scholarly journals Class1-3 integrons and antimicrobial resistance profile in Salmonella spp. isolated from broiler chicken in Western Iran

2021 ◽  
Vol 71 (4) ◽  
pp. 2471
Author(s):  
F. NEMATI ◽  
E. AHMADI
Keyword(s):  
Antimicrobial Resistance ◽  
Broiler Chicken ◽  
High Rate ◽  
Diffusion Method ◽  
Salmonella Spp ◽  
Disk Diffusion Method ◽  
Western Iran ◽  
Class 1 ◽  
Resistance Patterns ◽  
Resistance Rates

Salmonella spp. are major etiologies of food-borne infections that are disseminated primarily through poultry to human. Nowadays, the high rate of antimicrobial resistance and the emergence of multi-drug resistant (MDR) strains, worse the threat imposed to the public health. Integrons are attributed as important contributors to MDR isolates. The present research aimed to identify the frequency of integrons 1-3 and the antimicrobial resistance patterns in Salmonella spp. isolated from broiler chicken in Western Iran. A total of 500 fecal samples were screened for Salmonella phenotypically. The isolates were confirmed genotypically and the frequency of integrons 1-3 was evaluated molecularly among the isolates. Besides, the antimicrobial resistance of the isolates was determined through the agar disk diffusion method. In general, 67 (13.4%) isolates of Salmonella spp. were recovered phenotypically, all of which were confirmed molecularly. The incidence of class 1, 2, and 3 integrons was 40.29% (27 isolates), 28.35% (19 isolates), and 11.94% (eight isolates), respectively. Coexistence of integrons was also detected in 26.86% of the isolates including class 1+2 (13 isolates, 40.62%), class 1+3 (2 isolates, 6.25%), and class 1+2+3 (3 isolates, 9.37%). No statistical association was detected between the frequencies of Salmonella spp. or Salmonella-bearing integron isolates with age, season, and location. The most frequent antimicrobial resistance was exhibited to ampicillin, nalidixic acid, trimethoprim-sulphamethoxazole, and tetracycline; while ciprofloxacin, gentamicin, and ceftazidime were the most effective drugs. 35.82% of the isolates were MDR, all of which harbored at least one class of integrons. Statistical assessment represented an association between the prevalence of integrons and tetracycline, chloramphenicol, streptomycin, and ceftazidime resistance rates. An alarming rate of integrons and MDR frequency among poultry-originated Salmonella spp. in the studied region demands the constant stewardship and prudent prescription and use of antibiotics to prevent human infections and preserve the effectiveness of those antibiotics in treating human salmonellosis.

scholarly journals Antimicrobial resistance in Salmonella enterica serovar Enteritidis in Morocco

2010 ◽  
Vol 4 (12) ◽  
pp. 804-809 ◽  
Author(s):  
Farida Ohmani ◽  
Khadija Khedid ◽  
Saad Britel ◽  
Aicha Qasmaoui ◽  
Reda Charof ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Nalidixic Acid ◽  
Salmonella Enterica ◽  
Inhibitory Concentration ◽  
Diffusion Method ◽  
Salmonella Enterica Serovar Enteritidis ◽  
Gastrointestinal Infections ◽  
Disk Diffusion Method ◽  
Resistance Patterns ◽  
Resistance Rates

Introduction: Salmonella enterica is recognised worldwide as one of the major agents of human gastrointestinal infections. The aim of the present work is to ascertain the antimicrobial susceptibilities of 150 Salmonella enterica serovar Enteritidis isolates from humans in Morocco during the period from 2000 to 2008. Methodology: Antimicrobial resistance determination was performed by disk diffusion method using seven antibiotics. The minimal inhibitory concentration (MIC) of ciprofloxacin was determined for nalidixic acid-resistant (NAR) isolates using E-test strips. Results: Sixty-one (42%) isolates were resistant to at least one class of antimicrobial agent. The largest numbers of resistant isolates were observed for nalidixic acid with 53 isolates (36%) followed by ampicillin with 7 isolates (5%), tetracycline with 6 isolates (4%), and trimethoprim/sulfamethoxazole with 2 isolates (1%).The resistant isolates were grouped in seven different resistance patterns of which two isolates were resistant to three antibiotics. Among the 53 (36%) NAR isolates, 37 (76%) had a reduced susceptibility to ciprofloxacin. Conclusion: Resistance rates of Salmonella enterica serovar Enteritidis from Morocco are generally low but the resistance to nalidixic acid is worryingly common. Continual surveillance of antibiotic resistance is of primary importance.

