Molecular Characterization of Multidrug-Resistant Salmonella enterica subsp. enterica Serovar Typhimurium Isolates from Swine

ABSTRACT As part of a longitudinal study of antimicrobial resistance among salmonellae isolated from swine, we studied 484 Salmonella enterica subsp. enterica serovar Typhimurium (including serovar Typhimurium var. Copenhagen) isolates. We found two common pentaresistant phenotypes. The first was resistance to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, and tetracycline (the AmCmStSuTe phenotype; 36.2% of all isolates), mainly of the definitive type 104 (DT104) phage type (180 of 187 isolates). The second was resistance to ampicillin, kanamycin, streptomycin, sulfamethoxazole, and tetracycline (the AmKmStSuTe phenotype; 44.6% of all isolates), most commonly of the DT193 phage type (77 of 165 isolates), which represents an unusual resistance pattern for DT193 isolates. We analyzed 64 representative isolates by amplified fragment length polymorphism (AFLP) analysis, which revealed DNA fingerprint similarities that correlated with both resistance patterns and phage types. To investigate the genetic basis for resistance among DT193 isolates, we characterized three AmKmStSuTe pentaresistant strains and one hexaresistant strain, which also expressed resistance to gentamicin (Gm phenotype), all of which had similar DNA fingerprints and all of which were collected during the same sampling. We found that the genes encoding the pentaresistance pattern were different from those from isolates of the DT104 phage type. We also found that all strains encoded all of their resistance genes on plasmids, unlike the chromosomally encoded genes of DT104 isolates, which could be transferred to Escherichia coli via conjugation, but that the plasmid compositions varied among the isolates. Two strains (strains UT08 and UT12) had a single, identical plasmid carrying blaTEM (which encodes ampicillin resistance), aphA1-Iab (which encodes kanamycin resistance), strA and strB (which encode streptomycin resistance), class B tetA (which encodes tetracycline resistance), and an unidentified sulfamethoxazole resistance allele. The third pentaresistant strain (strain UT20) was capable of transferring by conjugation two distinct resistance patterns, AmKmStSuTe and KmStSuTe, but the genes were carried on plasmids with slightly different restriction patterns (differing by a single band of 15 kb). The hexaresistant strain (strain UT30) had the same plasmid as strains UT08 and UT12, but it also carried a second plasmid that conferred the AmKmStSuGm phenotype. The second plasmid harbored the gentamicin resistance methylase (grm), which has not previously been reported in food-borne pathogenic bacteria. It also carried the sul1 gene for sulfamethoxazole resistance and a 1-kb class I integron bearing aadA for streptomycin resistance. We also characterized isolates of the DT104 phage type. We found a number of isolates that expressed resistance only to streptomycin and sulfamethoxazole (the StSu phenotype; 8.3% of serovar Typhimurium var. Copenhagen strains) but that had AFLP DNA fingerprints similar or identical to those of strains with genes encoding the typical AmCmStSuTe pentaresistance phenotype of DT104. These atypical StSu DT104 isolates were predominantly cultured from environmental samples and were found to carry only one class I integron of 1.0 kb, in contrast to the typical two integrons (InC and InD) of 1.0 and 1.2 kb, respectively, of the pentaresistant DT104 isolates. Our findings show the widespread existence of multidrug-resistant Salmonella strains and the diversity of multidrug resistance among epidemiologically related strains. The presence of resistance genes on conjugative plasmids and duplicate genes on multiple plasmids could have implications for the spread of resistance factors and for the stability of multidrug resistance among Salmonella serovar Typhimurium isolates.

[1]  T. O'Brien Emergence, spread, and environmental effect of antimicrobial resistance: how use of an antimicrobial anywhere can increase resistance to any antimicrobial anywhere else. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[2]  P. Fedorka-Cray,et al.  Antimicrobial use and resistance in animals. , 2002, Clinical infectious diseases : an official publication of the Infectious Diseases Society of America.

[3]  P. McDermott,et al.  Antimicrobial resistance of foodborne pathogens. , 2002, Microbes and infection.

[4]  D G White,et al.  The isolation of antibiotic-resistant salmonella from retail ground meats. , 2001, The New England journal of medicine.

