title: Estimated Incidence of Antimicrobial Drug-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2012.
abstract: Salmonella infections are a major cause of illness in the United States. The antimicrobial agents used to treat severe infections include ceftriaxone, ciprofloxacin, and ampicillin. Antimicrobial drug resistance has been associated with adverse clinical outcomes. To estimate the incidence of resistant culture-confirmed nontyphoidal Salmonella infections, we used Bayesian hierarchical models of 2004-2012 data from the Centers for Disease Control and Prevention National Antimicrobial Resistance Monitoring System and Laboratory-based Enteric Disease Surveillance. We based 3 mutually exclusive resistance categories on susceptibility testing: ceftriaxone and ampicillin resistant, ciprofloxacin nonsusceptible but ceftriaxone susceptible, and ampicillin resistant but ceftriaxone and ciprofloxacin susceptible. We estimated the overall incidence of resistant infections as 1.07/100,000 person-years for ampicillin-only resistance, 0.51/100,000 person-years for ceftriaxone and ampicillin resistance, and 0.35/100,000 person-years for ciprofloxacin nonsusceptibility, or ≈6,200 resistant culture-confirmed infections annually. These national estimates help define the magnitude of the resistance problem so that control measures can be appropriately targeted.
authors.forename: Felicita
authors.initials: F
authors.lastname: Medalla
authors.forename: Weidong
authors.initials: W
authors.lastname: Gu
authors.forename: Barbara E
authors.initials: BE
authors.lastname: Mahon
authors.forename: Michael
authors.initials: M
authors.lastname: Judd
authors.forename: Jason
authors.initials: J
authors.lastname: Folster
authors.forename: Patricia M
authors.initials: PM
authors.lastname: Griffin
authors.forename: Robert M
authors.initials: RM
authors.lastname: Hoekstra
mesh_terms: D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D001499:Bayes Theorem; D024901:Drug Resistance, Multiple, Bacterial; D006801:Humans; D015994:Incidence; D008826:Microbial Sensitivity Tests; D012475:Salmonella / Q000187:drug effects*; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology / Q000517:prevention & control; D014481:United States / Q000453:epidemiology
chemical_list: D000900:Anti-Bacterial Agents
keywords: Salmonella; United States; ampicillin; antibiotic resistance; antimicrobial resistance; bacteria; ceftriaxone; ciprofloxacin; drug resistance; food safety; incidence