Antimicrobial Resistance and Presence of Class 1 Integrons Among Different Serotypes of Salmonella spp. Recovered From Children with Diarrhea in Tehran, Iran

2020 ◽  
Vol 20 (2) ◽  
pp. 160-166
Author(s):  
Seyedeh Hanieh Eshaghi Zadeh ◽  
Hossein Fahimi ◽  
Fatemeh Fardsanei ◽  
Mohammad Mehdi Soltan Dallal
Keyword(s):  
Antibiotic Resistance ◽  
Antimicrobial Resistance ◽  
Multidrug Resistant ◽  
Salmonella Spp ◽  
Class 1 Integron ◽  
Class 1 Integrons ◽  
Food Borne ◽  
Class 1 ◽  
Resistance Patterns ◽  
C 30

Background: Salmonellosis is a major food-borne disease worldwide. The increasing prevalence of antimicrobial resistance among food-borne pathogens such as Salmonella spp. is concerning. Objective: The main objective of this study is to identify class 1 integron genes and to determine antibiotic resistance patterns among Salmonella isolates from children with diarrhea. Methods: A total of 30 Salmonella isolates were recovered from children with diarrhea. The isolates were characterized for antimicrobial susceptibility and screened for the presence of class 1 integron genes (i.e. intI1, sulI1, and qacEΔ1). Results: The most prevalent serotype was Enteritidis 36.7%, followed by Paratyphi C (30%), and Typhimurium (16.7%). The highest rates of antibiotic resistance were obtained for nalidixic acid (53.3%), followed by streptomycin (40%), and tetracycline (36.7%). Regarding class 1 integrons, 36.7%, 26.7%, and 33.3% of the isolates carried intI1, SulI, and qacEΔ1, respectively, most of which (81.8%) were multidrug-resistant (MDR). Statistical analysis revealed that the presence of class 1 integron was significantly associated with resistance to streptomycin and tetracycline (p = 0.042). However, there was no association between class 1 integron and other antibiotics used in this study (p > 0.05). Conclusion: The high frequency of integron class 1 gene in MDR Salmonella strains indicates that these mobile genetic elements are versatile among different Salmonella serotypes, and associated with reduced susceptibility to many antimicrobials.

scholarly journals Characterization of cefotaxime resistant Escherichia coli isolated from broiler farms in Ecuador

2018 ◽  
Author(s):  
Christian Vinueza-Burgos ◽  
David Ortega-Paredes ◽  
Cristian Narváez ◽  
Lieven De Zutter ◽  
Jeannete Zurita
Keyword(s):  
Antimicrobial Resistance ◽  
Latin American ◽  
Production Systems ◽  
Diffusion Method ◽  
Poultry Production ◽  
Disk Diffusion Method ◽  
E Coli ◽  
Resistance Patterns ◽  
Latin American Countries

AbstractAntimicrobial resistance (AR) is a worldwide concern. Up to a 160% increase in antibiotic usage in food animals is expected in Latin American countries. The poultry industry is an increasingly important segment of food production and contributor to AR. The objective of this study was to evaluate the prevalence, AR patterns and the characterization of relevant resistance genes in Extended Spectrum β-lactamases (ESBL) and AmpC E. coli from large poultry farms in Ecuador. Sampling was performed from June 2013 to July 2014 in 6 slaughterhouses that slaughter broilers from 115 farms totaling 384 flocks. Each sample of collected caeca was streaked onto TBX agar supplemented with cefotaxime (3 mg/l). In total, 176 isolates were analyzed for antimicrobial resistance patterns by the disk diffusion method and for blaCTX-M, blaTEM, blaCMY, blaSHV, blaKPC, and mcr-1 by PCR and sequencing. ESBL and AmpC E. coli were found in 362 flocks (94.3%) from 112 farms (97.4%). We found that 98.3% of the isolates were multi-resistant to antibiotics. Low resistance was observed for ertapenem and nitrofurantoin. The most prevalent ESBL genes were the blaCTX-M (90.9%) blaCTX-M-65, blaCTX-M-55 and blaCTX-M-3 alleles. Most of the AmpC strains presented the blaCMY-2 gene. Three isolates showed the mcr-1 gene. Poultry production systems represent a hotspot for antimicrobial resistance in Ecuador, possibly mediated by the extensive use of antibiotics. Monitoring this sector in national and regional plans of antimicrobial resistance surveillance should therefore be considered.