[5]  D. Sandvang,et al.  [Five cases of gastroenteritis with multiresistant Salmonella enterica serovar Typhimurium DT104 related to farm animals in Denmark]. , 2001, Ugeskrift for laeger.

[6]  M. Woodward,et al.  Variation in clonality and antibiotic-resistance genes among multiresistant Salmonella enterica serotype typhimurium phage-type U302 (MR U302) from humans, animals, and foods. , 2001, Microbial drug resistance.

[7]  S. Carlson,et al.  Relative Distribution and Conservation of Genes Encoding Aminoglycoside-Modifying Enzymes in Salmonella enterica Serotype Typhimurium Phage Type DT104 , 2001, Applied and Environmental Microbiology.

[8]  T. Leegaard,et al.  Emerging antibiotic resistance in Salmonella Typhimurium in Norway , 2000, Epidemiology and Infection.

[9]  S. Fanning,et al.  Characterization and Chromosomal Mapping of Antimicrobial Resistance Genes in Salmonella enterica Serotype Typhimurium , 2000, Applied and Environmental Microbiology.

[10]  M. Pfaller,et al.  Animal and Human Multidrug-Resistant, Cephalosporin-ResistantSalmonella Isolates Expressing a Plasmid-Mediated CMY-2 AmpC β-Lactamase , 2000, Antimicrobial Agents and Chemotherapy.

[11]  T. Besser,et al.  Identification of DT104 and U302 Phage Types amongSalmonella enterica Serotype Typhimurium Isolates by PCR , 2000, Journal of Clinical Microbiology.

[12]  F. Aarestrup,et al.  Characterisation of streptomycin resistance determinants in Danish isolates of Salmonella Typhimurium. , 2000, Veterinary microbiology.

[13]  P. Fey,et al.  Ceftriaxone-resistant salmonella infection acquired by a child from cattle. , 2000, The New England journal of medicine.

[14]  E. Heir,et al.  Fluorescent Amplified-Fragment Length Polymorphism Genotyping of Salmonella enterica subsp. enterica Serovars and Comparison with Pulsed-Field Gel Electrophoresis Typing , 2000, Journal of Clinical Microbiology.

[15]  J. Lederberg Multidrug-resistant Salmonella enterica serotype typhimurium DT104. , 2000, The New England journal of medicine.

[16]  L. Ng,et al.  Genetic Characterization of Antimicrobial Resistance in Canadian Isolates of Salmonella Serovar Typhimurium DT104 , 1999, Antimicrobial Agents and Chemotherapy.

[17]  F. Aarestrup,et al.  An outbreak of multidrug-resistant, quinolone-resistant Salmonella enterica serotype typhimurium DT104. , 1999, The New England journal of medicine.

[18]  D. Michael Olive,et al.  Principles and Applications of Methods for DNA-Based Typing of Microbial Organisms , 1999, Journal of Clinical Microbiology.

[19]  H. S. Hurd,et al.  Detection of multiresistant Salmonella typhimurium DT104 using multiplex and fluorogenic PCR. , 1999, Molecular and cellular probes.

[20]  A. Brisabois,et al.  Multidrug-resistant human and animal Salmonella typhimurium isolates in France belong predominantly to a DT104 clone with the chromosome- and integron-encoded beta-lactamase PSE-1. , 1999, The Journal of infectious diseases.

[21]  P. Fratamico,et al.  Molecular Characterization of an Antibiotic Resistance Gene Cluster of Salmonella typhimuriumDT104 , 1999, Antimicrobial Agents and Chemotherapy.

[22]  V. Agmon,et al.  Emergence of multidrug-resistant Salmonella enterica serotype Typhimurium phage-type DT104 among salmonellae causing enteritis in Israel , 1998, Epidemiology and Infection.

[23]  F. Aarestrup,et al.  Characterisation of recently emerged multiple antibiotic-resistant Salmonella enterica serovar typhimurium DT104 and other multiresistant phage types from Danish pig herds , 1998, Veterinary Record.

[24]  M. Domenichini,et al.  A community-based outbreak of Salmonella enterica serotype Typhimurium associated with salami consumption in Northern Italy , 1998, Epidemiology and Infection.

[25]  M. Glynn,et al.  Emergence of multidrug-resistant Salmonella enterica serotype typhimurium DT104 infections in the United States. , 1998, The New England journal of medicine.

