Trends in Isolation and Antimicrobial Susceptibility of Enteropathogenic Bacteria in 2011-2019 at a Korean Tertiary Care Hospital Compared with Data in the Preceding Reports
1Department of Global Health Security, Yonsei University Graduate school of Public Health, Seoul
2Brain Korea 21plus Programfor Medical Science, Yonsei University College of Medicine, Seoul
3Department of Laboratory Medicine and Research Institute of Bacterial Resistance, Yonsei University College of Medicine, Seoul, Korea
ABSTRACT
Background: Environmental sanitation plays a significant role on the prevalence of enteropathogenic bacteria. This study aimed to determine the trends in the prevalence and antimicrobial resistance profiles of enteropathogenic bacteria from 2011 to 2019.
Methods: A retrospective analysis was performed using data from stool cultures of Salmonella spp., Shigella spp., Plesiomonas shigelloides, Yersinia spp., Vibrio spp., and Campylobacter spp. Samples were obtained between 2011 and 2019 from Severance Hospital. Antimicrobial susceptibility profile was determined using the disk diffusion method for nontyphoidal Salmonella (NTS) and Campylobacter spp., following the Clinical and Laboratory Standards Institute (CLSI) guidelines.
Results: The number of specimens obtained for stool culture increased significantly from 13,412 during the period of 19691978, to 48,476 over the past nine years (20112019), whereas the ratio of positive specimens decreased significantly from 1,732 (12.9%) to 449 (0.9%). The proportion of samples positive for Salmonella Typhi decreased from 472 (93.6%, 19691978) to 4 (1.5%, 20112019), whereas the proportion of NTS increased from 14 (2.8%, 19691978) to 261 (96.7%, 20112019). Among all the enteropathogenic bacteria isolated, Shigella spp. accounted for 60.0% (1,039) isolates from 1969 to 1978, but only 1.6% (7) from 2011 to 2019. Campylobacter was the second most prevalent enteropathogenic bacteria, accounting for 29.4% isolates (132). Among the NTS strains isolated from 2016 to 2019, their susceptibility rates to ampicillin and sulfamethoxazole-trimethoprim were 51.1% and 85.2%, respectively. Additionally, the susceptibility rate of Campylobacter to ciprofloxacin was 15.8%.
Conclusion: The prevalence of Salmonella Typhi and Shigella spp. significantly decreased, whereas those of NTS and Campylobacter spp. increased. Therefore, continuous monitoring of ciprofloxacin-resistant Campylobacter spp. is of vital importance.
Keywords
Campylobacter species, Enteropathogenic bacteria, Salmonella species
Figures & Tables
Table 1. Comparison of trends in isolation of enteropathogenic bacteriaa t a tertiary-care hospital
Characteristic |
Period of data acquisition* |
||||
1969-1978 |
1979-1988 |
1989-1998 |
2001-2010 |
2011-2019 |
|
No. of specimen cultured |
13,412 |
37,846 |
51,441 |
60,714 |
48,476 |
No. of positive specimen |
1,732 |
3,503 |
2,140 |
648 |
449 |
% of positive specimen |
12.9 |
9.2 |
4.2 |
1.1 |
0.9 |
No. of positive patient |
1,677 |
3,182 |
1,531 |
565 |
449 |
Salmonella Typhi |
472 |
469 |
58 |
1 |
4 |
Salmonella Paratyphi A |
18 |
101 |
3 |
2 |
0 |
Salmonella serogroup B |
3 |
245 |
564 |
86 |
111 |
Salmonella serogroup C |
4 |
108 |
126 |
89 |
82 |
Salmonella serogroup D |
5 |
107 |
341 |
157 |
63 |
Salmonella serogroup E |
2 |
32 |
55 |
22 |
5 |
Salmonella other serogroup |
0 |
40 |
39 |
2 |
5 |
All Salmonella isolates |
504 |
1,102 |
1,186 |
359 |
270 |
Shigella subgroup A |
16 |
5 |
2 |
0 |
0 |
Shigella subgroup B |
781 |
1,246 |
30 |
3 |
1 |
Shigella subgroup C |
8 |
43 |
0 |
0 |
6 |
Shigella subgroup D |
234 |
214 |
19 |
95 |
0 |
All Shigella isolates |
1,039 |
1,508 |
51 |
98 |
7 |
Campylobacter spp. |
NT |
185 |
239 |
85 |
132 |
Yersinia enterocolitica |
NT |
29 |
18 |
1 |
1 |
Vibrio parahaemolyticus |
45 |
96 |
42 |
27 |
7 |
Plesiomonas shigelloides |
NT |
4 |
11 |
0 |
0 |
*The data from 1969-2010 were adapted from reference [7]. |