scholarly journals Molecular Detection of blaOXA-type Carbapenemase Genes and Antimicrobial Resistance Patterns among Clinical Isolates of Acinetobacter baumannii

2021 ◽  
Author(s):  
Maghsoud Kafshnouchi ◽  
Marzieh Safari ◽  
Amir Khodavirdipour ◽  
Abbas Bahador ◽  
Seyed Hamid Hashemi ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Acinetobacter Baumannii ◽  
Dominant Gene ◽  
Diffusion Method ◽  
Phylogenetic Tree Analysis ◽  
Disk Diffusion Method ◽  
Treatment Regimens ◽  
Class D ◽  
Resistance Patterns ◽  
New Treatment

Abstract Acinetobacter baumannii is a bacterium found in most places, especially in clinics and hospitals, and an important agent of nosocomial infections. The presence of class D enzymes such as OXA-type carbapenemases in A. baumannii is proven to have a key function in resistance to carbapenem. The aim of the current study is to determine the blaOXA-type carbapenemase genes and antimicrobial resistance among clinically isolated samples of A. baumannii. We assessed 100 clinically isolated specimens of A. baumannii from patients in intensive care units of educational hospitals of Hamadan, West of Iran. The A. baumannii isolates' susceptibility to antibiotics was performed employing disk diffusion method. Multiplex polymerase chain reaction was used to identify the blaOXA-24-like , blaOXA-23-like , blaOXA-58-like , and blaOXA-51-like genes. The blaOXA-23-like , blaOXA-24-like , and blaOXA-58-like genes' prevalence were found to be 84, 58, and 3%, respectively. The highest coexistence of the genes was for blaOXA-51/23 (84%) followed by blaOXA-51/24-like (58%). The blaOXA-51/23- like pattern of genes is a sort of dominant gene in resistance in A. baumannii from Hamadan hospitals. The highest resistance to piperacillin (83%) and ciprofloxacin (81%) has been observed in positive isolates of blaOXA-23-like . The A. baumannii isolates with blaOXA-58-like genes did not show much resistance to antibiotics. Based on the results of the phylogenetic tree analysis, all isolates have shown a high degree of similarity. This study showed the high frequency of OXA-type carbapenemase genes among A. baumannii isolates from Hamadan hospitals, Iran. Thus, applying an appropriate strategy to limit the spreading of these strains and also performing new treatment regimens are necessary.

scholarly journals Antimicrobial Resistance in Outpatient Escherichia coli Urinary Isolates in Dakar, Senegal

2007 ◽  
Vol 1 (03) ◽  
pp. 263-268 ◽  
Author(s):  
Jean-Marie Sire ◽  
Pierre Nabeth ◽  
Jean-David Perrier-Gros-Claude ◽  
Ibrahim Bahsoun ◽  
Tidiane Siby ◽  
...  
Keyword(s):  
Escherichia Coli ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Diffusion Method ◽  
Disk Diffusion Method ◽  
Extended Spectrum Beta Lactamase ◽  
Predominant Pathogen ◽  
Overall Resistance ◽  
Tract Infections ◽  
Resistance Rates

Background: Data regarding the evolution of antimicrobial resistance are needed to suggest appropriate empirical treatment of urinary tract infections (UTI) in developing countries. To assess the antimicrobial susceptibility of Escherichia coli, the predominant pathogen in community-acquired UTI, a prospective multicenter study was carried out in Dakar, Senegal. Methodology: From February 2004 to October 2006, 1010 non-duplicate E. coli strains were collected from four centres. Antimicrobial susceptibility testing was performed using disk diffusion method according to the recommendations of the CA-SFM (2004). Results: Most of the isolates were resistant to amoxicillin (73.1%), amoxicillin-clavulanic acid (67.5%), cephalothin (55.8%), and trimethoprim/sulfamethoxazole (68.1%). Extended spectrum beta-lactamase was detected in 38 strains. The overall resistance rates to nalidixic acid, norfloxacin and ciprofloxacin were 23.9%, 16.4% and 15.5%, respectively. Most of the strains were susceptible to gentamicin, nitrofurantoin and fosfomycin (respective susceptibility rates, 93.8%, 89.9%, and 99.3%). During this period, a significant decrease in sensitivity was observed for cephalothin, fluoroquinolones and trimethoprim/sulfamethoxazole (p

