Characterisation of extended spectrum beta-lactamases (ESBL) resistance in multi-drug resistant Salmonella concord

Salmonellosis in children from Ethiopia is caused mainly by Salmonella Concord, which are highly invasive, multi-drug resistant and extended-spectrum β-lactamase (ESBL) producers. S. Concord infections have been observed in children adopted from Ethiopia, now living in Europe and United States. S. Concord infections are present in parents of these adopted children, posing a significant dilemma for treatment. Data from Salmonella isolates are stored in Public Health England’s in-house Gastro Data Warehouse (GDW) database. Resistance profiles for 37 pure S. Concord isolates were determined using agar incorporation methods using EUCAST guidelines. The minimum inhibitory concentration (MIC) was determined for 18 antimicrobial agents and ESBL resistance was confirmed using Double Disk Synergy and ESBL E-test methods. ESBL resistance was present in 8 isolates with resistance most commonly seen against penicillins and cephalosporins. Isolates 408 and 537, and isolate 527 displayed resistance to 78 % and 56 % of the antibiotics respectively. Drug resistant regions in isolates 408, 527 and 537 that have been previously sequenced by an Illumina HiSeq 2500 were characterised. ESBL genes blaCTXM-15 was present in isolate 527 and 408 and blaSHV-12 was found in isolate 537. Replicons from plasmids, InCI2, InCFIB, InCF2 and IncH2 were located in the assembled sequences of the three previously sequenced isolates. In conclusion, the possible mechanisms causing spread of ESBL resistance in S. Concord is most likely due to acquisition of plasmids through horizontal gene transfer from various Enterobacteriaceae, however further research must be conducted to confirm this to advance antimicrobial research in this area.