title: Characterization of Salmonella Isangi possessing a CTX-M15 ESBL associated with an outbreak in a US Hospital.
abstract: Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 negative, susceptible isolates were isolated from a single patient who initially had a CTX-M positive, resistant strain. Isolates were clonally related, including both resistant and susceptible strains, as confirmed by pulse field gel electrophoresis (PFGE). This is the first case of a novel Salmonella outbreak at this hospital, and we believe it to be the first case of an S. Isangi serotype outbreak in the United States.
authors.affiliation: Department of Infectious Disease, Henry Ford Health System, Detroit, MI 48202.
authors.forename: Geehan
authors.initials: G
authors.lastname: Suleyman
authors.affiliation: Infectious Disease Research Laboratory, Henry Ford Health System, Detroit, MI 48202.
authors.forename: Mary
authors.initials: M
authors.lastname: Perri
authors.affiliation: Infectious Disease Research Laboratory, Henry Ford Health System, Detroit, MI 48202.
authors.forename: Dora
authors.initials: D
authors.lastname: Vager
authors.affiliation: Department of Pathology, Henry Ford Health System, Detroit, MI 48202.
authors.forename: Linoj
authors.initials: L
authors.lastname: Samuel
authors.affiliation: Department of Infectious Disease, Henry Ford Health System, Detroit, MI 48202.
authors.forename: Marcos J
authors.initials: MJ
authors.lastname: Zervos
authors.affiliation: Department of Infectious Disease, Henry Ford Health System, Detroit, MI 48202.
authors.forename: George
authors.initials: G
authors.lastname: Alangaden
authors.affiliation: Department of Pathology, Henry Ford Health System, Detroit, MI 48202. Electronic address: rtibbet1@hfhs.org.
authors.forename: Robert J
authors.initials: RJ
authors.lastname: Tibbetts
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology; D016000:Cluster Analysis; D003428:Cross Infection / Q000453:epidemiology* / Q000382:microbiology; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D016521:Electrophoresis, Gel, Pulsed-Field; D005838:Genotype; D006801:Humans; D017720:Molecular Epidemiology; D058889:Molecular Typing; D060888:Real-Time Polymerase Chain Reaction; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology; D019779:Salmonella enterica / Q000145:classification / Q000187:drug effects / Q000201:enzymology* / Q000302:isolation & purification*; D062606:Tertiary Care Centers; D014481:United States / Q000453:epidemiology; D001618:beta-Lactamases / Q000032:analysis* / Q000235:genetics
chemical_list: D000900:Anti-Bacterial Agents; C473109:beta-lactamase CTX-M-15; D001618:beta-Lactamases
keywords: CTX-M-15; PFGE; Salmonella Isangi; extended-spectrum beta-lactamases; nontyphoidal Salmonella spp; nosocomial outbreak