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Superbug

Salmonella Typhimurium

Salmonella Newport
Salmonella Heidelberg

Most frequently encountered multi-drug resistance pattern: ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, tetracycline (ACSSuT). Many of the Typhimurium isolates with this resistance pattern have been further subtyped, using phage typing, to be Definitive Type 104 (DT104).

Relevance: Foodborne pathogen that causes illness in some animals particularly cattle and humans and is also isolated occasionally from the feces of asymptomatic animals. Illness in humans commonly associated with animal contact or animal-derived foodstuffs. Persons already taking antibiotics for other reasons are particularly likely to become ill.

Most frequently encountered multi-drug resistance pattern: ampicillin, chloramphenicol, streptomycin, sulfamethoxazole, tetracycline, amoxicillin/clauvulanic acid, cephalothin, cefoxitin and ceftiofur (MDR-AmpC).

Relevance: Food-borne pathogen that causes illness in cattle and humans. Illness in humans commonly associated with eating animal-derived foodstuffs, particularly ground beef or animal contact, particularly cattle.

Most frequently encountered multi-drug resistance pattern: ampicillin, amoxicillin-clavulanic acid, ceftiofur, and cephalothin.

Revelance: Food-borne pathogen that causes illness in poultry and humans. Illness in humans commonly associated with eating animal derived-foodstuffs, particularly poultry.

Salmonella Enteritidis Enterococcus fecalis / Enterococcus faecium Staphylococcus aureus
Salmonella Enteritidis
Enterococcus faecium
Staphylococcus aureus

Most frequently encountered resistance pattern: Most cases of human S. Enteritidis are pansusceptible.

Relevance: Food-borne pathogen that causes illness in humans. In poultry, S. Enteritidis infects the ovary which results in eggs that become contaminated before the shell is formed. Illness in humans commonly associated with eating eggs.

Most frequently encountered multi-drug resistance pattern: Gentamicin, vancomycin, and quinupriston/dalfopristin.

Relevance: Serious vancomycin-resistant Enterococci (VRE) infections occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) particularly among persons with weakened immune systems. In Europe, the presence of VRE in the intestinal tract of humans in the community is related to historical use of avoparcin as an antimicrobial growth promoter in livestock. In the United States, quinupriston/dalfopristin resistance among Enterococci in the intestinal tract of humans may be related to use of virginiamycin as an antimicrobial growth promoter.

Most frequently encountered multi-drug resistance pattern: Methicillin resistant S. aureus (MRSA).

Heathcare Associated MRSA – penicillin, oxacillin, methicillin, cephalosporins, carbapenems, erythromycin, clindamycin, and tetracycline.

Community Associated MRSA – penicillin, oxicillin, methicillin, cephalosporins, carbapenems, and erythromycin.Relevance: Serious “Staph” infections, including MRSA, occur most frequently among persons in hospitals and healthcare facilities (such as nursing homes and dialysis centers) particularly among persons with weakened immune systems. Recently, community associated MRSA has increasingly been described among persons who have not been hospitalized and among persons who are otherwise healthy. MRSA has also been associated with clinical infections in companion animals and horses, usually surgical patients. However, animals can also be non-clinical carriers of the organism.

Streptococcus pneumoniae

Mycobacterium tuberculosis  
Streptococcus pneumoniae
Mycobacterium tuberculosis
 

Most frequently encountered multi-drug resistance pattern: Penicillin, cephalosporins, macrolides, and co-trimoxazole (trimethoprim/sulfamethoxazole).

Relevance: S. pneumoniae infections are among the leading causes worldwide of illness and death for young children, persons with underlying debilitating medical conditions, and the elderly. Pneumococcal infections range in clinical manifestation from otitis media (typically mild) to bacteremia, pneumonia, and meningitis (typically severe). The increasing prevalence of drug-resistant S.pneumoniae in the US has complicated empiric treatment and led to increased numbers of treatment failures. S.pneumoniae is not a veterinary pathogen.

Most frequently encountered multi-drug resistance pattern: isoniazid, rifampin, streptomycin, and ethambutol.

Relevance: To prevent the emergence of drug resistance, standard anti-tuberculosis regimens employ multiple drugs. Drug-resistant tuberculosis is caused by M. tuberculosis resistant to at least one antimicrobial agent commonly used to treat tuberculosis. Multi-drug resistant tuberculosis is the presence of resistance to at least isoniazid and rifampin, the two most potent drugs in the standard first-line regimen. Treating and curing multi-drug resistant tuberculosis requires the use of second line drugs, which are more toxic, less effective (requiring more prolonged therapy), and more expensive. M. tuberculosis is a rare veterinary pathogen.

 

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Salmonella

Gram-negative, rod-shaped bacteria that cause illness in humans and animals. Over 2700 serotypes of Salmonella exist. The four most common serotypes causing infections in humans are Typhimurium, Enteritidis, Heidelberg, and Newport.

Salmonellosis in Humans

Clinical signs and symptoms usually occur within 8 to 72 hours after becoming infected (usually by ingestion): diarrhea (often bloody), fever, and abdominal cramps. Serious invasive illness may occur.

Illness usually lasts 4 to 7 days.

Most recover with supportive treatment; however, some develop severe infections, and a few have chronic sequelae.

Antimicrobial agents may be life-saving. Hospitalization is common.

Drugs commonly used for empiric treatment:

Children: third generation cephalosporins (e.g., ceftriaxone)

Adults: fluoroquinolones (e.g., ciprofloxacin)

People at high risk for serious infections: elderly, infants, immune-compromised and patients taking antibiotics for treatment of other illnesses.