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Open Access Research article

Characterization of Salmonella enterica serovar Enteritidis isolates recovered from blood and stool specimens in Thailand

Rene S Hendriksen1*, Eija Hyytia-Trees2, Chaiwat Pulsrikarn3, Srirat Pornruangwong3, Phattharaporn Chaichana3, Christina Aaby Svendsen1, Rafiq Ahmed4 and Matthew Mikoleit2

Author Affiliations

1 Division of Bacterial Genomics and Epidemiology, WHO Collaborating Center for Antimicrobial Resistance in Food borne Pathogens and European Union Reference Laboratory for Antimicrobial Resistance, National Food Institute, Technical University of Denmark, Kemitorvet, Building 204, DK-2800, Kgs. Lyngby, Denmark

2 Division of Foodborne, Waterborne, and Environmental Diseases; Enteric Diseases Laboratory Branch; Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases, Mail stop CO3, 1600 Clifton Road, Atlanta, GA, 30333, USA

3 Department of Medical Sciences, WHO National Salmonella and Shigella Center, National Institute of Health, Ministry of Public Health, Tiwanond Road, Amphur Muang, Nonthaburi, 11000, Thailand

4 National Microbiology Laboratory, Public Health Agency of Canada, 1015 Arlington Street, Winnipeg, MB, R3E 3R2, Canada

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BMC Microbiology 2012, 12:92  doi:10.1186/1471-2180-12-92

Published: 6 June 2012

Abstract

Background

Bacteremia due to Salmonella spp. is a life-threatening condition and is commonly associated with immune compromise. A 2009 observational study estimated risk factors for the ten most common non-typhoidal Salmonella (NTS) serovars isolated from Thai patients between 2002ā€“2007. In this study, 60.8% of Salmonella enterica serovar Enteritidis isolates (nā€‰=ā€‰1517) were recovered from blood specimens and infection with Salmonella serovar Enteritidis was a statistically significant risk factor for bacteremia when compared to other NTS serovars. Based on this information, we characterized a subset of isolates collected in 2008 to determine if specific clones were recovered from blood or stool specimens at a higher rate. Twenty blood isolates and 20 stool isolates were selected for antimicrobial resistance testing (MIC), phage typing, PFGE, and MLVA.

Result

Eight antibiogrammes, seven MLVA types, 14 XbaI/BlnI PFGE pattern combinations, and 11 phage types were observed indicating considerable diversity among the 40 isolates characterized. Composite analysis based on PFGE and MLVA data revealed 22 genotypes. Seven of the genotypes containing two or more isolates were from both stool and blood specimens originating from various months and zones. Additionally, those genotypes were all further discriminated by phage type and/or antibiogramme. Ninety percent of the isolates were ciprofloxacin resistant.

Conclusions

The increased percentage of bloodstream infections as described in the 2009 observational study could not be attributed to a single clone. Future efforts should focus on assessing the immune status of bacteriaemic patients and identifying prevention and control measures, including attribution studies characterizing non-clinical (animal, food, and environmental) isolates.