Vertebral osteomyelitis due to Salmonella Poona in a healthy adolescent female
SAGE OPEN MEDICAL CASE REPORTS
Authors: Toofan, Yalda; Tarun, Samiksha; Bender, Jonathan D.; Auerbach, Sarah A.; Stewart, David A.; Watson, Michael E., Jr.
We present a case of vertebral osteomyelitis in a previously healthy, adolescent Caucasian female athlete. After months of lower back pain, spinal imaging demonstrated phlegmon and suspected osteomyelitis of the L4 vertebral body. A bone biopsy was obtained, and microbiologic cultures yielded pure growth of Salmonella enterica subsp. enterica serovar Poona (S. Poona), a member of the nontyphoid Salmonella group associated with food-borne gastroenteritis in the United States. This case represents the first reported association of S. Poona with osteomyelitis and is interesting in that the infection developed in a patient without traditional risk factors for invasive Salmonella disease (i.e. sickle cell disease). This case highlights the importance of keeping a broad differential diagnosis for lower back pain and emphasizes the value of obtaining specimens for microbiologic culture to aid in diagnosing non-traditional and potentially emerging bacterial pathogens.
Serotypes, antibiotic resistance, and molecular characterization of non-typhoidal salmonella isolated from diarrheic patients in Guangxi Zhuang Autonomous Region, China, 2014-2017
Authors: Zeng, Xianying; Lv, Suling; Qu, Cong; Lan, Lan; Tan, Dongmei; Li, Xiugui; Bai, Li
The serotype, antimicrobial resistance, and molecular typing of 843 Salmonella isolates recovered from diarrheic patients in Guangxi Zhuang Autonomous Region (Guangxi), China from 2014 to 2017 were investigated. Among these 843 isolates, a total of 67 Salmonella serotypes and four un-typable isolates were detected by the slide agglutination method. The most prevalence serotype was Salmonella 1,4, ,12:i:- (27.4%, 231/843), followed by S. Enteritidis (20.8%) and S. Typhimurium (16.1%). Many of these isolates (86.2%, 727/843) were resistant to more than one antibiotic. The rate of resistance to early generation antimicrobial agents was high (AMP [73.8%], TET [65.5%], and NAL [43.2%]). Moreover, the rate of resistance to clinically important antimicrobial agents was of great concern (CIP [21.6%], CTX [12.9%], and AZM [5.7%]). Importantly, 34 (4.0%) isolates of nine serovars were resistant to both CIP and CTX, which included 14 (1.7%) that were also resistant to AZM. In addition, 74.9% (631/843) of nontyphoidal Salmonella isolates demonstrated decreased susceptibility to cipmfloxacin with S. Enteritidis as the dominant serovar. Overall, 393 (46.6%) isolates were identified as multidrug resistance (MDR) with resistance to three or more classes of antimicrobials, of which MDR S. 1,4,,12:i:-accounted for the highest proportion (31.6%, 124/393). Genotypic analyses by pulsed-field gel electrophoresis of 447 isolates containing the three most common serotypes revealed a high diversity, suggesting that the majority human salmonellosis cases are attributed to sporadic events. These results highlighted the diversity of Salmonella serotypes and the high prevalence of emerging MDR Salmonella. 1,4,,12:i:- isolates in Guangxi. Therefore, surveillance of these emerging MDR isolates should be enhanced to monitor antimicrobial resistant Salmonella in the food chain and to inform risk-based decisions to protect public health.