Notice to Readers
Establishment of a National Surveillance Program for Antimicrobial
Resistance in Salmonella
On August 18, 1995, the Food and Drug Administration (FDA)
approved sarafloxacin for use in drinking water for poultry to
control illnesses caused by Escherichia coli. * This is the first
fluoroquinolone antimicrobial agent approved for use in animals
intended for food in the United States. Fluoroquinolones commonly
are used to treat many infectious conditions in adult humans,
including invasive Salmonella and Campylobacter infections, which
occur more frequently in persons infected with human
immunodeficiency virus (1). There have been no reports of the
detection of fluoroquinolone resistance among Salmonella or
Campylobacter isolates in the United States, but
fluoroquinolone-resistant Salmonella have been reported among human
isolates from France (2) and Germany (3). The recent approval and
use of a fluoroquinolone antimicrobial agent in humans
(norfloxacin) and in poultry (enrofloxacin) in the Netherlands was
followed by the emergence of resistance among Campylobacter
isolates from humans in that country (4). CDC recommends that
clinical laboratories now include fluoroquinolones when determining
the susceptibility patterns of Salmonella and Campylobacter
isolates from humans, and contact CDC through state health
departments if such resistance is detected.
FDA, CDC, a sample of state public health laboratories, and
the U.S. Department of Agriculture are implementing a national
surveillance program for Salmonella isolates obtained from clinical
specimens from humans and animals (farm and companion), healthy
farm animals, carcasses at slaughter plants, and vegetables to
monitor changes in antimicrobial susceptibilities. Confidentiality
regarding the source of the isolates will be maintained throughout
the study. This surveillance program will facilitate the timely
detection of changes in susceptibility patterns to fluoroquinolones
in Salmonella in either humans, animals, or vegetables and identify
areas for educational programs or further studies.
Reported by: Center for Veterinary Medicine, Food and Drug
Administration. Animal and Plant Health Inspection Svc, Food Safety
and Inspection Svc, Agricultural Research Svc, US Dept of
Agriculture. Foodborne and Diarrheal Diseases Br, Div of Bacterial
and Mycotic Diseases, National Center for Infectious Diseases, CDC.
References
Angulo FJ, Swerdlow DL. Bacterial enteric infections in persons
infected with human immunodeficiency virus. Clin Infect Dis
1995;2(suppl 1):S84-S93.
Brown JC, Shanahan PMA, Jesudason MV, Thomson CJ, Amyes SGB.
Mutations of gyrA responsible for quinolone resistance in
multi-resistant Salmonella typhi: an emerging therapeutic
problem?
{Abstract}. In: Program and abstracts of the 35th Interscience
Conference on Antimicrobial Agents and Chemotherapy. Washington,
DC: American Society for Microbiology, 1995:50.
Heisig P, Kratz B, Halle E, et al. Identification of DNA gyrase
A mutations in ciprofloxacin-resistant isolates of Salmonella
typhimurium from men and cattle in Germany. Microbial Drug
Resistance 1995;1:211-8.
Endtz HP, Ruijs GJ, van Klingeren B, Jansen WH, van der Reyden
T, Mouton RP. Quinolone resistance in Campylobacter isolated
from
man and poultry following the introduction of fluoroquinolones
in
veterinary medicine. J Antimicrob Chemother 1991;27:199-208.
60 FR 50,097.
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