Over an approximately 50-day period in 2015, an outbreak of CTX-M-15 extended spectrum β-lactamase-(ESBL)-possessing Salmonella Isangi occurred among 19 adult surgical patients and one healthcare worker (HCW) at a large urban tertiary care hospital in the United States. A total of 45 S. Isangi isolates were isolated from stool (35), blood (4), urine (3), respiratory (2), and wound (1) cultures. Phenotypically, all but three isolates demonstrated resistance to ampicillin, ampicillin/sulbactam, ceftriaxone, and cefepime, and one isolate was resistant to ertapenem. Genotypically, a single CTX-M-15 ESBL was identified in all but three isolates by real-time PCR. Interestingly, two of the CTX-M-15 negative, susceptible isolates were isolated from a single patient who initially had a CTX-M positive, resistant strain. Isolates were clonally related, including both resistant and susceptible strains, as confirmed by pulse field gel electrophoresis (PFGE). This is the first case of a novel Salmonella outbreak at this hospital, and we believe it to be the first case of an S. Isangi serotype outbreak in the United States. Copyright © 2016 Elsevier Inc. All rights reserved. Se recalca que esta presentación no es mas que una explicación de el articulo hecho por los autores mencionados

2. BY:
Santiago Ospina García.
Carlos López Díaz.

3. INTRODUCTION
Nonthyphoidal
Salmonella(NTS)
Major cause of foodborne
gastroenteritis,septicemia,end
ovascular infections,and
meningitis.
Sub-Saharan
Africa.
Morbidity
Mortality

4. INTRODUCTION
Actually the problem is the tolerance created by
the microorganisms. Consequently, this has
promoted the development of extended-spectrum
β-lactamase-(ESBL)-production in Salmonella
TEM CTX-M SHV
To the treatment of these infections were used antimicrobials.
CTX-M 15 Mobilizing ability

5. SALMONELLA
Salmonella is the genus name for a group of bacteria that consists of two
species; Salmonella bongori and Salmonella enteric. Salmonella enteric is
responsible for the majority of Salmonella infections in warm-blooded
animals.
• Family: Enterobactericeae
• Gram-negative bacteria
• Anaerobic facultative bacteria
• Mesophilic microorganism though survive in frozen and
dried states for a long time

6. SALMONELLA
HABITAT
Salmonellae are natural inhabitants of the gastrointestinal
tracts of domesticated and wild animals
Humans can also be carriers following an infection and shed
the pathogens through feces for a long time
 They have also been isolated from soil, water, and sewage
contaminated with fecal matters

7. Salmonellosis

8. Antibiotic resistance.
What is?
Antibiotic resistance occurs when an antibiotic has lost its ability to effectively
control or kill bacterial growth; in other words, the bacteria are "resistant" and
continue to multiply in the presence of therapeutic levels of an antibiotic.

10. Mechanism
Enzyme that degrades
antibiotics.
Efflux pump.
Alteration of the antibitics.

11. ESBL
Extended-spectrum beta-lactamases are enzymes
that confer resistance to most beta-lactam
antibiotics, including penicillins, cephalosporins,
and the monobactam aztreonam. Infections with
ESBL-producing organisms have been associated
with poor outcomes.

12. OBJECTIVE
To study the phenotypic and genotypic of the diferents strains of Salmonella and
the relation between CTX-M15 and the antimicriobian resistance.

13. MATERIALES Y MÉTODOS
Aislamientos
Toma de muestra
Se coloca medio de
cultivo(caldo de
enriquecimiento)
Inoculacion(37°C)
Se utiliza Hektoen-
enteric.
Se detecta el sulfuro
de hidrogeno.
Se observa los
patrones de
suceptibilidad.

14. EXTRACCIÓN DNA Y PCR
isopropanolol Acido
acético
Buffer.

15. PCR-real time

16. • ELECTROFORESIS DE GEL EN CAMPO
PULSADO(PFGE)

17. Results
Misma formula
antigénica :
6,7:d:1,5

18. Results

19. Results

20. Discussion
Usha (2008) He said that salmonella spp
can harbor multiple ESBL
enzyme-types
simultaneously.
Dropa(2015) and Woerther
(2013)
They said that CTMX15
enzyme have become the
dominant ESBL type due to
their highly mobile genetic
elements between strains.
Krauland (2010) He said that Multi-drug
resistance in salmonella is
primarily mediated by
resistance genes associated
with mobile genetic
elements such as
plasmids,transposons,and
integrons encoding ESBL
enzymes.

21. Conclusions
• With this researches we can understand the
resistance mechanism and kind of b-lactamase of
different salmonella isangi species.
• The studies of salmonella isangi are very
important because we can know the resistance of
differents salmonella isangy species and treat it
according to the species present in the patients
treatment of the patient

22. • The resistance of Salmonella multidrug has
increased in the last decades because it has
the potential to perform mutations and make
B-lactamases have greater action .
• When there is resistance to antimicrobian
drugs is possible give an ideal medicine to
prevent the development of the disease and
its propagation.
• .