[26]  F. Aarestrup,et al.  Characterisation of integrons and antibiotic resistance genes in Danish multiresistant Salmonella enterica Typhimurium DT104. , 1998, FEMS microbiology letters.

[27]  E. Threlfall,et al.  Increasing incidence of resistance to trimethoprim and ciprofloxacin in epidemic Salmonella typhimurium DT104 in England and Wales. , 1997, Euro surveillance : bulletin Europeen sur les maladies transmissibles = European communicable disease bulletin.

[28]  S. Rankin,et al.  Antimicrobial resistance of Salmonella enterica Typhimurium DT104 isolates and investigation of strains with transferable apramycin resistance , 1997, Epidemiology and Infection.

[29]  T. Besser,et al.  Salmonellosis associated with S typhimurium DT104 in the USA. , 1997, The Veterinary record.

[30]  D. Munro,et al.  Multiple-resistant Salmonella typhimurium DT104 in cats , 1996, The Lancet.

[31]  M. Cooke,et al.  An outbreak of Salmonella typhimurium DT104 food poisoning associated with eating beef. , 1996, Communicable disease report. CDR review.

[32]  B. Rowe,et al.  Multiresistant Salmonella typhimurium DT104 in cats: a public health risk , 1996, The Lancet.

[33]  E. Threlfall,et al.  Salmonella typhimurium DT 193: differentiation of an epidemic phage type by antibiogram, plasmid profile, plasmid fingerprint and salmonella plasmid virulence (spv) gene probe. , 1995, The Journal of applied bacteriology.

[34]  H C Wegener,et al.  Phage Types of Salmonella enterica ssp. enterica serovar Typhimurium Isolated from Production Animals and Humans i Denmark , 1994, Acta Veterinaria Scandinavica.

[35]  H C Wegener,et al.  Salmonella Typhimurium phage types from human salmonellosis in Denmark 1988–1993 , 1994, APMIS : acta pathologica, microbiologica, et immunologica Scandinavica.

[36]  E. Threlfall,et al.  Epidemic in cattle and humans of Salmonella typhimurium DT 104 with chromosomally integrated multiple drug resistance , 1994, Veterinary Record.

[37]  H. Maguire,et al.  A large outbreak of human salmonellosis traced to a local pig farm , 1993, Epidemiology and Infection.

[38]  J. Petersen,et al.  Sensitivity and Specificity of Different Methods for the Isolation of Salmonella from Pigs , 1991, Acta Veterinaria Scandinavica.

[39]  R. Hall,et al.  A novel family of potentially mobile DNA elements encoding site‐specific gene‐integration functions: integrons , 1989, Molecular microbiology.

[40]  J. Wells,et al.  Toward a population genetic analysis of Salmonella: genetic diversity and relationships among strains of serotypes S. choleraesuis, S. derby, S. dublin, S. enteritidis, S. heidelberg, S. infantis, S. newport, and S. typhimurium. , 1988, Proceedings of the National Academy of Sciences of the United States of America.

[41]  E. Bruck,et al.  National Committee for Clinical Laboratory Standards. , 1980, Pediatrics.

[42]  L R Ward,et al.  Spread of multiresistant strains of Salmonella typhimurium phage types 204 and 193 in Britain. , 1978, British medical journal.

[43]  E. S. Anderson,et al.  Drug Resistance and its Transfer in Salmonella typhimurium , 1965, Nature.

[44]  O. Cars,et al.  A European study on the relationship between antimicrobial use and antimicrobial resistance. , 2002, Emerging infectious diseases.

[45]  P. Fedorka-Cray,et al.  Fecal shedding of Salmonella spp. by dairy cows on farm and at cull cow markets. , 2001, Journal of food protection.

[46]  E. Threlfall,et al.  The Emergence of a new Salmonella Typhimurium phage type associated with pigs , 2001 .

[47]  C. Hart,et al.  Analysis of Salmonella enterica serotype Typhimurium by phage typing, antimicrobial susceptibility and pulsed-field gel electrophoresis. , 1999, Journal of medical microbiology.

[48]  P. Vos,et al.  AFLP: a new technique for DNA fingerprinting. , 1995, Nucleic acids research.