Antimicrobial Resistance Profile of Salmonella and Listeria monocytogenes Isolated from Products Marketed on the Border of Brazil with Argentina and Uruguay

2020 ◽  
Vol 83 (11) ◽  
pp. 1941-1946
Author(s):  
JULIANO GONÇALVES PEREIRA ◽  
VANESSA MENDONÇA SOARES ◽  
LEONARDO ERENO TADIELO ◽  
TASSIANA RAMIRES ◽  
WLADIMIR PADILHA da SILVA
Keyword(s):  
Listeria Monocytogenes ◽  
Antimicrobial Resistance ◽  
Foodborne Pathogens ◽  
Penicillin G ◽  
Diffusion Method ◽  
Salmonella Spp ◽  
Disk Diffusion Method ◽  
Resistance Profile ◽  
Antimicrobial Resistance Profile ◽  
Antimicrobial Resistance Genes

ABSTRACT We aimed to perform serotyping and the antimicrobial resistance profile of Salmonella spp. and Listeria monocytogenes strains isolated from raw meats imported illegally into Brazil along the borders of Argentina and Uruguay. Distinct isolates of Salmonella spp. (n = 6) and L. monocytogenes (n = 25) obtained from 270 of these food products of earlier work were serotyped and tested for antimicrobial resistance by agar disk diffusion method. For strains that were considered phenotypically resistant, antimicrobial resistance genes were investigated: strA, strB, floR, tetA, tetB, blaZ, blaTEM, ermB, ermC, and ereB to Salmonella sp. and blaZ and mecA to L. monocytogenes. All Salmonella isolates were identified as Salmonella Infantis; they were multidrug resistant and harbored the genes blaTEM (n = 6), strA (n = 1), strB (n = 1), floR (n = 1), ermB (n = 1), tetA (n = 3), and tetB (n = 3). L. monocytogenes isolates belonged to serovars 1/2a (n = 1), 1/2b (n = 14), 1/2c (n = 2), and 4b (n = 8), showed resistance only to penicillin G (n = 12), and did not show the blaZ and mecA genes. The results demonstrated that illegal foods that are commercialized in the Brazilian international border with Argentina and Uruguay may harbor foodborne pathogens, and some of them have multidrug resistance characteristics, such as Salmonella, emphasizing the need for greater control of international food transit in Brazil, especially in the region evaluated. HIGHLIGHTS

scholarly journals PREVALENCE OF PSEUDOMONAS AERUGINOSA (P. AERUGINOSA) AND ANTIMICROBIAL SUSCEPTIBILITY PATTERNS AT A PRIVATE HOSPITAL IN SANA'A, YEMEN

2018 ◽  
Author(s):  
Ali Alyahawi ◽  
Abdul Monem Alhomidi ◽  
Nawal Al-Henhena
Keyword(s):  
Pseudomonas Aeruginosa ◽  
Antimicrobial Resistance ◽  
Antimicrobial Susceptibility ◽  
Hospitalized Patients ◽  
Diffusion Method ◽  
Antimicrobial Drugs ◽  
Disk Diffusion Method ◽  
Antimicrobial Susceptibility Pattern ◽  
Treatment Regimens ◽  
Resistance Patterns

