title: Clonal dissemination of the multi-drug resistant Salmonella enterica serovar Braenderup, but not the serovar Bareilly, of prevalent serogroup C1 Salmonella from Taiwan.
abstract: BACKGROUND
  Nontyphoidal Salmonella is the main cause of human salmonellosis. In order to study the prevalent serogroups and serovars of clinical isolates in Taiwan, 8931 Salmonellae isolates were collected from 19 medical centers and district hospitals throughout the country from 2004 to 2007. The pulsed-field eletrophoresis types (PFGE) and antibiotic resistance profiles of Salmonella enterica serovars Bareilly (S. Bareilly) and Braenderup (S. Braenderup) were compared, and multi-drug resistance (MDR) plasmids were characterized.
  
  
  RESULTS
  Over 95% of human salmonellosis in Taiwan was caused by five Salmonella serogroups: B, C1, C2-C3, D1, and E1. S. Typhymurium, S. Enteritidis, S. Stanley and S. Newport were the four most prevalent serovars, accounting for about 64% of isolates. While only one or two major serovars from four of the most prevalent serogroups were represented, four predominant serovars were found in serogroup C1 Salmonellae. The prevalence was decreasing for S. Choleraeuis and S. Braenderup, and S. Virchow and increasing for S. Bareilly. S. Braenderup mainly caused gastroenteritis in children; in contrast, S. Bareiley infected children and elderly people. Both serovars differed by XbaI-PFGE patterns. Almost all S. Bareilly isolates were susceptible to antibiotics of interest, while all lacked plasmids and belonged to one clone. Two distinct major clones in S. Braenderup were cluster A, mainly including MDR isolates with large MDR plasmid from North Taiwan, and cluster B, mainly containing susceptible isolates without R plasmid from South Taiwan. In cluster A, there were two types of conjugative R plasmids with sizes ranging from 75 to 130 kb. Type 1 plasmids consisted of replicons F1A/F1B, blaTEM, IS26, and a class 1 integron with the genes dfrA12-orfF-aadA2-qacEDelta1-sulI. Type 2 plasmids belonged to incompatibility group IncI, contained tnpA-blaCMY-2-blc-sugE genetic structures and lacked both IS26 and class 1 integrons. Although type 2 plasmids showed higher conjugation capability, type 1 plasmids were the predominant plasmid.
  
  
  CONCLUSIONS
  Serogroups B, C1, C2-C3, D1, and E1 of Salmonella caused over 95% of human salmonellosis. Two prevalent serovars within serogroup C1, S. Bareilly and cluster B of S. Braenderup, were clonal and drug-susceptible. However, cluster A of S. Braenderup was MDR and probably derived from susceptible isolates by acquiring one of two distinct conjugative R plasmids.
authors.affiliation: The Central Region Laboratory, Center of Research and Diagnostics, Centers for Disease Control, No. 30, Wenxin S. 3rd Rd., Nantun Dist., Taichung, 40856, Taiwan. nipmcsc@cdc.gov.tw
authors.forename: Chien-Shun
authors.initials: CS
authors.lastname: Chiou
authors.forename: Jui-Ming
authors.initials: JM
authors.lastname: Lin
authors.forename: Cheng-Hsun
authors.initials: CH
authors.lastname: Chiu
authors.forename: Chi-Hong
authors.initials: CH
authors.lastname: Chu
authors.forename: Shu-Wun
authors.initials: SW
authors.lastname: Chen
authors.forename: Yung-Fu
authors.initials: YF
authors.lastname: Chang
authors.forename: Bor-Chun
authors.initials: BC
authors.lastname: Weng
authors.forename: Jwu-Guh
authors.initials: JG
authors.lastname: Tsay
authors.forename: Chyi-Liang
authors.initials: CL
authors.lastname: Chen
authors.forename: Chien-Hsing
authors.initials: CH
authors.lastname: Liu
authors.forename: Chishih
authors.initials: C
authors.lastname: Chu
mesh_terms: D000293:Adolescent; D000328:Adult; D017677:Age Distribution; D002648:Child; D002675:Child, Preschool; D016000:Cluster Analysis; D024901:Drug Resistance, Multiple, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007223:Infant; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D010802:Phylogeny; D010957:Plasmids; D012150:Polymorphism, Restriction Fragment Length; D015995:Prevalence; D012480:Salmonella Infections / Q000453:epidemiology*; D019779:Salmonella enterica / Q000145:classification / Q000235:genetics*; D012703:Serotyping; D013624:Taiwan / Q000453:epidemiology; D055815:Young Adult