title: Evaluation of antimicrobial resistance among Salmonella and Shigella isolates in the University Hospital "St. George," Plovdiv, Bulgaria.
abstract: The aim of this work is to study the epidemiology and antimicrobial resistance to the most commonly used antibiotics for the treatment of acute gastroenteritis caused by Salmonella and Shigella at the largest Bulgarian hospital-University Hospital "St. George," Plovdiv-for the period 2009-2013. Two hundred ninety strains were in vitro tested for resistance to 15 antimicrobial agents. The presence of extended-spectrum beta-lactamases (ESBLs) was demonstrated by a variety of specialized tests. For comparison, a collection of 28 strains submitted by the National Reference Laboratory (NRL) "Enteric Infections" at the National Center of Infectious and Parasitic Diseases (NCIPD), Sofia, was also tested for the production of ESBLs. In isolates, phenotypically demonstrated as ESBL producers, polymerase chain reaction (PCR) detection of the genes bla-CTX-M, bla-SHV, and bla-TEM was performed. Among the 290 tested isolates, only two- Salmonella serotype Livingstone and Shigella flexneri-were phenotypically proven to be ESBL producers. Only 4 strains from the collection of 28, submitted from the NRL "Intestinal Infections" in NCIPD, Sofia, were phenotypically confirmed as ESBL producers. The presence of the bla-CTX-M gene was detected in all of the tested strains (4 from NRL, NCIPD, Sofia, and 2 from the University Hospital St. George, Plovdiv), the bla-SHV gene only in strain S. Livingstone from Plovdiv, and the bla-TEM gene in two from Sofia and one (again S. Livingstone) from Plovdiv. In conclusion, Salmonella and Shigella isolates from patients hospitalized at the University Hospital St. George, Plovdiv, with acute gastroenteritis demonstrate good susceptibility to the most commonly used antibiotic agents, including azithromycin.
authors.affiliation: Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University-Plovdiv, 15A "Vassil Aprilov" Blvd, 4000, Plovdiv, Bulgaria. mishopetrov23@yahoo.com.
authors.forename: Michael M
authors.initials: MM
authors.lastname: Petrov
authors.affiliation: Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University-Plovdiv, 15A "Vassil Aprilov" Blvd, 4000, Plovdiv, Bulgaria.|Laboratory of Microbiology, University Hospital "St. George"-Plovdiv, 15A Vassil Aprilov Blvd, Plovdiv, Bulgaria.
authors.forename: Atanaska
authors.initials: A
authors.lastname: Petrova
authors.affiliation: Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University-Plovdiv, 15A "Vassil Aprilov" Blvd, 4000, Plovdiv, Bulgaria.|Laboratory of Microbiology, University Hospital "St. George"-Plovdiv, 15A Vassil Aprilov Blvd, Plovdiv, Bulgaria.
authors.forename: Irina
authors.initials: I
authors.lastname: Stanimirova
authors.affiliation: Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University-Plovdiv, 15A "Vassil Aprilov" Blvd, 4000, Plovdiv, Bulgaria.
authors.forename: Marina
authors.initials: M
authors.lastname: Mircheva-Topalova
authors.affiliation: Laboratory of Microbiology, University Hospital "St. George"-Plovdiv, 15A Vassil Aprilov Blvd, Plovdiv, Bulgaria.
authors.forename: Lalka
authors.initials: L
authors.lastname: Koycheva
authors.affiliation: Department of Infectious Diseases and Parasitology, Faculty of Medicine, Medical University-Plovdiv and University Hospital "St. George"-Plovdiv, Plovdiv, Bulgaria.
authors.forename: Rayna
authors.initials: R
authors.lastname: Velcheva
authors.affiliation: Department of Infectious Diseases and Parasitology, Faculty of Medicine, Medical University-Plovdiv and University Hospital "St. George"-Plovdiv, Plovdiv, Bulgaria.
authors.forename: Mariana
authors.initials: M
authors.lastname: Stoycheva-Vartigova
authors.affiliation: Department of Social Medicine and Public Health, Faculty of Public Health, Medical University-Plovdiv, 15A Vassil Aprilov Blvd, Plovdiv, Bulgaria.
authors.forename: Ralitsa
authors.initials: R
authors.lastname: Raycheva
authors.affiliation: National Reference Laboratory "Enteric infections," National Center of Infectious and Parasitic Diseases, 26 Yanko Sakazov Blvd., Sofia, Bulgaria.
authors.forename: Galina
authors.initials: G
authors.lastname: Asseva
authors.affiliation: National Reference Laboratory "Enteric infections," National Center of Infectious and Parasitic Diseases, 26 Yanko Sakazov Blvd., Sofia, Bulgaria.
authors.forename: Petar
authors.initials: P
authors.lastname: Petrov
authors.affiliation: Department of Life Science, "Aquachim JSC", 83 Prof Tzv. Lazarov Blvd., Sofia, Bulgaria.
authors.forename: Velichka
authors.initials: V
authors.lastname: Kardjeva
authors.affiliation: Department of Microbiology and Immunology, Faculty of Pharmacy, Medical University-Plovdiv, 15A "Vassil Aprilov" Blvd, 4000, Plovdiv, Bulgaria.|Laboratory of Microbiology, University Hospital "St. George"-Plovdiv, 15A Vassil Aprilov Blvd, Plovdiv, Bulgaria.
authors.forename: Marianna
authors.initials: M
authors.lastname: Murdjeva
mesh_terms: D000208:Acute Disease; D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002031:Bulgaria / Q000453:epidemiology; D002648:Child; D002675:Child, Preschool; D004269:DNA, Bacterial / Q000235:genetics; D024881:Drug Resistance, Bacterial / Q000235:genetics*; D004405:Dysentery, Bacillary / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D005260:Female; D005759:Gastroenteritis / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D015870:Gene Expression; D006785:Hospitals, University; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012189:Retrospective Studies; D012475:Salmonella / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics / Q000254:growth & development; D012480:Salmonella Infections / Q000175:diagnosis / Q000188:drug therapy* / Q000453:epidemiology / Q000382:microbiology; D012760:Shigella / Q000187:drug effects* / Q000201:enzymology / Q000235:genetics; D001618:beta-Lactamases / Q000235:genetics / Q000378:metabolism
chemical_list: D000900:Anti-Bacterial Agents; D004269:DNA, Bacterial; D001618:beta-Lactamases
keywords: Antimicrobial resistance; ESBL; PCR; Salmonella; Shigella