title: Ceftriaxone-Resistant Nontyphoidal Salmonella from Humans, Retail Meats, and Food Animals in the United States, 1996-2013.
abstract: Ceftriaxone resistance in Salmonella is a serious public health threat. Ceftriaxone is commonly used to treat severe Salmonella infections, especially in children. Identifying the sources and drivers of ceftriaxone resistance among nontyphoidal Salmonella is crucial.
  
  
  
  The National Antimicrobial Resistance Monitoring System (NARMS) tracks antimicrobial resistance in foodborne and other enteric bacteria from humans, retail meats, and food animals. We examined NARMS data reported during 1996-2013 to characterize ceftriaxone-resistant Salmonella infections in humans. We used Spearman rank correlation to examine the relationships between the annual percentage of ceftriaxone resistance among Salmonella isolates from humans with isolates from retail meats and food animals.
  
  
  
  A total of 978 (2.9%) of 34,100 nontyphoidal Salmonella isolates from humans were resistant to ceftriaxone. Many (40%) ceftriaxone-resistant isolates were from children younger than 18 years. Most ceftriaxone-resistant isolates were one of three serotypes: Newport (40%), Typhimurium (26%), or Heidelberg (12%). All were resistant to other antimicrobials, and resistance varied by serotype. We found statistically significant correlations in ceftriaxone resistance between human and ground beef Newport isolates (r = 0.83), between human and cattle Typhimurium isolates (r = 0.57), between human and chicken Heidelberg isolates (r = 0.65), and between human and turkey Heidelberg isolates (r = 0.67).
  
  
  
  Ceftriaxone resistance among Salmonella Newport, Typhimurium, and Heidelberg isolates from humans strongly correlates with ceftriaxone resistance in isolates from ground beef, cattle, and poultry, respectively. These findings support other lines of evidence that food animals are important reservoirs of ceftriaxone-resistant Salmonella that cause human illness in the United States.
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Martha
authors.initials: M
authors.lastname: Iwamoto
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Jared
authors.initials: J
authors.lastname: Reynolds
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Beth E
authors.initials: BE
authors.lastname: Karp
authors.affiliation: 2 Division of Animal and Food Microbiology, Office of Research, Center for Veterinary Medicine , U.S. Food and Drug Administration, Laurel, Maryland.
authors.forename: Heather
authors.initials: H
authors.lastname: Tate
authors.affiliation: 3 Bacterial Epidemiology and Antimicrobial Resistance Research Unit, Agricultural Research Service , U.S. Department of Agriculture, Athens, Georgia .|4 Department of Population Health and Pathobiology, North Carolina State University , College of Veterinary Medicine, Raleigh, North Carolina.
authors.forename: Paula J
authors.initials: PJ
authors.lastname: Fedorka-Cray
authors.affiliation: 3 Bacterial Epidemiology and Antimicrobial Resistance Research Unit, Agricultural Research Service , U.S. Department of Agriculture, Athens, Georgia .
authors.forename: Jodie R
authors.initials: JR
authors.lastname: Plumblee
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Jean M
authors.initials: JM
authors.lastname: Whichard
authors.affiliation: 1 Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Mahon
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D002443:Ceftriaxone / Q000494:pharmacology*; D002648:Child; D002675:Child, Preschool; D024901:Drug Resistance, Multiple, Bacterial; D005260:Female; D005506:Food Contamination / Q000032:analysis* / Q000517:prevention & control; D005516:Food Microbiology; D006801:Humans; D007223:Infant; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D011200:Poultry / Q000382:microbiology; D000069466:Red Meat / Q000382:microbiology*; D012475:Salmonella / Q000187:drug effects / Q000302:isolation & purification*; D012478:Salmonella Food Poisoning / Q000382:microbiology; D014481:United States; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D002443:Ceftriaxone
keywords: Salmonella; antimicrobial resistance; cephalosporin; foodborne disease