealth,Brussels,Belgium,6NationalReferenceLaboratoryforMonitoringofAntimicrobial ResistanceinGram-negativeBacteria,CliniquesUniversitairesUCLdeMont-Godinne,Yvoir,Belgium,7UniversityHospitalLeuven,Leuven,Belgium Abstract Background: Co-resistance against the first-line antibiotics ampicillin, chloramphenicol and trimethoprim/sulphamethox- azole or multidrug resistance (MDR) is common in non typhoid Salmonella (NTS). Use of alternative antibiotics, such as fluoroquinolonesorthirdgenerationcephalosporinsisthreatenedbyincreasingresistance,butremainspoorlydocumented inCentral-Africa. Methodology/Principalfindings:AspartofamicrobiologicalsurveillancestudyinDRCongo,bloodcultureswerecollected between 2007 and 2011. Isolated NTS were assessed for serotype and antimicrobial resistance including decreased ciprofloxacin susceptibility and extended-spectrum beta-lactamase (ESBL) production. In total, 233 NTS isolates (representing 23.6% of clinically significant organisms) were collected, mainly consisting of Salmonella Typhimurium (79%)andSalmonellaEnteritidis(18%).ThemajorityofNTSwereisolatedintherainyseason,andrecoveredfromchildren #2yearsold.MDR,decreasedciprofloxacinsusceptibility,azithromycinandcefotaximeresistancewere80.7%,4.3%,3.0% and 2.1% respectively. ESBL prod