Pseudomonas aeruginosa is clinically significant and opportunistic pathogenthat causes infections in hospitalized patients. Antibiotic resistance is a major concern in clinical practice. The ongoing emergence of resistant strains that cause nosocomial infections contributes substantially to the morbidity and mortality of hospitalized patients. Objective of present study was to estimate the prevalence of Pseudomonas aeruginosa and the antimicrobial resistance patterns of P. aeruginosa isolates from hospitalized patients. The study was performed at microbiology department of a local hospital in Sana’a, Yemen. All the patients' samples of hospital departments from January, 2017 to December, 2017 were included. A Total of 2079 samples were collected during the study period. Among them, 193 strains of Pseudomonas spp. were isolated. One hundred ninety three isolates of P. aeruginosa were isolated from different clinical specimens and fully characterized by standard bacteriological procedures. Antimicrobial susceptibility pattern of each isolates was carried out by the Kirby-Bauer disk diffusion method as per CLSI guidelines. Majority of P. aeruginosa were isolated from Sputum, followed by urine specimens. The isolate pathogen showed the highest sensitive to Meropenem (85.5%), followed by Amikacin (80.5%), Imipenem (80.0%), and Piperacillin/tazobactam (77.2). The highest frequency of resistance (96.2%) was observed with amoxicillin /clavulinic Acid followed by cefuroxime 94.6%, ampicillin/ sulbactam 94.5%, Co-Trimoxzole 80.5%, and norfloxacin 54%. The result confirmed the occurrence of drug resistance strains of P. aeruginosa. Meropenem, imipenem, and amikacin, were found to be the most effective antimicrobial drugs. It therefore calls for a very judicious, appropriate treatment regimens selection by the physicians to limit the further spread of antimicrobial resistance P. aeruginosa.

scholarly journals Bacterial Contamination of Iranian Paper Currency and Their Antibiotic Resistance Patterns

2017 ◽  
Vol 5 (4) ◽  
pp. 106-110 ◽  
Author(s):  
Farzaneh Firoozeh ◽  
Ehsan Dadgostar ◽  
Hussein Akbari ◽  
Mohammad Zibaei ◽  
Seyed Mohammad Sadjjad Sadjjadian ◽  
...  
Keyword(s):  
Antibiotic Resistance ◽  
Bacterial Contamination ◽  
Diffusion Method ◽  
Coagulase Negative Staphylococci ◽  
Disk Diffusion Method ◽  
Paper Currency ◽  
Microbiological Methods ◽  
Resistance Patterns ◽  
Resistance Rates ◽  
Antibiotic Resistance Patterns

Background: Paper banknotes would be a vector for transmission of pathogenic microorganisms through handling. Objective: This study aimed to determine bacterial contamination of Iranian paper currencies in circulation and their antibiotic resistance patterns. Materials and Methods: In this study, 337 currency notes of different value were collected from markets, shops, restaurants, bus stations and banks in Kashan, Iran during April 2015 to March 2016. The currency notes transferred to microbiology laboratory and were tested for bacterial contamination using standard microbiological methods. Antibiotic resistance patterns of isolated bacteria were determined by disk diffusion method according to the Clinical and Laboratory Standards Institute (CLSI) standards. The results and data were analyzed using descriptive statistics. Results: Of 337 currency notes, 262 (77.7%) were identified with bacterial contamination. Bacteria isolated from currency notes were as follows: Bacillus spp 113 (43.1%), coagulase-negative staphylococci 99 (37.7%), Escherichia coli 20 (7.6%), Enterococci species 14 (5.3%), Staphylococcus aureus 8 (3.1%), Klebsiella spp 4 (1.5%), Shigella species 2 (0.8%), and Pseudomonas species 2 (0.8%). The most and least contaminated currency notes were 50000 and 500 Rials, respectively. The highest resistance rates in gram-negative rods were against nalidixic acid, and ampicillin. However, the highest resistance rates in S. aureus, coagulase-negative staphylococci and Enterococci species were against ampicillin, erythromycin and tetracycline. Conclusion: Our study revealed that the bacterial contamination among Iranian paper currency in circulation especially those obtained from certain sources including shops and bus stations is high and in most cases these bacterial isolates are antibiotic-resistant strains.

scholarly journals Pattern of antimicrobial resistance of Gram-negative bacilli in surgical site infections in in-patients and out-patients at an apex trauma Center: 2013–2016

2018 ◽  
Vol 10 (04) ◽  
pp. 432-436 ◽  
Author(s):  
Nidhi Bhardwaj ◽  
Surbhi Khurana ◽  
Minu Kumari ◽  
Rajesh Malhotra ◽  
Purva Mathur
Keyword(s):  
Antimicrobial Resistance ◽  
Hospital Stay ◽  
Surgical Site Infections ◽  
Diffusion Method ◽  
Resistance Pattern ◽  
Gram Negative Bacteria ◽  
Disk Diffusion Method ◽  
Gram Negative ◽  
Resistance Patterns ◽  
Mueller Hinton Agar

ABSTRACT INTRODUCTION: Antimicrobial resistance is an increasing problem worldwide especially among the surgical site infections (SSIs). SSI is becoming more serious due to hospital-acquired infections/nosocomial infections, which further leads to the overuse of broad-spectrum antibiotics. To investigate the antimicrobial resistance patterns among Gram-negative bacteria in SSI in in- and out-patients the present study was designed. METHODOLOGY: During the 4 years (January 2013–December 2016), the antimicrobial resistant pattern was studied in the admitted patients and in the patients who were followed up to the outpatients department (OPD) after discharge. Antimicrobial resistance pattern testing was done by the disk diffusion method on Mueller-Hinton agar and by E-test for ten antibiotics according to The Clinical and Laboratory Standards Institute guidelines for Gram-negative bacilli. RESULTS: A total of 2,447 strains were isolated from the studied population on over the period of 4 years. Of 2447, 1996 (81%) were isolated from patients who had SSI during the hospital stay, and 451 (18%) were from patients who attended the OPD after discharge. In the outpatients, who followed up in the OPD for the SSI, Escherichia coli (148), and Pseudomonas aeruginosa (93), whereas in the patients who develop SSI during their hospital stay, Acinetobacter baumannii (622), E. coli (424), and Klebsiella pneumoniae (315) were found to be common. A very high resistance pattern was observed in both the studied groups; however, a higher resistance pattern was seen in in-patients as compared to outpatients. CONCLUSION: In our study, we have reported resistance pattern in Gram-negative bacteria isolated from the patients who were came for the follow as well as in the inpatients. For the outpatients, it can be concluded that it could be a community-acquired infection which is also an alarming condition for our society.

scholarly journals Non-typhoidalSalmonellain Calabria, Italy: a laboratory and patient-based survey

BMJ Open ◽  
2017 ◽  
Vol 7 (9) ◽  
pp. e017037 ◽  
Author(s):  
Valentina Mascaro ◽  
Claudia Pileggi ◽  
Maria Crinò ◽  
Yolande Therese Rose Proroga ◽  
Maria Rosaria Carullo ◽  
...  
Keyword(s):  
Antimicrobial Resistance ◽  
Active Surveillance ◽  
Diffusion Method ◽  
The European Union ◽  
Disk Diffusion Method ◽  
High Prevalence ◽  
Resistance Patterns ◽  
Region Data ◽  
Foodborne Outbreaks ◽  
Biochemical Identification

IntroductionAlthough there has been a decrease in the number of cases of salmonellosis in the European Union, it still represents the primary cause of foodborne outbreaks. In Calabria region, data are lacking for the incidence of human non-typhoid salmonellosis as active surveillance has never been carried out.ObjectiveTo report the results of a laboratory and patient-based morbidity survey in Calabria to describe the incidence and distribution ofSalmonellaserovars isolated from humans, with a focus on antimicrobial resistance patterns.MethodsPositive cultures from human samples were collected from every laboratory participating in the surveillance, with a minimum set of information about each isolate. A questionnaire was then administered to the patients by telephone interview to assess the potential risk exposures.Salmonellaisolates underwent biochemical identification, molecular analysis by PCR and antimicrobial susceptibility testing by the disk-diffusion method.ResultsDuring a 2-year period, 105 strains ofSalmonellaspp were isolated from samples of patients with diarrhoea, with the highest isolation rate for children aged 1–5 years. The standardised rate was 2.7 cases per 1 00 000 population. The most commonSalmonellaisolates belonged to monophasic variant ofS.Typhimurium (S.4,[5],12:i:-) (33.3%), followed byS. Typhimurium (21.9%). 30.5% of the isolates were susceptible to all microbial agents tested and the most common pan-susceptible serotype wasS.Napoli (100%).S. 4,[5],12:i:- was resistant to ampicillin, streptomycin, sulfonamides and tetracyclines in 42.9% cases, while resistance to quinolones was seen in 14.3% of the isolates.ConclusionsThe results provide evidence that an active surveillance system effectively enhancesSalmonellanotifications. The high prevalence of antimicrobial resistance, including resistance to quinolones and multiresistance, enforces the need to strengthen strategies of surveillance and monitoring of antimicrobial use.

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