title: Antimicrobial use and outcomes in patients with multidrug-resistant and pansusceptible Salmonella Newport infections, 2002-2003.
abstract: Multidrug-resistant Salmonella Newport with decreased susceptibility to ceftriaxone (MDR-AmpC) is becoming increasingly common in its food animal reservoirs and in humans. Few data exist on rates of antimicrobial use or differences in clinical outcomes in persons infected with MDR-AmpC or other Salmonella strains. We conducted a case-comparison analysis of data from a multistate population-based case-control study to identify antimicrobial treatment choices and differences in clinical outcomes in those infected with MDRAmpC compared to pansusceptible S. Newport. Of isolates from 215 laboratory-confirmed S. Newport cases, 54 (25%) were MDR-AmpC, 146 (68%) were pansusceptible, and 15 (7%) had other resistance patterns; 146 (68%) patients with S. Newport were treated with antimicrobial agents and 66 (33%) were hospitalized. Over two-thirds of cases at low-risk for serious complications received antimicrobial therapy, most commonly with fluoroquinolones, to which this strain was susceptible. There were no significant differences in symptoms, hospitalization, duration of illness, or other outcomes between the persons infected with MDR-AmpC and pansusceptible S. Newport. Although currently prevalent MDR-AmpC S. Newport strains remains susceptible to the antimicrobial most commonly prescribed for it, continued efforts to reduce unnecessary use of antimicrobial agents in food animals and humans are critical to prevent further development of resistance to quinolones and cephalosporins, which is likely to lead to substantial adverse outcomes.
authors.affiliation: Tennessee Department of Health, Nashville, Tennessee, USA.
authors.forename: Rose A
authors.initials: RA
authors.lastname: Devasia
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.forename: Jean
authors.initials: J
authors.lastname: Whichard
authors.forename: Sonya
authors.initials: S
authors.lastname: Gettner
authors.forename: Alicia B
authors.initials: AB
authors.lastname: Cronquist
authors.forename: Sharon
authors.initials: S
authors.lastname: Hurd
authors.forename: Suzanne
authors.initials: S
authors.lastname: Segler
authors.forename: Kirk
authors.initials: K
authors.lastname: Smith
authors.forename: Dina
authors.initials: D
authors.lastname: Hoefer
authors.forename: Beletshachew
authors.initials: B
authors.lastname: Shiferaw
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
authors.forename: Timothy F
authors.initials: TF
authors.lastname: Jones
mesh_terms: D000328:Adult; D000368:Aged; D000900:Anti-Bacterial Agents / Q000494:pharmacology* / Q000627:therapeutic use*; D016022:Case-Control Studies; D002443:Ceftriaxone / Q000494:pharmacology; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D012475:Salmonella / Q000187:drug effects* / Q000302:isolation & purification; D012480:Salmonella Infections / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone