60 results on '"Chien-Shun Chiou"'
Search Results
2. New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017
- Author
-
Chien-Shun Chiou, Yu-Ping Hong, Ying-Shu Liao, You-Wun Wang, Yueh-Hua Tu, Bo-Han Chen, and Yi-Syong Chen
- Subjects
Salmonella enterica serovar Anatum ,antimicrobial resistance ,multidrug resistance ,molecular epidemiology ,bacteria ,Taiwan ,Medicine ,Infectious and parasitic diseases ,RC109-216 - Abstract
In 2011, a Salmonella enterica serovar Anatum clone emerged in Taiwan. During 2016–2017, infections increased dramatically, strongly associated with emergence and spread of multidrug-resistant strains with a plasmid carrying 11 resistance genes, including blaDHA-1. Because these resistant strains infect humans and food animals, control measures are urgently needed.
- Published
- 2019
- Full Text
- View/download PDF
3. Changing epidemiology of shigellosis in Taiwan, 2010-2019: an emerging threat to HIV-infected patients and men who have sex with men
- Author
-
Chin-Shiang Tsai, Kuan-Yin Lin, Bo-Huang Liou, Chien-Shun Chiou, Yi-Chun Lin, Yuan-Ti Lee, Chia-Jui Yang, Hung-Jen Tang, Ying-Shu Liao, Chun-Eng Liu, Chen-Hsiang Lee, Po-Liang Lu, Sung-Hsi Huang, Chien-Ching Hung, Wen-Chien Ko, and on behalf of the Taiwan HIV Study Group
- Subjects
Adult ,Male ,Epidemiology ,Immunology ,Taiwan ,HIV Infections ,Infectious and parasitic diseases ,RC109-216 ,Microbiology ,Sexual and Gender Minorities ,Virology ,Drug Discovery ,Humans ,antimicrobial resistance ,Homosexuality, Male ,fluoroquinolones ,Dysentery, Bacillary ,Retrospective Studies ,General Medicine ,sexually transmitted disease ,biochemical phenomena, metabolism, and nutrition ,QR1-502 ,Anti-Bacterial Agents ,oro-anal sex ,Infectious Diseases ,Parasitology ,bacillary dysentery - Abstract
Shigellosis appears to increase in certain at-risk populations in developed countries. Based on the nationwide surveillance, the annual incidence of shigellosis in Taiwan (1999-2019) was 0.38-5.77 cases per 100,000 people. Indigenous shigellosis has mostly affected men who have sex with men (MSM) and people living with HIV (PLWH) since 2015. In this retrospective study, compared with those diagnosed before 2015, indigenous cases diagnosed during 2015–2019 mostly occurred in male adults (96.0% vs 47.1%, P
- Published
- 2022
4. Microbiological and genomic investigations of invasive Salmonella enterica serovar Panama from a large outbreak in Taiwan
- Author
-
Lin-Hui Su, Chien Shun Chiou, Hsin-Ping Yang, Yi-Hua Li, Chyi-Liang Chen, Hsin-Chieh Li, Yi-Jung Chang, Cheng-Hsun Chiu, and Ye Feng
- Subjects
Serotype ,Salmonella ,Taiwan ,Virulence ,Serogroup ,medicine.disease_cause ,complex mixtures ,Disease Outbreaks ,Microbiology ,parasitic diseases ,medicine ,Humans ,Panama ,biology ,business.industry ,Case-control study ,Salmonella enterica ,food and beverages ,Outbreak ,Genomics ,General Medicine ,medicine.disease ,biology.organism_classification ,Case-Control Studies ,Child, Preschool ,Bacteremia ,Salmonella Infections ,business - Abstract
BACKGROUND/PURPOSE Salmonella Panama was considered an invasive non-typhoidal Salmonella (iNTS) serovar. Comprehensive clinical, microbiological, and genomic studies on S. Panama are scarce. We aimed to characterize the clinical and microbiological characteristics of S. Panama infection. Virulence mechanism of S. Panama and other iNTS serovars were also examined. METHODS Based on data from the longitudinal surveillance system for Salmonella deployed in Taiwan since 2004, a case-control study was undertaken to evaluate clinical characteristics of S. Panama infection during an outbreak in 2015-2016. Cellular experiments were conducted to compare pathogenicity of S. Panama and other iNTS with S. Typhimurium. RESULTS Most patients (41/44, 93.2%) infected by S. Panama were
- Published
- 2022
5. Demographic Features of Invasive Meningococcal Disease in Taiwan, 1993 to 2020, and Genetic Characteristics of Neisseria meningitidis Isolates, 2003 to 2020
- Author
-
Chien-Shun Chiou, Ying-Shu Liao, Bo-Han Chen, Min-Chi Lu, Yu-Ping Hong, You-Wun Wang, and Ru-Hsiou Teng
- Subjects
Microbiology (medical) ,General Immunology and Microbiology ,Ecology ,Physiology ,Incidence ,Taiwan ,Infant ,Cell Biology ,Neisseria meningitidis ,Serogroup ,Meningococcal Infections ,Infectious Diseases ,Genetics ,Humans ,Multilocus Sequence Typing - Abstract
We present the demographic features of invasive meningococcal disease (IMD) in Taiwan between 1993 and 2020 and the genetic characteristics of Neisseria meningitidis isolates recovered from 2003 to 2020. IMD was rare in Taiwan between 1993 and 2020, with an annual incidence ranging from 0.009 to 0.204 per 100,000 people. The case fatality rate (CFR) declined from 18.1% for patients in 1993 to 2002 to 9.8% in 2003 to 2020. Infants less than 12 months were most susceptible to the disease. N. meningitidis serogroup B (NmB) was most predominant, responsible for 81.2% (134/165) of the IMD cases in 2003 to 2020. The majority of the isolates recovered from 2003 to 2020 belonged to 4 worldwide-spread hyperinvasive clonal complexes (cc), cc4821 (30.3%), cc32 (19.4%), cc41/44 (12.7%), cc23 (7.3%), and also a newly assigned clonal complex, cc3439 (10.3%). Core genome multilocus sequence typing (cgMLST) profile comparisons revealed that the cc4821 isolates with a T-to-I substitution at position 91 in
- Published
- 2022
6. Antimicrobial Resistance in Campylobacter coli and Campylobacter jejuni from Human Campylobacteriosis in Taiwan, 2016 to 2019
- Author
-
Bo-Han Chen, Shiu-Yun Liang, Chi-Sen Tsao, Ying-Shu Liao, Chien-Shun Chiou, Ru-Hsiou Teng, You-Wun Wang, Yu-Ping Hong, Hui-Yung Sung, and Jui-Hsien Chang
- Subjects
Nalidixic acid ,Taiwan ,Campylobacteriosis ,Erythromycin ,Campylobacter coli ,Microbial Sensitivity Tests ,Campylobacter jejuni ,Microbiology ,Antibiotic resistance ,Mechanisms of Resistance ,Campylobacter Infections ,Drug Resistance, Bacterial ,medicine ,Humans ,Pharmacology (medical) ,Pharmacology ,biology ,biology.organism_classification ,medicine.disease ,Anti-Bacterial Agents ,Ciprofloxacin ,Infectious Diseases ,Multilocus sequence typing ,medicine.drug - Abstract
Campylobacter coli and Campylobacter Jejuni are highly resistant to most therapeutic antimicrobials in Taiwan; rapid diagnostics of resistance in bacterial isolates is crucial for the treatment of campylobacteriosis. We characterized 219 (40 C. coli and 179 C. jejuni) isolates recovered from humans from 2016 to 2019 using whole-genome sequencing to investigate the genetic diversity among isolates and the genetic resistance determinants associated with antimicrobial resistance. Susceptibility testing with 8 antimicrobials was conducted to assess the concordance between phenotypic resistance and genetic determinants. The conventional and core genome multilocus sequence typing analysis revealed diverse clonality among the isolates. Mutations in gyrA (T86I, D90N), rpsL (K43R, K88R), and 23S rRNA (A2075G) were found in 91.8%, 3.2%, and 6.4% of the isolates, respectively. The horizontally transferable resistance genes ant(6)-I, aad9, aph(3′)-IIIa, aph(2″), bla(OXA), catA/fexA, cfr(C), erm(B), lnu, sat4, and tet were identified in 24.2%, 21.5%, 33.3%, 11.9%, 96.3%, 10.0%, 0.9%, 6.8%, 3.2%, 13.2%, and 96.3%, respectively. High-level resistance to 8 antimicrobials in isolates was 100% predictable by the known resistance determinants, whereas low-level resistance to azithromycin, clindamycin, nalidixic acid, ciprofloxacin, and florfenicol in isolates was associated with sequence variations in CmeA and CmeB of the CmeABC efflux pump. Resistance-enhancing CmeB variants were identified in 62.1% (136/219) of isolates. In conclusion, an extremely high proportion of C. coli (100%) and C. jejuni (88.3%) were multidrug-resistant, and a high proportion (62.5%) of C. coli isolates were resistant to azithromycin, erythromycin, and clindamycin, which would complicate the treatment of invasive campylobacteriosis in this country.
- Published
- 2022
7. Emergence ofVibrio choleraeO1 Sequence Type 75 in Taiwan
- Author
-
Yen-Yi Liu, Yi-Syong Chen, Ying-Shu Liao, You-Wun Wang, Yu-Ping Hong, Ru-Hsiou Teng, Chien-Shun Chiou, Bo-Han Chen, and Yueh-Hua Tu
- Subjects
Male ,Epidemiology ,Emergence of Vibrio cholerae O1 Sequence Type 75 in Taiwan ,Clone (cell biology) ,lcsh:Medicine ,multilocus sequence typing ,Multilocus sequence typing (MLST) ,core genome MLST ,medicine.disease_cause ,Communicable Diseases, Emerging ,molecular epidemiology ,Disease Outbreaks ,0302 clinical medicine ,Pandemic ,Prevalence ,030212 general & internal medicine ,Child ,Vibrio cholerae ,Genetics ,Vibrio cholerae O1 ,Middle Aged ,Cholera ,Infectious Diseases ,whole-genome sequencing ,Electrophoresis, Polyacrylamide Gel ,Female ,MLST ,Adult ,Microbiology (medical) ,Adolescent ,030231 tropical medicine ,Taiwan ,cholera ,Biology ,lcsh:Infectious and parasitic diseases ,Young Adult ,03 medical and health sciences ,Research Letter ,medicine ,Humans ,lcsh:RC109-216 ,Aged ,Sequence (medicine) ,Bacteria ,Molecular epidemiology ,enteric infections ,lcsh:R ,medicine.disease ,Whole genome sequencing ,Multilocus sequence typing ,cgMLST - Abstract
We investigated the epidemiology of cholera in Taiwan during 2002–2018. Vibrio cholerae sequence type (ST) 75 clone emerged in 2009 and has since become more prevalent than the ST69 clone from a previous pandemic. Closely related ST75 strains have emerged in 4 countries and may now be widespread in Asia.
- Published
- 2020
8. New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017
- Author
-
You-Wun Wang, Chien-Shun Chiou, Yueh-Hua Tu, Yi-Syong Chen, Ying-Shu Liao, Yu-Ping Hong, and Bo-Han Chen
- Subjects
Microbiology (medical) ,Serotype ,Epidemiology ,030231 tropical medicine ,Clone (cell biology) ,Taiwan ,lcsh:Medicine ,Microbiology ,lcsh:Infectious and parasitic diseases ,03 medical and health sciences ,0302 clinical medicine ,Plasmid ,Antibiotic resistance ,multidrug resistance ,Drug Resistance, Multiple, Bacterial ,Humans ,lcsh:RC109-216 ,030212 general & internal medicine ,antimicrobial resistance ,bacteria ,Molecular Epidemiology ,Molecular epidemiology ,biology ,Salmonella enterica serovar Anatum ,lcsh:R ,Dispatch ,Salmonella enterica ,biology.organism_classification ,Anti-Bacterial Agents ,Multiple drug resistance ,Infectious Diseases ,Salmonella Infections ,New Multidrug-Resistant Salmonella enterica Serovar Anatum Clone, Taiwan, 2015–2017 ,Bacteria ,Plasmids - Abstract
In 2011, a Salmonella enterica serovar Anatum clone emerged in Taiwan. During 2016-2017, infections increased dramatically, strongly associated with emergence and spread of multidrug-resistant strains with a plasmid carrying 11 resistance genes, including blaDHA-1. Because these resistant strains infect humans and food animals, control measures are urgently needed.
- Published
- 2019
9. cgMLST@Taiwan: A web service platform for Vibrio cholerae cgMLST profiling and global strain tracking
- Author
-
Chien-Shun Chiou, You Wun Wang, Yi-Syong Chen, Bo-Han Chen, Yueh-Hua Tu, Yu Ping Hong, Ru Hsiou Teng, and Yen Yi Liu
- Subjects
0301 basic medicine ,Microbiology (medical) ,Computer science ,030106 microbiology ,Taiwan ,Computational biology ,Molecular typing ,computer.software_genre ,medicine.disease_cause ,Genome ,Microbiology ,03 medical and health sciences ,0302 clinical medicine ,Cholera ,Databases, Genetic ,medicine ,Immunology and Allergy ,Profiling (information science) ,Humans ,030212 general & internal medicine ,Vibrio cholerae ,Phylogeny ,Core genome multilocus sequence typing (cgMLST) ,Whole genome sequencing ,Whole-genome sequencing ,Internet ,General Immunology and Microbiology ,Whole Genome Sequencing ,business.industry ,Web service ,Strain (biology) ,Strain tracking ,General Medicine ,QR1-502 ,Infectious Diseases ,Multilocus sequence typing ,The Internet ,business ,computer ,Genome, Bacterial ,Multilocus Sequence Typing - Abstract
Background Cholera, a rapidly dehydrating diarrheal disease caused by toxigenic Vibrio cholerae, is a leading cause of morbidity and mortality in some regions of the world. Core genome multilocus sequence typing (cgMLST) is a promising approach in generating genetic fingerprints from whole-genome sequencing (WGS) data for strain comparison among laboratories. Methods We constructed a V. cholerae core gene allele database using an in-house developed computational pipeline, a database with cgMLST profiles converted from genomic sequences from the National Center for Biotechnology Information, and built a REST-based web accessible via the Internet. Results We built a web service platform—cgMLST@Taiwan and installed a V. cholerae allele database, a cgMLST profile database, and computational tools for generating V. cholerae cgMLST profiles (based on 3,017 core genes), performing rapid global strain tracking, and clustering analysis of cgMLST profiles. This web-based platform provides services to researchers, public health microbiologists, and physicians who use WGS data for the investigation of cholera outbreaks and tracking of V. cholerae strain transmission across countries and geographic regions. The cgMLST@Taiwan is accessible at http://rdvd.cdc.gov.tw/cgMLST .
- Published
- 2020
10. Investigation of a salmonellosis outbreak linked to French toast sandwich with the use of surveillance camera, Taiwan, 2018
- Author
-
Tsuey-Fong Lee, Chien-Shun Chiou, Yu-Neng Chueh, Chiao-Wen Lin, Chia-Ping Su, Ying-Shu Liao, Jui-Chen Chang, Chao-Jung Lee, and Tsai-Hsia Du
- Subjects
Salmonella ,Salmonellosis ,Restaurants ,Genotype ,Epidemiology ,Salmonella enteritidis ,Eggs ,Taiwan ,Video Recording ,medicine.disease_cause ,Disease Outbreaks ,Environmental health ,Pulsed-field gel electrophoresis ,medicine ,Odds Ratio ,Humans ,Surveillance camera ,Foodborne outbreak ,Original Paper ,Whole-genome sequencing ,Transmission (medicine) ,Outbreak ,Case-control study ,Infectious Diseases ,Geography ,Salmonella Infections ,Food Microbiology ,Food preparation - Abstract
Salmonellais a leading cause of foodborne outbreaks in Taiwan. On 27 April 2018, a salmonellosis outbreak among customers of a restaurant was reported to the Taiwan CDC. We investigated the outbreak to identify infection sources and prevent further transmission. We interviewed ill customers and their dining companions. We conducted a case-control study to identify foods associated with the illness. Case-patients were those who had diarrhoea within 72 h after eating at the restaurant during 16–27 April 2018. Specimens, food samples and environmental samples were collected and tested for enteric pathogens.Salmonellaisolates were analysed with pulse-field gel electrophoresis and whole-genome sequencing. We inspected the restaurant sanitation and reviewed kitchen surveillance camera recordings. We identified 47 case-patients, including one decedent. Compared with 44 controls, case-patients were more likely to have had a French toast sandwich (OR: 102.4; 95% CI: 18.7–952.3).SalmonellaEnteritidis isolates from 16 case-patients shared an indistinguishable genotype. Camera recordings revealed eggshell contamination, long holding time at room temperature and use of leftovers during implicated food preparation. Recommendations for restaurant egg-containing food preparation are to use pasteurised egg products and ensure a high enough cooking temperature and long enough cooking time to preventSalmonellacontamination.
- Published
- 2020
11. The first imported case of extensively drug-resistant Salmonella enterica serotype Typhi infection in Taiwan and the antimicrobial therapy
- Author
-
Po-Yu Liu, Bo-Han Chen, Kung-Ching Wang, Chien-Shun Chiou, Yu-Ping Hong, and Zhi-Yuan Shi
- Subjects
0301 basic medicine ,Serotype ,Male ,Salmonella ,Drug resistance ,medicine.disease_cause ,0302 clinical medicine ,Communicable Diseases, Imported ,Drug Resistance, Multiple, Bacterial ,Immunology and Allergy ,Pakistan ,030212 general & internal medicine ,Child ,biology ,Ceftriaxone ,General Medicine ,Antimicrobial ,QR1-502 ,Anti-Bacterial Agents ,Infectious Diseases ,Salmonella enterica ,Salmonella enterica serovar Typhi ,Child, Preschool ,Female ,Travel-Related Illness ,Fluoroquinolones ,medicine.drug ,Microbiology (medical) ,Adult ,030106 microbiology ,Taiwan ,Microbial Sensitivity Tests ,Serogroup ,Microbiology ,Meropenem ,Typhoid fever ,03 medical and health sciences ,Young Adult ,medicine ,Humans ,Typhoid Fever ,General Immunology and Microbiology ,business.industry ,Salmonella typhi ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Travel medicine ,business - Abstract
The first imported case of XDR typhoid fever in Taiwan contracted with a bacterial strain, which was most closely related to the blaCTX-M-15-carrying strains linked to Pakistan. Meropenem, in combination with an antimicrobial with intracellular activity against Salmonella, should be used for the treatment of XDR typhoid fever.
- Published
- 2019
12. Emergence of Multidrug-Resistant Salmonella enterica Serovar Goldcoast Strains in Taiwan and International Spread of the ST358 Clone
- Author
-
Chien-Shun Chiou, Ying-Shu Liao, Yi-Syong Chen, Chi-Sen Tsao, Ru-Hsiou Teng, Bo-Han Chen, Shiu-Yun Liang, Yen-Yi Liu, Jui-Hsien Chang, Yueh-Hua Tu, Yu-Ping Hong, and You-Wun Wang
- Subjects
clone (Java method) ,Serotype ,Taiwan ,Microbial Sensitivity Tests ,Polymorphism, Single Nucleotide ,Genome ,Epidemiology and Surveillance ,Microbiology ,03 medical and health sciences ,Plasmid ,Drug Resistance, Multiple, Bacterial ,medicine ,Pharmacology (medical) ,030304 developmental biology ,Pharmacology ,0303 health sciences ,Molecular epidemiology ,biology ,030306 microbiology ,Zoonosis ,High-Throughput Nucleotide Sequencing ,Salmonella enterica ,biology.organism_classification ,medicine.disease ,Multiple drug resistance ,Infectious Diseases - Abstract
Salmonella enterica serovar Goldcoast infection was rare in Taiwan; it was not detected in routine surveillance from 2004 to 2013. This serovar was first identified in 2014, but the frequency of infection remained low until 2017. From 2014 to 2016, all but one isolate was pan-susceptible. S. Goldcoast infections abruptly increased in 2018, and all isolates were multidrug-resistant (MDR). All MDR isolates harbored an IncHI2 plasmid, and the majority carried 14 antimicrobial resistance genes, aac(3)-IId, aadA22, aph(3′)-Ia, aph(6)-Id, bla(TEM-1B), bla(CTX-M-55), lnu(F), floR, qnrS13, arr-2, sul2, sul3, tet(A), and dfrA14. S. Goldcoast strains recovered in Taiwan and 96 of 99 strains from Germany, the Netherlands, the United Kingdom, and the United States belonged to sequence type 358 (ST358). Whole-genome single-nucleotide polymorphism and core genome multilocus sequence type analyses revealed that all strains of the ST358 clone shared a high degree of genetic relatedness. The present study highlighted that a dramatic increase in S. Goldcoast infections followed the emergence of MDR strains and indicated that a genetically closely related S. Goldcoast ST358 clone may have widespread significance internationally.
- Published
- 2019
13. The association of Salmonella enterica from aquatic environmental and clinical samples in Taiwan
- Author
-
Bing-Mu Hsu, Hsin-Chi Tsai, Ying-Ning Ho, and Chien-Shun Chiou
- Subjects
0301 basic medicine ,Serotype ,Veterinary medicine ,Salmonella ,Environmental Engineering ,Genotype ,030106 microbiology ,Taiwan ,Microbial Sensitivity Tests ,Subspecies ,medicine.disease_cause ,03 medical and health sciences ,Rivers ,Pulsed-field gel electrophoresis ,medicine ,Humans ,Environmental Chemistry ,Waste Management and Disposal ,Genotyping ,biology ,Salmonella enterica ,biology.organism_classification ,Pollution ,Electrophoresis, Gel, Pulsed-Field ,Aquatic environment ,Water Microbiology ,Environmental Monitoring - Abstract
Salmonella is one of the most common pathogens of waterborne and foodborne disease-causing pathogens. In this study, we collected 172 surface water samples from Puzih River and Kaoping River between the years 2010 and 2011. Salmonella was detected in 31.7% (32/101) and 42.2% (30/71) of the samples from the two rivers, respectively. From these positive samples, 44 Salmonella isolates were obtained from these positive samples and were characterized using serotyping and pulsed-field gel electrophoresis (PFGE) genotyping. The isolates were found with 17 serovars and 32 PFGE patterns. Salmonella enterica Newport, Bareilly, Kedougou, Albany and subspecies IIIb 50:k:z were the five most common serovars in aquatic environmental Salmonella isolates. In addition, of the total clinical samples from Chiayi and Kaohsiung, 33.7% (60/178) Newport serovars were isolated. After conducting categorical analysis, we found that the serovar Newport was not uniformly distributed cross the cities. The serovar Newport was over-represented (p
- Published
- 2018
14. Comparison of prevalence, phenotype, and antimicrobial resistance of Salmonella serovars isolated from turkeys in Taiwan
- Author
-
Cheng Jc, Jih-Ching Yeh, Chiou-Lin Chen, Hung-Chih Kuo, Chien-Shun Chiou, and Dan-Yuan Lo
- Subjects
0301 basic medicine ,Serotype ,Florfenicol ,Turkeys ,Veterinary medicine ,Salmonella ,Nalidixic acid ,030106 microbiology ,Taiwan ,Oxytetracycline ,Biology ,Serogroup ,medicine.disease_cause ,03 medical and health sciences ,chemistry.chemical_compound ,Antibiotic resistance ,Drug Resistance, Multiple, Bacterial ,Ampicillin ,Prevalence ,medicine ,Animals ,Poultry Diseases ,Salmonella Infections, Animal ,General Medicine ,Anti-Bacterial Agents ,030104 developmental biology ,chemistry ,Colistin ,Animal Science and Zoology ,medicine.drug - Abstract
Salmonella spp. is a foodborne pathogen that causes zoonotic disease worldwide. The aim of this study was to investigate the prevalence of antimicrobial resistance of Salmonella isolated from turkey farms in Taiwan. During the past 2 yr, 243 strains of Salmonella were isolated from 2,040 samples (11.9%) from turkey farms, including 32.5% (52/160) from the intestines of 12-day-old turkey poults, 14.2% (119/840) from feces collected from the turkey growing periods, and 6.9% (72/1,040) from finishing periods. S. Albany (35.0%, 85/243), S. Schwarzengrund (23.0%, 56/243), and S. Hadar (19.3%, 47/243) were the most common serovars on turkey farms. For these strains, a high frequency of resistance was observed against florfenicol (97.5%), oxytetracycline (89.3%), doxycycline (78.6%), colistin (77.8%), ampicillin (75.7%), amoxicillin (75.3%), trimethoprim-sulfamethoxazole (73.7%), chloramphenicol (69.1%), and nalidixic acid (67.9%). floR (63.8%), tet (A) (60.5%), blaPSE (57.6%), blaTEM (42.0%), blaCTX-M (34.2%), cmlA (34.2%), and tet (D) (29.2%) were the most common resistance genes found in this study. The int1 gene was identified in 72.4% (176/243) of Salmonella isolates in which the conserved region 3’ of class 1 integrons also was amplified, whereas none had the int2 gene. This study demonstrates that imported and fattening turkeys could be a reservoir for Salmonella isolates resistant to multiple antimicrobials. These results also reinforce the need to develop strategies and implement specific control procedures to reduce the development of antimicrobial resistance.
- Published
- 2018
15. Highly prevalent emmSTG840.0 and emmSTC839.0 types of erythromycin non-susceptible group G Streptococcus isolated from bacteremia in southern Taiwan
- Author
-
Jiunn Jong Wu, Yuen Chi Chan, Chien-Shun Chiou, Po Xing Zheng, Cheng Lu Hsieh, and Chuan Chiang-Ni
- Subjects
0301 basic medicine ,Microbiology (medical) ,Southern taiwan ,030106 microbiology ,Taiwan ,lcsh:QR1-502 ,Erythromycin ,Bacteremia ,Biology ,lcsh:Microbiology ,Microbiology ,Agar dilution ,law.invention ,Group G streptococcus ,03 medical and health sciences ,Bacterial Proteins ,Disk Diffusion Antimicrobial Tests ,law ,Streptococcal Infections ,Drug Resistance, Bacterial ,medicine ,Humans ,Immunology and Allergy ,Polymerase chain reaction ,Gel electrophoresis ,Antigens, Bacterial ,General Immunology and Microbiology ,Membrane Proteins ,Streptococcus ,Methyltransferases ,General Medicine ,biology.organism_classification ,medicine.disease ,Virology ,Anti-Bacterial Agents ,Infectious Diseases ,Spectrometry, Mass, Matrix-Assisted Laser Desorption-Ionization ,Carrier Proteins ,Streptococcus dysgalactiae ,Bacterial Outer Membrane Proteins ,medicine.drug - Abstract
Background/Purpose: Group G Streptococcus (GGS) infections in human have increased. Treatment relied on antibiotic therapy, including erythromycin. However, information regarding the dominant strains and erythromycin susceptibility in GGS bacteremia is limited. Methods: A total of 134 GGS were isolated from patients with bacteremia in a university hospital of southern Taiwan during 1993â2010. The erythromycin susceptibility was determined by disc diffusion and agar dilution assays. The bacterial species was determined by MALDI-TOF. The presence of erythromycin-resistant genes and emm types were determined by polymerase chain reaction and sequence. The clonal spreading was analyzed by pulsed-field gel electrophoresis with SmaI or SgrAI digestion. Results: The annual erythromycin non-susceptible rate varied, with an average of 40.3%. All erythromycin non-susceptible strains belonged to the Streptococcus dysgalactiae. No erythromycin non-susceptible strains belong to the anginosus group. The most prevalent erythromycin-resistant gene was mefA (57.4%), followed by ermB (37%), and ermA (3.7%). The N terminal hyper variable region of emm was sequenced to determine the emm type, and only S. dysgalactiae had the emm gene. The most prevalent emm types were emmSTG840.0 (17.2%), emmSTG485.0 (10.4%), and emmSTC839.0 (9.0%). 73% and 47% of the strains with only mefA and ermB belonged to emmSTG840.0 and emmSTC839.0 types, respectively. Pulsed-field gel electrophoresis showed that different clones of emmSTG840.0 and emmSTC839.0 strains were spread in this region during the 18 years of surveillance. Conclusion: Our data indicate that there were dominant emm types with erythromycin non-susceptibility in S. dysgalactiae isolated from bacteremia in Taiwan, and thus constant surveillance is warranted. Keywords: emm, Epidemiology, Erythromycin, Group G Streptococcus
- Published
- 2017
16. Molecular characterization of antimicrobial susceptibility of Salmonella isolates: First identification of a plasmid carrying qnrD or oqxAB in Taiwan
- Author
-
Yi Fang Liu, Jiunn Jong Wu, Chien-Shun Chiou, Cheng Yen Kao, Jing Jou Yan, Chun An Chen, and Hsiu Mei Wu
- Subjects
0301 basic medicine ,Microbiology (medical) ,Salmonella ,Cefotaxime ,Genotype ,medicine.drug_class ,plasmid-mediated quinolone resistance ,Cefepime ,030106 microbiology ,Cephalosporin ,cephalosporin ,Taiwan ,lcsh:QR1-502 ,Ceftazidime ,Microbial Sensitivity Tests ,Biology ,Quinolones ,medicine.disease_cause ,Polymerase Chain Reaction ,beta-Lactamases ,lcsh:Microbiology ,Microbiology ,03 medical and health sciences ,Anti-Infective Agents ,Bacterial Proteins ,Immunology and Microbiology(all) ,Drug Resistance, Multiple, Bacterial ,medicine ,Escherichia coli ,Immunology and Allergy ,Humans ,Cefoxitin ,General Immunology and Microbiology ,Base Sequence ,General Medicine ,Quinolone ,Anti-Bacterial Agents ,Cephalosporins ,Ciprofloxacin ,oqxAB ,030104 developmental biology ,Infectious Diseases ,DNA Gyrase ,Genes, Bacterial ,medicine.drug ,Plasmids ,qnrD - Abstract
Background/Purpose The aim of this study is to characterize antibiotic-nonsusceptible Salmonella isolates in Taiwan. Methods A total of 76 Salmonella isolates showing lower susceptibility to cephalosporins or quinolones were identified from 1416 clinical isolates from 1999 to 2008. Minimal inhibitory concentrations for selected antimicrobial agents were tested by the agar dilution method. Antibiotic resistance-related genes were determined by polymerase chain reaction (PCR) combined with sequencing. Southern blotting, conjugation tests, and transformation tests were used to characterize plasmid-mediated quinolone resistance (PMQR) determinants. Results The observed nonsusceptible phenotypes of 76 isolates were against cefoxitin (57.9%), cefotaxime (43.4%), ceftazidime (40.8%), ceftriaxone (42.1%), cefepime (5.3%), ciprofloxacin (80.3%), and levofloxacin (81.6%). Among 44 cephalosporin-resistant isolates, TEM-1, CMY-2, CMY-14, CTX-M-3-like and CTX-M-15-like determinants were present in 31 (70.5%), 32 (72.7%), 1 (2.3%), 1 (2.3%), and 1 (2.3%) of isolates, respectively. PCR screening for PMQR genes of 62 quinolone-nonsusceptible isolates revealed the presence of qnrS , qnrD , aac(6 ′ )-Ib-cr , and oqxAB in 3 (4.8%), 2 (3.2%), 1 (1.6%), and 10 (16.1%) isolates, respectively. Among 36 isolates showing high resistance to quinolones, S83F/D87N and S83F/D87G amino acid substitutions of GyrA were found in 29 (80.6%) and 6 (16.7%) isolates, respectively. Moreover, among quinolone highly resistant isolates, eight (22.2%) of isolates showed over-expression of the PAβN-sensitive efflux pump. Transformants and transconjugants harboring qnrD - or oqxAB -plasmids showed decreased susceptibility to quinolones. Conclusion GyrA mutations are the major mechanisms associated with quinolone-resistant Salmonella isolates in Taiwan. Overproduction of efflux pump genes and the presence of qnr and oqxAB play additional roles in reduced susceptibility to quinolones.
- Published
- 2017
17. Transmission and evolution of OXA-48-producing Klebsiella pneumoniae ST11 in a single hospital in Taiwan
- Author
-
Ming-Ko Chiang, Ru-Hsiou Teng, Yu-Ping Hong, Bo-Han Chen, You-Wun Wang, Chien-Shun Chiou, Yi-Chyi Lai, Yen-Yi Liu, Yi-Syong Chen, Hui-Ling Tang, Ying-Tsong Chen, and Min-Chi Lu
- Subjects
Microbiology (medical) ,Genotype ,Klebsiella pneumoniae ,Taiwan ,beta-Lactamases ,Evolution, Molecular ,Plasmid ,Bacterial Proteins ,Lysogenic cycle ,Humans ,Pharmacology (medical) ,Prophage ,Pharmacology ,Whole genome sequencing ,Cross Infection ,biology ,Transmission (medicine) ,Outbreak ,biology.organism_classification ,Virology ,Hospitals ,Klebsiella Infections ,Infectious Diseases ,Plasmids - Abstract
Objectives Epidemic spread of OXA-48-producing Klebsiella pneumoniae, mainly mediated by the transmission of a blaOXA-48-carrying plasmid, has threatened global health during the last decade. Since its introduction to Taiwan in 2013, OXA-48 has become the second most common carbapenemase. We described the transmission and evolution of an OXA-producing K. pneumoniae clone in a single hospital. Methods Twenty-two OXA-48 K. pneumoniae were isolated between October 2013 and December 2015. Comparative genomic analysis was performed based on the WGS data generated with Illumina and MinION techniques. Results Seventeen of the 22 OXA-48 K. pneumoniae that belonged to ST11, with the same capsular genotype, KL64, and differed from each other by seven or fewer SNPs, were considered outbreak strains. Eight of the 17 outbreak strains harboured a 65 499 bp blaOXA-48-carrying IncL plasmid (called pOXA48). pOXA48 was absent from the remaining nine strains. Instead, a 24.9 kb blaOXA-48-carrying plasmid fragment was integrated into a prophage region of their chromosomes. Transmission routes of the ST11_KL64 K. pneumoniae sublineages, which carried either pOXA48 or chromosomally integrated blaOXA-48, were reconstructed. Conclusions Clonal expansion of ST11_KL64 sublineages contributed to the nosocomial outbreak of OXA-48 K. pneumoniae. The chromosome-borne blaOXA-48 lineage emerged during a 2 year period in a single hospital. Dissemination of OXA-48, which is vertically transmitted in K. pneumoniae even in the absence of selective pressure from antimicrobials, deserves public health attention.
- Published
- 2019
18. Salmonella enterica serotype typhimurium and S. Stanley differ in genomic evolutionary patterns and early immune responses in human THP-1 cell line and CD14
- Author
-
Pei-Chun Tu, Chin-Chin Huang, Chishih Chu, Chang-Lin Huang, Li-Ting Sun, Shao-Hung Wang, Chien-Shun Chiou, and Li-Te Chin
- Subjects
Serotype ,Salmonella typhimurium ,Salmonella ,040301 veterinary sciences ,THP-1 Cells ,CD14 ,Phagocytosis ,030231 tropical medicine ,Immunology ,Interleukin-1beta ,Taiwan ,medicine.disease_cause ,Microbiology ,Monocytes ,beta-Lactamases ,0403 veterinary science ,03 medical and health sciences ,0302 clinical medicine ,Immune system ,Cell Line, Tumor ,mental disorders ,medicine ,Immunology and Allergy ,Humans ,General Veterinary ,biology ,Interleukin-6 ,Tumor Necrosis Factor-alpha ,Monocyte ,04 agricultural and veterinary sciences ,General Medicine ,biology.organism_classification ,humanities ,Electrophoresis, Gel, Pulsed-Field ,Infectious Diseases ,medicine.anatomical_structure ,Salmonella enterica ,Salmonella Infections ,Reactive Oxygen Species ,Bacteria - Abstract
Salmonella Typhimurium and S. Stanley are the most prevalent serogroup B serovars to infect humans in Taiwan. The aim was to determine possible factors to influence the prevalence between S. Typhimurium and S. Stanley. Genotypes were determined by pulsed field gel electrophoresis (PFGE) analysis and the intracellular survival, phagocytosis, reactive oxygen species (ROS) production of human monocyte THP-1 cell and tumor necrosis factor-α(TNF-α), interleukin-6 (IL-6), and IL-1βexpression in peripheral blood CD14+ cells after infection were analyzed. 182 S. Stanley was clonal disseminated with main pulsotypes 2 from 2004 to 2007. Overall S. Typhimurium evolved more genotypes, while S. Stanley conserved in genotypes. Human blood CD14+ monocytes expressed TNF-α, IL-6 and IL-1β differently among serovars and bacterial conditions (live vs. killed). Live S. Stanley and S. Typhimurium suppressed the TNF-α and IL-6 expression compared to killed bacteria. However, live S. Typhimurium stimulated more IL-1β expression than the killed bacteria, but S. Stanley expressed similar IL-1β levels in both conditions. Furthermore, S. Stanley and S. Typhimurium differed in intracellular survival in the THP-1 cells, an early decrease for S. Stanley, not for S. Typhimurium. Additionally, higher reactive oxygen species (ROS) production in THP-1 cells was found agsinst S. Stanley infection, not found in S. Typhimurium. However, some isolates of S. Stanley could recover from early loss to become more in the monocytes than S. Typhimurium. Difference in phagocytized number, intracellular survival, ROS production and IL-1β expression may contribute to prevalence different between two serovars.
- Published
- 2018
19. Genetic Relationships among Multidrug-Resistant Salmonella enterica Serovar Typhimurium Strains from Humans and Animals
- Author
-
Bo-Han Chen, Yu Ping Hong, Ying-Shu Liao, Yueh Hua Tu, I-Hsiu Huang, Chien-Shun Chiou, Yu-Chieh Liao, Yen-Yi Liu, You-Wun Wang, and Hung-Chih Kuo
- Subjects
Salmonella typhimurium ,0301 basic medicine ,Serotype ,Salmonella ,Swine ,Tetracycline ,030106 microbiology ,Taiwan ,Microbial Sensitivity Tests ,Azithromycin ,medicine.disease_cause ,Microbiology ,03 medical and health sciences ,Plasmid ,Antibiotic resistance ,Mechanisms of Resistance ,Drug Resistance, Multiple, Bacterial ,medicine ,Animals ,Humans ,Pharmacology (medical) ,Cefoxitin ,Pharmacology ,Salmonella Infections, Animal ,Whole Genome Sequencing ,biology ,bacterial infections and mycoses ,biology.organism_classification ,Anti-Bacterial Agents ,Multiple drug resistance ,030104 developmental biology ,Infectious Diseases ,Salmonella enterica ,Multigene Family ,Chickens ,Plasmids ,medicine.drug - Abstract
We identified 20 to 22 resistance genes, carried in four incompatibility groups of plasmids, in each of five genetically closely related Salmonella enterica serovar Typhimurium strains recovered from humans, pigs, and chickens. The genes conferred resistance to aminoglycosides, chloramphenicol, sulfonamides, trimethoprim, tetracycline, fluoroquinolones, extended-spectrum cephalosporins and cefoxitin, and azithromycin. This study demonstrates the transmission of multidrug-resistant Salmonella strains among humans and food animals and may be the first identification of mphA in azithromycin-resistant Salmonella strains in Taiwan.
- Published
- 2018
20. Clonal dissemination of carbapenemase-producing Klebsiella pneumoniae: Two distinct sub-lineages of Sequence Type 11 carrying bla
- Author
-
Min-Chi, Lu, Hui-Ling, Tang, Chien-Shun, Chiou, Yao-Chen, Wang, Ming-Ko, Chiang, and Yi-Chyi, Lai
- Subjects
Adult ,Aged, 80 and over ,Male ,Inpatients ,Molecular Epidemiology ,Genotype ,Taiwan ,Sequence Analysis, DNA ,Middle Aged ,Polymerase Chain Reaction ,beta-Lactamases ,Electrophoresis, Gel, Pulsed-Field ,Klebsiella Infections ,Hospitals, University ,Molecular Typing ,Klebsiella pneumoniae ,Young Adult ,Carbapenem-Resistant Enterobacteriaceae ,Bacterial Proteins ,Humans ,Female ,Prospective Studies ,Bacterial Capsules ,Aged - Abstract
The global spread of carbapenem-resistant Klebsiella pneumoniae (CR-Kp) has become a massive threat to human health. We investigated the clonal relatedness of CR-Kp strains in central Taiwan.CR-Kp strains were prospectively collected from inpatients referred to Chung Shan Medical University Hospital (CSMUH) during September 2011 to December 2015. The presence of carbapenemase genes, including blaA total of 174 CR-Kp strains were collected. KPC-2 and OXA-48 were present in 63 (36.2%) and 22 (12.6%) CR-Kp strains, respectively. Two strains isolated in 2014 coproduced KPC-2 and OXA-48. Nearly all (98%) carbapenemase-producing K. pneumoniae strains belonged to the ST11 clone and could be further grouped into distinct sub-lineages. Intriguingly, the first sub-lineage, designated ST11-Clade I, contained all KPC-2 strains; OXA-48 strains were mostly included in the second sub-lineage, ST11-Clade II. Furthermore, a variation on the capsule synthesis loci was detected between these two sub-lineages: KL-47 was assigned to ST11-Clade I, whereas KL-64 or KL-9 were the main types for the ST11-Clade II strains.Clonal expansion of ST11 was responsible for the dissemination of carbapenemase-producing K. pneumoniae. Although KPC-2 still predominates, OXA-48 has emerged rapidly. Co-existence of KPC-2 and OXA-48 in two ST11-Clade I K. pneumoniae highlights the urgency to unravel mechanisms that contribute to this highly transmissible lineage.
- Published
- 2017
21. Molecular typing and epidemiology of Clostridium difficile in respiratory care wards of central Taiwan
- Author
-
Chien-Wen Huang, Sung-Hsi Wei, Chih-Hung Shih, Yi-Wen Huang, Chien-Shun Chiou, Yi-Sheng Liou, Hsiao-Lun Wei, Jin-Chyr Hsu, and Min-Chi Lu
- Subjects
Diarrhea ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Genotype ,Prevalence ,Taiwan ,Minisatellite Repeats ,Multiple Loci VNTR Analysis ,Molecular typing ,Asymptomatic ,Ribotyping ,Microbiology ,Internal medicine ,Immunology and Microbiology(all) ,Epidemiology ,Medicine ,Infection control ,Cluster Analysis ,Humans ,Immunology and Allergy ,Prospective Studies ,Aged ,Aged, 80 and over ,Multiple-locus variable-number tandem-repeat analysis (MLVA) ,Cross Infection ,Molecular Epidemiology ,General Immunology and Microbiology ,business.industry ,Clostridioides difficile ,General Medicine ,Clostridium difficile ,Middle Aged ,Infectious Diseases ,Clostridium Infections ,Female ,medicine.symptom ,business - Abstract
Background/purpose In industrialized countries, Clostridium difficile is the major cause of nosocomial diarrhea. This study involved a broad overview of baseline epidemiology for C. difficile in Taiwan. Materials and methods Point prevalence was estimated from a prospective survey conducted in the respiratory care wards of six hospitals in central Taiwan. Polymerase chain reaction (PCR) ribotyping and multiple-locus variable-number tandem-repeat analysis (MLVA) were performed on all toxigenic C. difficile isolates, including asymptomatic and symptomatic strains. Results A total of 149 patients were screened for C. difficile ; the point prevalence for C. difficile infection (CDI) and C. difficile colonization was 4% and 19%, respectively. CDI cases were significantly related to end-stage renal disease, and C. difficile colonization cases were significantly associated with previous admission to an acute-care facility. No hypervirulent PCR ribotype 027 strain was found. MLVA detected two clusters of CDI-related and three clusters of asymptomatic C. difficile strains circulating in wards. Conclusion Our results demonstrate a high prevalence of toxigenic C. difficile colonization in hospitals. Infection control personnel should pay attention to the increasing numbers of CDI cases, and molecular typing for C. difficile should be performed when necessary.
- Published
- 2015
- Full Text
- View/download PDF
22. Antimicrobial Resistance in Salmonella enterica Serovar Typhi Isolates from Bangladesh, Indonesia, Taiwan, and Vietnam
- Author
-
Jung-Che Kuo, Pei-Chen Chen, Shiu-Yun Liang, Yen-Yi Liu, Tsai-Ling Lauderdale, Pei-Jen Wang, Chien-Shun Chiou, Haruo Watanabe, and Dac Cam Phung
- Subjects
Genotype ,Nalidixic acid ,Taiwan ,Microbial Sensitivity Tests ,Biology ,Salmonella typhi ,Polymorphism, Single Nucleotide ,DNA gyrase ,Typhoid fever ,Epidemiology and Surveillance ,Microbiology ,Nalidixic Acid ,Antibiotic resistance ,Ciprofloxacin ,Drug Resistance, Multiple, Bacterial ,medicine ,Humans ,Pharmacology (medical) ,Typhoid Fever ,Phylogeny ,Pharmacology ,Bangladesh ,Base Sequence ,Sequence Analysis, DNA ,medicine.disease ,Antimicrobial ,Anti-Bacterial Agents ,Multiple drug resistance ,Infectious Diseases ,Vietnam ,Indonesia ,Carrier Proteins ,Plasmids ,medicine.drug - Abstract
We characterized Salmonella enterica serovar Typhi isolates from Bangladesh, Indonesia, Taiwan, and Vietnam to investigate their genetic relatedness and antimicrobial resistance. The isolates from Bangladesh and Vietnam were genetically closely related but were distant from those from Indonesia and Taiwan. All but a few isolates from Indonesia and Taiwan were susceptible to all antimicrobials tested. The majority of isolates from Bangladesh and Vietnam were multidrug resistant (MDR) and belonged to the widespread haplotype H58 clone. IncHI1 plasmids were detected in all MDR S . Typhi isolates from Vietnam but in only 15% of MDR isolates from Bangladesh. Resistance genes in the majority of MDR S . Typhi isolates from Bangladesh should reside in the chromosome. Among the isolates from Bangladesh, 82% and 40% were resistant to various concentrations of nalidixic acid and ciprofloxacin, respectively. Several resistance mechanisms, including alterations in gyrase A, the presence of QnrS, and enhanced efflux pumps, were involved in the reduced susceptibility and resistance to fluoroquinolones. Intensive surveillance is necessary to monitor the spread of chromosome-mediated MDR and fluoroquinolone-resistant S . Typhi emerging in Bangladesh.
- Published
- 2014
23. Usefulness of pulsed-field gel electrophoresis profiles for the determination of Salmonella serovars
- Author
-
Jung-Che Kuo, Mia Torpdahl, You-Wun Wang, Chi-Sen Tsao, Chun-Hsing Liao, Shiu-Yun Liang, Ying-Shu Liao, Yen-Yi Liu, and Chien-Shun Chiou
- Subjects
Genetics ,Gel electrophoresis ,Serotype ,Salmonella ,Geographic area ,Denmark ,Taiwan ,General Medicine ,Biology ,Serogroup ,medicine.disease_cause ,Microbiology ,Bacterial Typing Techniques ,Electrophoresis, Gel, Pulsed-Field ,Pulsed-field gel electrophoresis ,medicine ,Food Science - Abstract
We created a database consisting of a large number of Salmonella pulsed-field gel electrophoresis (PFGE) profiles covering a wide range of different serovars. This database was used for the prediction of the serovars based on the PFGE profiles for isolates from Taiwan and Denmark. The PFGE profiles proved very useful in the determination of a serovar although serovar prediction was more efficient for local isolates than those from a distant geographic area. To use a highly stringent band matching tolerance in the BioNumerics software is also important for the grouping of serovars.
- Published
- 2015
24. Shigellosis outbreak among MSM living with HIV: a case-control study in Taiwan, 2015-2016
- Author
-
Yi-Ting Shen, Hao-Hsin Wu, Yi-Chun Lo, Chi-Tai Fang, and Chien-Shun Chiou
- Subjects
Adult ,Male ,medicine.medical_specialty ,Shigellosis ,Substance-Related Disorders ,Sexual Behavior ,Taiwan ,HIV Infections ,Dermatology ,Men who have sex with men ,Disease Outbreaks ,Methamphetamine ,03 medical and health sciences ,Gonorrhea ,Sexual and Gender Minorities ,0302 clinical medicine ,Risk Factors ,Environmental health ,Epidemiology ,medicine ,Odds Ratio ,Humans ,030212 general & internal medicine ,Syphilis ,Risk factor ,Dysentery, Bacillary ,030505 public health ,business.industry ,Coinfection ,Bacillary dysentery ,Outbreak ,Viral Load ,medicine.disease ,Infectious Diseases ,Logistic Models ,Case-Control Studies ,Multivariate Analysis ,0305 other medical science ,Risk assessment ,business ,Sodium Oxybate - Abstract
ObjectivesOutbreaks of shigellosis among men who have sex with men (MSM) have been reported since the late 1990s. HIV infection is an important risk factor. Since 2014, the global shigellosis epidemic has intensified. Whether chemsex (the use of crystal methamphetamine, γ-hydroxybutyrate or mephedrone to enhance sex) is a new risk factor has not been previously examined.MethodsWe conducted a population-based, case–control study in Taiwan. Acute shigellosis cases diagnosed during the 2015 outbreak among MSM living with HIV were compared with those without shigellosis. CD4+ counts, plasma viral load (pVL), gonorrhoea, syphilis and amoebiasis records were obtained from the Notifiable Disease Surveillance System database. We invited cases/controls to provide information on illicit drug use and sexual behaviours, using a structured questionnaire.ResultsSeventy-five shigellosis cases were compared with 225 controls. High pVL (>100 000 copies/mL; adjusted OR (aOR): 4.9, 95% CI 1.4 to 16.9), gonorrhoea (aOR: 29.4, 95% CI 2.3 to 340.2) and syphilis (aOR: 4.3, 95% CI 1.6 to 11.6) were independent risk factors of shigellosis. Twenty shigellosis cases and 59 controls completed the questionnaire. Oral-to-anal sex (aOR: 15.5, 95% CI 3.6 to 66.7), chemsex (aOR: 5.6, 95% CI 1.4 to 22.7) and poppers use (aOR: 10.9, 95% CI 1.9 to 64.2) within 12 months were independent behavioural risk factors of shigellosis.ConclusionsChemsex is a new risk factor for shigellosis among MSM living with HIV, as identified in the 2015–2016 outbreak. Additional risk factors include poppers use, sexual risk behaviours and high pVL. Further studies on chemsex among MSM, which is a rising public health concern, are urgently required.
- Published
- 2017
25. A Large Outbreak of Salmonellosis Associated with Sandwiches Contaminated with Multiple Bacterial Pathogens Purchased via an Online Shopping Service
- Author
-
Yu-Lun Liu, Chien-Shun Chiou, Angela S. Huang, Ying-Shu Liao, and Sung-Hsi Wei
- Subjects
Adult ,Male ,Staphylococcus aureus ,Veterinary medicine ,Salmonella ,Adolescent ,Genotype ,Eggs ,Salmonella enteritidis ,Taiwan ,medicine.disease_cause ,Applied Microbiology and Biotechnology ,Microbiology ,Disease Outbreaks ,Foodborne Diseases ,Young Adult ,Bacillus cereus ,Enterotoxigenic Escherichia coli ,medicine ,Humans ,Food microbiology ,Child ,Aged ,Aged, 80 and over ,Internet ,business.industry ,digestive, oral, and skin physiology ,Food Services ,Infant ,Outbreak ,Original Articles ,Middle Aged ,Food safety ,Salmonella Food Poisoning ,Diarrhea ,Child, Preschool ,Food Microbiology ,Female ,Animal Science and Zoology ,medicine.symptom ,business ,Food Science - Abstract
Food sold over the internet is an emerging business that also presents a concern with regard to food safety. A nationwide foodborne disease outbreak associated with sandwiches purchased from an online shop in July 2010 is reported. Consumers were telephone interviewed with a structured questionnaire and specimens were collected for etiological examination. A total of 886 consumers were successfully contacted and completed the questionnaires; 36.6% had become ill, with a median incubation period of 18 h (range, 6-66 h). The major symptoms included diarrhea (89.2%), abdominal pain (69.8%), fever (47.5%), headache (32.7%), and vomiting (17.3%). Microbiological laboratories isolated Salmonella enterica serovar Enteritidis, Salmonella Virchow, Staphylococcus aureus, Bacillus cereus, and enterotoxigenic Escherichia coli from the contaminated sandwiches, Salmonella Enteritidis and Salmonella Virchow from the patients, and Salmonella Enteritidis and Staphylococcus aureus from food handlers. Pulsed-field gel electrophoresis genotyping suggested a common origin of Salmonella bacteria recovered from the patients, food, and a food handler. Among the pathogens detected, the symptoms and incubation period indicated that Salmonella, likely of egg origin, was the probable causative agent of the outbreak. This outbreak illustrates the importance of meticulous hygiene practices during food preparation and temperature control during food shipment and the food safety challenges posed by online food-shopping services.
- Published
- 2014
26. Multidrug-resistant Salmonella enterica serovar Panama carrying class 1 integrons is invasive in Taiwanese children
- Author
-
Shu Ching Huang, Chien Shun Chiou, Cheng-Hsun Chiu, and Yao Jong Yang
- Subjects
class 1 integrons ,Serotype ,Salmonella ,invasiveness ,Salmonella enteritidis ,Taiwan ,Biology ,medicine.disease_cause ,Integrons ,Microbiology ,multidrug resistance ,Drug Resistance, Multiple, Bacterial ,Ampicillin ,Drug Resistance, Bacterial ,Genotype ,medicine ,Humans ,Serotyping ,Child ,Medicine(all) ,lcsh:R5-920 ,Panama ,Virulence ,Salmonella enterica ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,Virology ,Multiple drug resistance ,Caco-2 Cells ,lcsh:Medicine (General) ,medicine.drug - Abstract
Background/Purpose An increase in group D Salmonella isolates with high antimicrobial resistant rates is being seen in Taiwan. This study aimed to determine the multidrug-resistant (MDR, more than three antibiotics) phenotype, genotype, and the correlation between the presence of class 1 integrons and its invasiveness of Salmonella panama and Salmonella enteritidis isolated from children. Methods Twenty S. panama and 59 S. enteritidis isolates were examined for minimal inhibitory concentrations of ampicillin, chloramphenicol, streptomycin, sulfonamides, and tetracycline by agar dilution method. The presence of bla PSE-1 , floR , aadA2 , sul1 , and tet(G) resistance genes, class 1 integrons, and Salmonella genomic island 1 (SGI1) was identified by polymerase chain reaction. The adhesion and invasion assays of S. panama to Caco-2 cells were determined using the pour plate method. Results All S. panama and 15 (25.4%) of the S. enteritidis isolates displayed MDR phenotype. Furthermore, MDR genotype was present in 70.0% of S. panama and 6.8% of S. enteritidis . Class 1 integrons were present in 40.0% of S. panama and 11.9% of S. enteritidis . None contained SGI1 or SGI1 variants. Strains carrying class 1 integrons were more frequently isolated from bacteria with MDR (73.3% vs. 37.5%; odds ratio, 4.6; 95% confidence interval, 1.3-16.0; p = 0.01) and isolated from blood and cerebrospinal fluid (46.7% vs. 21.9%; odds ratio, 3.1; 95% confidence interval, 1.0-10.1; p = 0.05) than noncarriers. S. panama carrying class 1 integrons were more invasive to Caco-2 cells than those without ( p = 0.01). Conclusion S. panama and S. enteritidis with class 1 integrons are significantly related to the presence of MDR phenotype. Moreover, S. panama with class 1 integrons may present more invasiveness than those without.
- Published
- 2013
- Full Text
- View/download PDF
27. Salmonella genomic island 1-J variants associated with change in the antibiotic resistance gene cluster in multidrug-resistant Salmonella enterica serovar Virchow isolated from humans, Taiwan, 2004–2006
- Author
-
Cheng-Hsun Chiu, C.-W. Lin, Y.-L. Lee, S.-W. Chen, Axel Cloeckaert, Chishih Chu, Benoît Doublet, Chien-Shun Chiou, National Chiayi University, Infectiologie et Santé Publique (UMR ISP), Institut National de la Recherche Agronomique (INRA)-Université de Tours, Center for disease control, Chang Gung University, and Institut National de la Recherche Agronomique (INRA)-Université de Tours (UT)
- Subjects
DNA, Bacterial ,Microbiology (medical) ,Salmonella ,Genomic Islands ,Genotype ,PFGE analysis ,Taiwan ,Microbial Sensitivity Tests ,Drug resistance ,Integron ,medicine.disease_cause ,Microbiology ,03 medical and health sciences ,Antibiotic resistance ,Salmonella genomic island ,Drug Resistance, Multiple, Bacterial ,Genomic island ,plasmid ,medicine ,Humans ,antimicrobial resistance ,Sequence Deletion ,030304 developmental biology ,Genetics ,0303 health sciences ,biology ,030306 microbiology ,Salmonella enterica ,General Medicine ,biology.organism_classification ,bacterial infections and mycoses ,S. virchow ,[SDV.MP.BAC]Life Sciences [q-bio]/Microbiology and Parasitology/Bacteriology ,3. Good health ,Multiple drug resistance ,Infectious Diseases ,Multigene Family ,Salmonella Infections ,biology.protein ,Genes, MDR - Abstract
International audience; Salmonella genomic island I (variant SGII-J3) has been previously identified in multi-drug resistant (MDR) Salmonella enterica serovar Virchow isolated from humans in 1994. In this study, antimicrobial resistance, genotypes and genetic relationship were investigated in 96 S. Virchow isolates collected from humans in 2004-2006. XbaI-PFGE analysis separated 96 isolates into two main related-clusters, I and II, which consisted of four major pulsotypes differing in prevalence by year. The majority of isolates were MDR to chloramphenicol, sulfonamide, trimethoprim and tetracyclines associated with antimicrobial resistance genes dfrA1, floR2, sull and tet(G) of variant SGII-J3. Among nine variants, we determined two novel variants SGII-J4 and -J5, which have undergone different homologous recombinational events resulting in partial deletions of the MDR region. The first one contained an empty integron structure and the second presented a deletion extending from the IS6100 element to the adjacent SGII backbone. SGII-J3 is largely encountered in clonally related MDR S. Virchow isolates collected from humans which spread vertically. The genomic island SGII appears to be largely responsible for the diversity of MDR phenotypes among S. Virchow isolates in Taiwan.
- Published
- 2012
- Full Text
- View/download PDF
28. Molecular epidemiology of Mycobacterium abscessus infections in a subtropical chronic ventilatory setting
- Author
-
Chien-Shun Chiou, Gwan-Han Shen, Jiann-Hwa Chen, and Wei-Chang Huang
- Subjects
DNA, Bacterial ,Male ,Microbiology (medical) ,medicine.medical_specialty ,Genotype ,Taiwan ,Disease ,Mycobacterium abscessus ,Artificial respiration ,Microbiology ,Mycobacterium ,law.invention ,law ,Internal medicine ,Pneumonia, Bacterial ,medicine ,Pulsed-field gel electrophoresis ,Cluster Analysis ,Humans ,Intensive care medicine ,Aged ,Aged, 80 and over ,Molecular Epidemiology ,Mycobacterium Infections ,Molecular epidemiology ,biology ,business.industry ,Outbreak ,General Medicine ,Middle Aged ,biology.organism_classification ,DNA Fingerprinting ,Long-Term Care ,Intensive care unit ,Hospitals ,Bacterial Typing Techniques ,Electrophoresis, Gel, Pulsed-Field ,Female ,Radiography, Thoracic ,Water Microbiology ,business ,Polymorphism, Restriction Fragment Length - Abstract
The aim of this study was to investigate the high level of pulmonaryMycobacterium abscessusinfections and implement a surveillance programme among 43 ventilator-dependent patients, 15 with pulmonaryM. abscessusinfections, in a hospital long-term respiratory care ward (RCW) in central Taiwan.M. abscessusisolates were obtained from 35 patients in the RCW of hospital A, 6 patients in the RCWs of another three hospitals (B, C and D), and from 4 water sources in two of the hospitals (A and B). Strains were characterized by methods includinghsp65 PCR–RFLP and PFGE. The patients were followed-up by chest X-ray for 1 year. All clinical isolates were type I and II, and belonged to ten distinct clusters of PFGE patterns. Five clinical strains in two hospitals belonged to a single cluster, whilst four clinical strains in the other two hospitals belonged to a single unique cluster. The strains from hospital A fell into nine clusters and were distinct from the strains isolated from the water supply. Patients infected with type I strains showed a significantly more rapid progression of disease. The number of different strains involved suggested either that there had been a polyclonal outbreak or that a high level of endemic infections was present in the RCW of hospital A. This and the lack of homology between the clinical and environmental isolates from hospital A raised the possibility that pulmonaryM. abscessusinfections may have been spread by the movement of patients between RCWs, a routine practice in Taiwan's integrated delivery system.
- Published
- 2010
29. Prevalence and Antimicrobial Susceptibility of Salmonellae Isolates from Reptiles in Taiwan
- Author
-
Wan-Ching Chen, Shih-Chien Chin, Chao-Chin Chang, Yuan-Man Hsu, Chun Yu Chen, Yen-Hsueh Lai, Kwong-Chung Tung, and Chien-Shun Chiou
- Subjects
Serotype ,Cefalotin ,Salmonella Infections, Animal ,Salmonella ,Antiinfective agent ,Veterinary medicine ,General Veterinary ,Taiwan ,Reptiles ,Outbreak ,Salmonella infection ,Drug resistance ,Biology ,medicine.disease_cause ,medicine.disease ,Anti-Bacterial Agents ,Microbiology ,Antibiotic resistance ,Drug Resistance, Multiple, Bacterial ,medicine ,Animals ,medicine.drug - Abstract
Pets, including reptiles, have been shown to be a source of Salmonella infection in humans. Due to increasing popularity and variety of exotic reptiles as pets in recent years, more human clinical cases of reptile-associated Salmonella infection have been identified. However, limited information is available with regard to serotypes in different reptiles (turtles, snakes, and lizards) and antimicrobial resistance of Salmonella in pet reptiles. The current study was thus conducted to determine the prevalence of Salmonella colonization in pet reptiles. Salmonella organisms were isolated from 30.9% of 476 reptiles investigated. The isolation prevalences were 69.7% (23/33), 62.8% (27/43), and 24.3% (97/400) in snakes, lizards, and turtles, respectively. A total of 44 different Salmonella serovars were identified. Compared with S. Heron, Bredeney, Treforest, and 4,[5],12:i:-, S. Typhimurium isolates were resistant to many antimicrobials tested, and notably 61.1% of the isolates were resistant to cephalothin. The results indicated that raising reptiles as pets could be a possible source of Salmonella infection in humans, particularly zoonotic Salmonella serovars such as S. Typhimurium that may be resistant to antimicrobials.
- Published
- 2010
30. The worldwide spread of ciprofloxacin-resistant Shigella sonnei among HIV-infected men who have sex with men, Taiwan
- Author
-
Ying-Shu Liao, Maho Kawamura, Hao-Hsin Wu, Ying-Shih Su, Wan-Chin Chen, Chien-Shun Chiou, Yi-Chun Lo, and Hidemasa Izumiya
- Subjects
0301 basic medicine ,Microbiology (medical) ,Adult ,DNA Topoisomerase IV ,Male ,Shigellosis ,medicine.medical_specialty ,Genotype ,030106 microbiology ,Mutation, Missense ,Taiwan ,Shigella sonnei ,HIV Infections ,Minisatellite Repeats ,Men who have sex with men ,Disease Outbreaks ,03 medical and health sciences ,Young Adult ,Ciprofloxacin ,Epidemiology ,Drug Resistance, Bacterial ,Disease Transmission, Infectious ,Medicine ,Humans ,Homosexuality, Male ,Dysentery, Bacillary ,Molecular Epidemiology ,Molecular epidemiology ,business.industry ,Transmission (medicine) ,Outbreak ,General Medicine ,Middle Aged ,medicine.disease ,Virology ,Anti-Bacterial Agents ,Electrophoresis, Gel, Pulsed-Field ,Molecular Typing ,Infectious Diseases ,DNA Gyrase ,Case-Control Studies ,Syphilis ,business - Abstract
Ciprofloxacin-resistant shigellosis outbreaks among men who have sex with men (MSM) have not been reported in Asia. During 3 March to 6 May 2015, the Notifiable Disease Surveillance System detected nine non-imported Shigella sonnei infections among human immunodeficiency virus (HIV) -infected Taiwanese MSM. We conducted a molecular epidemiological investigation using a 1 : 5 matched case-control study and laboratory characterizations for the isolates. Of the nine patients, four reported engagement in oral-anal sex before illness onset. Shigellosis was associated with a syphilis report within 12 months (adjusted odds ratio (aOR) 8.6; 95% CI 1.05-70.3) and no HIV outpatient follow-up within 12 months (aOR 22.3; 95% CI 2.5-201). Shigella sonnei isolates from the nine patients were all ciprofloxacin-resistant and the resistance was associated with S83L and D87G mutations in gyrA and S80I mutation in parC. The nine outbreak isolates were discriminated into two closely related pulsed-field gel electrophoresis (PFGE) genotypes and seven 8-locus multilocus variable-number tandem repeat analysis (MLVA8) types that suggest multiple sources of infections for the outbreak and possible under-recognition of infection among Taiwanese MSM. The outbreak isolates were characterized to be variants of the intercontinentally transmitted SS18.1 clone, which falls into the globally prevalent phylogenetic sub-lineage IIIb. Inter-database pattern similarity searching indicated that the two PFGE genotypes had emerged in the USA and Japan. The epidemiological characteristics of this outbreak suggest roles of risky sexual behaviours or networks in S. sonnei transmission. We urge enhanced surveillance and risk-reduction interventions regionally against the interplay of HIV and shigellosis among MSM.
- Published
- 2015
31. Clostridium difficile PCR Ribotype 027 Emerges in Taiwan
- Author
-
Tsai-Ling, Liao, Chin-Fu, Lin, Chien-Shun, Chiou, Gwan-Han, Shen, and John, Wang
- Subjects
Aged, 80 and over ,Male ,Clostridioides difficile ,Clostridium Infections ,Taiwan ,Humans ,Polymerase Chain Reaction ,Ribotyping - Abstract
Clostridium difficile PCR ribotype 027 is a hypervirulent strain that has caused significant nosocomial diarrhea in many countries but has not yet been reported or isolated in Taiwan previously. Here, we present the characteristics of a case of C. difficile PCR ribotype 027 identified in Taiwan. Taiwan is located in a key transportation center of Asia. This report is important for alerting hospitals and public health departments in Asia about the emergence of this hypervirulent strain so that close monitoring may be enacted to prevent potential outbreaks.
- Published
- 2015
32. Cephalosporin and Ciprofloxacin Resistance in Salmonella, Taiwan
- Author
-
Chien-Shun Chiou, Shu Huei Tsai, Jiunn Jong Wu, Tsai Ling Lauderdale, and Jing Jou Yan
- Subjects
Microbiology (medical) ,Serotype ,Salmonella ,Epidemiology ,medicine.drug_class ,Cephalosporin ,Taiwan ,lcsh:Medicine ,Microbial Sensitivity Tests ,medicine.disease_cause ,beta-Lactamases ,Microbiology ,lcsh:Infectious and parasitic diseases ,multidrug resistance ,ciprofloxacin ,£]-lactamase ,medicine ,Prevalence ,polycyclic compounds ,Humans ,lcsh:RC109-216 ,Serotyping ,Cephalosporin Resistance ,biology ,lcsh:R ,Dispatch ,Salmonella enterica ,CMY-2 ,biochemical phenomena, metabolism, and nutrition ,biology.organism_classification ,bacterial infections and mycoses ,Anti-Bacterial Agents ,Cephalosporins ,Ciprofloxacin ,Multiple drug resistance ,ceftriaxone ,Infectious Diseases ,Salmonella Infections ,Ceftriaxone ,medicine.drug ,Keywords: Salmonella - Abstract
We report the prevalence and characteristics of Salmonella strains resistant to ciprofloxacin and extended-spectrum cephalosporins in Taiwan from January to May 2004. All isolates resistant to extended-spectrum cephalosporins carried blaCMY-2, and all ciprofloxacin-resistant Salmonella enterica serotype Choleraesuis isolates were genetically related.
- Published
- 2005
33. Use of novel PCR primers specific to the genes of staphylococcal enterotoxin G, H, I for the survey of Staphylococcus aureus strains isolated from food-poisoning cases and food samples in Taiwan
- Author
-
Tong-Rong Chen, Hau-Yang Tsen, and Chien-Shun Chiou
- Subjects
DNA, Bacterial ,Staphylococcus aureus ,Salmonella ,Taiwan ,Bacillus cereus ,Enterotoxin ,Biology ,medicine.disease_cause ,Polymerase Chain Reaction ,Microbiology ,law.invention ,Enterotoxins ,Feces ,law ,medicine ,Humans ,Polymerase chain reaction ,DNA Primers ,Superantigens ,Food poisoning ,Vibrio parahaemolyticus ,digestive, oral, and skin physiology ,Outbreak ,General Medicine ,biology.organism_classification ,medicine.disease ,cardiovascular system ,Staphylococcal Food Poisoning ,Food Science - Abstract
Data regarding the incidence of the newly found enterotoxigenic Staphylococcus aureus strains in food poisoning cases and in food samples were to date not available in Taiwan. In this study, PCR primers specific for the detection of SEG, H and I genes, i.e., seg, seh and sei, were used for the assay of 55 human isolates of S. aureus negative to the classical enterotoxins (SEA-->SEE) detection. These isolates were from the fecal specimens of the patients suffering from food poisoning outbreaks. Only eight strains were found to have the seg, seh and sei. The presence of other bacterial pathogens, such as Vibrio parahaemolyticus, Bacillus cereus and Salmonella spp. and perhaps, strains producing other new staphylococcal enterotoxins, in the fecal specimens of these patients, may account for these food poisoning cases. For 139 strains from food samples, such as frozen Chinese foods, Chinese sausages and lunch meals, sea strains accounted for the major portion and it seemed to be the most common SE type to coexist with seg, seh and sei. Only two strains had sec and none of them had seg, seh or sei. For strains without the classical SE genes, only 13 strains had seg, seh and/or sei. The above results imply that seg, seh and sei S. aureus strains play only a minor role in food-borne outbreaks in Taiwan.
- Published
- 2004
34. Azithromycin-NonsusceptibleShigella flexneri3a in Men Who Have Sex with Men, Taiwan, 2015–2016
- Author
-
Chien-Shun Chiou, Yi-Chun Lo, Yen-Yi Liu, and Ying-Shu Liao
- Subjects
Male ,0301 basic medicine ,Epidemiology ,men who have sex with men ,lcsh:Medicine ,Azithromycin ,medicine.disease_cause ,Shigella flexneri ,Disease Outbreaks ,Men who have sex with men ,Azithromycin-Nonsusceptible Shigella flexneri 3a in Men who Have Sex with Men, Taiwan, 2015–2016 ,Shigella ,bacteria ,azithromycin ,biology ,Dysentery ,Anti-Bacterial Agents ,Infectious Diseases ,medicine.drug ,Adult ,Microbiology (medical) ,Shigellosis ,030106 microbiology ,Taiwan ,Sexually Transmitted Diseases ,lcsh:Infectious and parasitic diseases ,Young Adult ,dysentery ,03 medical and health sciences ,Antibiotic resistance ,Drug Resistance, Bacterial ,Research Letter ,medicine ,Humans ,lcsh:RC109-216 ,antimicrobial resistance ,Homosexuality, Male ,sexually transmitted infections ,Dysentery, Bacillary ,business.industry ,enteric infections ,lcsh:R ,Outbreak ,biology.organism_classification ,medicine.disease ,Virology ,shigella ,030104 developmental biology ,business - Abstract
We report an outbreak of azithromycin-nonsusceptible Shigella flexneri 3a infection in Taiwan associated with men who have sex with men. The bacterial strains belonged to the sublineage A of a recently reported outbreak lineage associated with men who have sex with men, characterized by reduced azithromycin susceptibility and circulation in shigellosis low-risk regions.
- Published
- 2016
35. An association of genotypes and antimicrobial resistance patterns among Salmonella isolates from pigs and humans in Taiwan
- Author
-
Ying-Shu Liao, Jung-Che Kuo, Chun-Hsing Liao, Chi-Sen Tsao, Dan-Yuan Lo, Chiou-Lin Chen, Chien-Shun Chiou, Shiu-Yun Liang, Hung-Chih Kuo, Tsai-Ling Lauderdale, and Pei-Chen Chen
- Subjects
Serotype ,Bacterial Diseases ,Salmonella ,Clinical Pathology ,Swine ,Veterinary Microbiology ,Taiwan ,lcsh:Medicine ,Microbial Sensitivity Tests ,Biology ,medicine.disease_cause ,Pathology and Laboratory Medicine ,Microbiology ,Foodborne Diseases ,Antibiotic resistance ,Anti-Infective Agents ,Drug Resistance, Multiple, Bacterial ,Zoonoses ,Genotype ,Pulsed-field gel electrophoresis ,medicine ,Medicine and Health Sciences ,Animals ,Humans ,lcsh:Science ,Microbial Pathogens ,Multidisciplinary ,lcsh:R ,Biology and Life Sciences ,biology.organism_classification ,Antimicrobial ,Electrophoresis, Gel, Pulsed-Field ,Bacterial Pathogens ,Multiple drug resistance ,Clinical Microbiology ,Infectious Diseases ,Veterinary Diseases ,Salmonella enterica ,Medical Microbiology ,Veterinary Science ,lcsh:Q ,Research Article - Abstract
We collected 110 Salmonella enterica isolates from sick pigs and determined their serotypes, genotypes using pulsed-field gel electrophoresis (PFGE), and antimicrobial susceptibility to 12 antimicrobials and compared the data with a collection of 18,280 isolates obtained from humans. The pig isolates fell into 12 common serovars for human salmonellosis in Taiwan; S. Typhimurium, S. Choleraesuis, S. Derby, S. Livingstone, and S. Schwarzengrund were the 5 most common serovars and accounted for a total of 84% of the collection. Of the 110 isolates, 106 (96%) were multidrug resistant (MDR) and 48 (44%) had PFGE patterns found in human isolates. S. Typhimurium, S. Choleraesuis, and S. Schwarzengrund were among the most highly resistant serovars. The majority of the 3 serovars were resistant to 8–11 of the tested antimicrobials. The isolates from pigs and humans sharing a common PFGE pattern displayed identical or very similar resistance patterns and Salmonella strains that caused severe infection in pigs were also capable of causing infections in humans. The results indicate that pigs are one of the major reservoirs to human salmonellosis in Taiwan. Almost all of the pig isolates were MDR, which highlights the necessity of strictly regulating the use of antimicrobials in the agriculture sector in Taiwan.
- Published
- 2014
36. Comparison of Pulsed-Field Gel Electrophoresis and Coagulase Gene Restriction Profile Analysis Techniques in the Molecular Typing of Staphylococcus aureus
- Author
-
Hsiao-Lun Wei, Chien-Shun Chiou, and Li-Chu Yang
- Subjects
Coagulase ,Microbiology (medical) ,Staphylococcus aureus ,Food Handling ,Taiwan ,medicine.disease_cause ,Disease Outbreaks ,Microbiology ,Restriction fragment ,Enterotoxins ,medicine ,Pulsed-field gel electrophoresis ,Humans ,Typing ,Gel electrophoresis ,Molecular Epidemiology ,Molecular epidemiology ,biology ,Bacteriology ,Sequence Analysis, DNA ,Molecular biology ,Bacterial Typing Techniques ,Electrophoresis, Gel, Pulsed-Field ,Latex fixation test ,Phenotype ,Genes, Bacterial ,biology.protein ,Staphylococcal Food Poisoning ,Latex Fixation Tests ,Polymorphism, Restriction Fragment Length - Abstract
Pulsed-field gel electrophoresis (PFGE) and coagulase gene restriction profile (CRP) analysis techniques were used to analyze 71 Staphylococcus aureus isolates recovered from nine food-borne disease outbreaks. Twenty-two PFGE profiles and 11 CRPs were identified, with discrimination indices of 0.86 and 0.72, respectively. In addition, the variable regions of the coagulase genes of 39 isolates were sequenced and showed extensive identity, indicating that this is not an efficient alternative for the molecular typing of S. aureus .
- Published
- 2000
37. A reduction in anti-tuberculosis drug resistance after the implementation of the national 'STOP TB' program in central Taiwan, 2003-2007
- Author
-
Chen-Fu Lin, Jiann-Hwa Chen, Kun-Ming Wu, Gwan-Han Shen, Chao-Hsien Chen, Wei-Chang Huang, Chien-Shun Chiou, and Chen-Cheng Huang
- Subjects
Microbiology (medical) ,Male ,medicine.medical_specialty ,Tuberculosis ,Capreomycin ,Antitubercular Agents ,Taiwan ,Drug resistance ,Mycobacterium tuberculosis ,Levofloxacin ,Moxifloxacin ,Internal medicine ,Drug Resistance, Multiple, Bacterial ,Tuberculosis, Multidrug-Resistant ,Medicine ,Humans ,Ethambutol ,biology ,business.industry ,Health Policy ,Incidence ,General Medicine ,Pyrazinamide ,medicine.disease ,biology.organism_classification ,Virology ,Infectious Diseases ,Treatment Outcome ,Communicable Disease Control ,Female ,business ,medicine.drug - Abstract
The aim of this study was to determine the performance of the national "STOP TB" program in central Taiwan during 2003-2007 by examining trends in the combined drug resistance to first-line anti-tuberculosis (TB) drugs among clinical Mycobacterium tuberculosis isolates. Using 4,819 clinical M. tuberculosis isolates obtained from two mycobacteriology referral laboratories, the resistance to drugs was measured and analyzed along with the treatment outcomes in notified TB patients. The proportion of isolates showing total resistance and multidrug-resistant tuberculosis (MDR-TB) isolates were 17.7% and 3.67%, respectively. More number of MDR-TB isolates showed high-level resistance to isoniazid (84.18%) and streptomycin (SM) (30.51%); low-level resistance to ethambutol (EMB) (61.58%), SM (41.81%), and pyrazinamide (66.1%); and resistance to ofloxacin (30.4%). However, fewer isolates showed high-level resistance to EMB (19.77%), levofloxacin (17.9%), moxifloxacin (19.6%), kanamycin (8.9%), amikacin (8.9%), and capreomycin (8.9%). Of these MDR-TB isolates, 7.1% were extensively drug-resistant. Trends in combined drug resistance to all the first-line anti-TB drugs and the incidence of MDR-TB were stable during the 2 years (2003-2004) before the implementation of the national "STOP TB" program. After the "STOP TB" program, there were significant declines in the incidence of MDR-TB during 2005-2007 in central Taiwan as well as improved TB-treatment outcomes. Thus, the national "STOP TB" program had a significant positive impact on TB control in central Taiwan.
- Published
- 2013
38. Infrequent cross-transmission of Shigella flexneri 2a strains among villages of a mountainous township in Taiwan with endemic shigellosis
- Author
-
Ching-Fen Ko, Yeong-Sheng Lee, Chiou-Ying Yang, Chien-Shun Chiou, Li-Yu Wang, Ming-Ching Liu, and Nien-Tsung Lin
- Subjects
Rural Population ,Veterinary medicine ,Shigellosis ,Endemic Diseases ,Antibiotic resistance ,Taiwan ,Microbial Sensitivity Tests ,medicine.disease_cause ,Shigella flexneri ,Drug Resistance, Bacterial ,Pulsed-field gel electrophoresis ,Medicine ,Humans ,Shigella ,Pulsed-field gel electrophoresis (PFGE) ,Genotyping ,Dysentery, Bacillary ,Antiinfective agent ,Molecular Epidemiology ,Molecular epidemiology ,biology ,business.industry ,Incidence ,Outbreak ,medicine.disease ,biology.organism_classification ,Virology ,Anti-Bacterial Agents ,Electrophoresis, Gel, Pulsed-Field ,Infectious Diseases ,Disease transmission/control ,business ,Research Article - Abstract
Background Shigellosis is rare in Taiwan, with an average annual incidence rate of 1.68 cases per 100,000 persons in 2000–2007. However, the incidence rate for a mountainous township in eastern Taiwan, Zhuoxi, is 60.2 times the average rate for the entire country. Traveling between Zhuoxi’s 6 villages (V1–V6) is inconvenient. Disease transmission among the villages/tribes with endemic shigellosis was investigated in this study. Methods Demographic data were collected in 2000–2010 for epidemiological investigation. Thirty-eight Shigella flexneri 2a isolates were subjected to pulsed-field gel electrophoresis (PFGE) genotyping and antimicrobial susceptibility testing (AST). Results Fifty-five shigellosis cases were identified in 2000–2007, of which 38 were caused by S. flexneri 2a from 2000–2007, 16 cases were caused by S. sonnei from 2000–2003, and 1 case was caused by S. flexneri 3b in 2006. S. flexneri 2a caused infections in 4 of the 6 villages of Zhuoxi Township, showing the highest prevalence in villages V2 and V5. PFGE genotyping categorized the 38 S. flexneri 2a isolates into 2 distinct clusters (clones), 1 and 2. AST results indicated that most isolates in cluster 1 were resistant to ampicillin, chloramphenicol, streptomycin, sulfamethoxazole and trimethoprim-sulfamethoxazole (ACSSuX); all isolates in cluster 2 were resistant to ACSSuX and tetracycline. Genotypes were primarily unique to different villages or tribes. Tribe V2-1 showed the highest endemic rates. Eighteen isolates recovered from V2-1 tribe members fell into 6 genotypes, where 5 were the same clone (cluster 1). An outbreak (OB2) in 2004 in village V2 was caused by different clonal strains; cases in tribe V2-1 were caused by 2 strains of clone 1, and those in tribe V2-2 were infected by a strain of clone 2. Conclusions From 2000–2007, 2 S. flexneri 2a clones circulated among 4 villages/tribes in the eastern mountainous township of Zhuoxi. Genotyping data showed restricted disease transmission between the villages and tribes, which may be associated with difficulties in traveling between villages and limited contact between different ethnic aborigines. Transmission of shigellosis in this township likely occurred via person-to-person contact. The endemic disease was controlled by successful public health intervention.
- Published
- 2013
39. Molecular characterization of clinical and environmental Vibrio parahaemolyticus isolates in Taiwan
- Author
-
Shing-en Tsai, Hin-Chung Wong, Wei-Ting Yu, Koa-Jen Jong, Yeong-Sheng Lee, Chien-Shun Chiou, and Yao Hsien Tey
- Subjects
Gene Transfer, Horizontal ,Virulence Factors ,Taiwan ,Virulence ,Biology ,medicine.disease_cause ,Microbiology ,Polymerase Chain Reaction ,law.invention ,law ,Phylogenetics ,Pulsed-field gel electrophoresis ,medicine ,Environmental Microbiology ,Animals ,Humans ,Gene ,Polymerase chain reaction ,Phylogeny ,Toxin ,Vibrio parahaemolyticus ,General Medicine ,biology.organism_classification ,Electrophoresis, Gel, Pulsed-Field ,Vibrio Infections ,Horizontal gene transfer ,Food Science - Abstract
Vibrio parahaemolyticus is the most prevalent foodborne pathogen in Taiwan and it is frequently recovered from seafood. In this study, V. parahaemolyticus that was isolated in recent years from aquacultural environments and clinical specimens were comparatively analyzed by NotI-restricted pulsed-field gel electrophoresis (PFGE) and polymerase chain reaction, targeting common toxin genes (tdh, trh, ureC), MTase gene, toxR regulator, markers for pandemic strains (ORF8, group-specific toxRS) and representative genes of type three secretion systems T3SS1 (vcrD1, VP1680, vopD) and T3SS2α (vcrD2, vopD2, vopB2, vopP, vopC, vopT). Among the 48 clinical isolates and 93 environmental isolates that were analyzed by PFGE, a total of 26 and 76 pulsetypes were identified and grouped into six and nine clusters, respectively, at 80% similarity. The pandemic O3:K6 clones and other clinical and environmental isolates were further characterized according to the distribution of these examined target genes. The MTase gene and the vopB2, vopP, vopC and vopT genes of T3SS2α were present at a significantly higher frequency (>90%) in the pandemic clones than in other clinical isolates. The MTase gene and some other virulence-associated genes were also present in a few of the environmental isolates, and these results suggest the horizontal transfer of these genes in the clinical and environmental isolates of this species.
- Published
- 2012
40. Human isolates of Salmonella enterica serovar Typhimurium from Taiwan displayed significantly higher levels of antimicrobial resistance than those from Denmark
- Author
-
Tsai-Ling Lauderdale, Ishien Li, Shiu-Yun Liang, Mia Torpdahl, Chien-Shun Chiou, and Sung-Hsi Wei
- Subjects
Serotype ,Salmonella typhimurium ,Salmonella ,Cefotaxime ,Genotype ,Denmark ,Taiwan ,Microbial Sensitivity Tests ,medicine.disease_cause ,Microbiology ,Antibiotic resistance ,Ampicillin ,Drug Resistance, Multiple, Bacterial ,medicine ,Humans ,Phylogeny ,biology ,General Medicine ,biology.organism_classification ,Antimicrobial ,Anti-Bacterial Agents ,Multiple drug resistance ,Salmonella enterica ,Multigene Family ,Salmonella Infections ,Food Science ,medicine.drug - Abstract
Salmonella enterica serovar Typhimurium is a major zoonotic pathogen with a high prevalence of antimicrobial resistance. This pathogen can disseminate across borders and spread far distances via the food trade and international travel. In this study, we compared the genotypes and antimicrobial resistance of 378 S. Typhimurium isolates collected in Taiwan and Denmark between 2009 and 2010. Genotyping revealed that many S. Typhimurium strains were concurrently circulating in Taiwan, Denmark and other countries in 2009 and 2010. When compared to the isolates collected from Denmark, the isolates from Taiwan displayed a significantly higher level of resistance to 11 of the 12 tested antimicrobials. Seven genetic clusters (A–G) were designated for the isolates. A high percentage of the isolates in genetic clusters C, F and G were multidrug-resistant. Of the isolates in cluster C, 79.2% were ASSuT-resistant, characterized by resistance to ampicillin, streptomycin, sulfamethoxazole, and tetracycline. In cluster F, 84.1% of the isolates were ACSSuT-resistant (resistant to ASSuT and chloramphenicol). Cluster G was unique to Taiwan and characterized in most isolates by the absence of three VNTRs (ST20, ST30 and STTR6) as well as a variety of multidrug resistance profiles. This cluster exhibited very high to extremely high levels of resistance to several first-line drugs, and among the seven clusters, it displayed the highest levels of resistance to cefotaxime and ceftazidime, ciprofloxacin and gentamicin. The high prevalence of antimicrobial resistance in S. Typhimurium from Taiwan highlights the necessity to strictly regulate the use of antimicrobials in the agriculture and human health care sectors.
- Published
- 2012
41. Transmission and strain variation of Shigella flexneri 4a after mass prophylaxis in a long-stay psychiatric centre
- Author
-
L. Y. Wang, H. C. Yeh, N. T. Lin, C. F. Ko, Chien-Shun Chiou, J. H. Renn, and Y. S. Lee
- Subjects
DNA, Bacterial ,medicine.medical_specialty ,Genotype ,Epidemiology ,Taiwan ,Microbial Sensitivity Tests ,Biology ,medicine.disease_cause ,Asymptomatic ,Microbiology ,Disease Outbreaks ,Shigella flexneri ,Antibiotic resistance ,Drug Resistance, Bacterial ,Trimethoprim, Sulfamethoxazole Drug Combination ,medicine ,Humans ,Shigella ,Psychiatry ,Dysentery, Bacillary ,Molecular Epidemiology ,Strain (chemistry) ,Transmission (medicine) ,Outbreak ,Antibiotic Prophylaxis ,Original Papers ,Long-Term Care ,Anti-Bacterial Agents ,Electrophoresis, Gel, Pulsed-Field ,Infectious Diseases ,Concomitant ,medicine.symptom - Abstract
SUMMARYShigella flexneri 4a caused sustained outbreaks in a large long-stay psychiatric centre, Taiwan, 2001–2006. Trimethoprim-sulphamethoxazole (SXT) prophylaxis was administered in 2004. We recovered 108 S. flexneri 4a isolates from 83 symptomatic (including one caregiver) and 12 asymptomatic subjects (11 contacts, one caregiver). The isolates were classified into eight antibiogram types and 15 genotypes (six clusters) by using antimicrobial susceptibility testing and pulsed-field gel electrophoresis of NotI-digested DNA, respectively. These characteristics altered significantly after SXT prophylaxis (P n = 71), the predominant epidemic genotype, caused infection in two caregivers and five patients under their care; two P01 isolates were recovered from the same patient 6 months apart. These results indicate the importance of sustained person-to-person transmission of S. flexneri 4a by long-term convalescent, asymptomatic or caregiver carriers, and support the emergence of SXT-resistant strains following selective pressure by SXT prophylaxis.
- Published
- 2012
42. Reduction of Salmonella enterica serovar Choleraesuis carrying large virulence plasmids after the foot and mouth disease outbreak in swine in southern Taiwan, and their independent evolution in human and pig
- Author
-
Chi-Hong Chu, Chien-Shun Chiou, Chia-Ming Yeh, Shu-Wun Chen, Jann-Inn Tzeng, Jiunn-Horng Lin, Chishih Chu, and Chern-Hsun Chiu
- Subjects
Microbiology (medical) ,Serotype ,Salmonella ,Evolution ,Swine ,Taiwan ,Virulence ,Bacteremia ,Microbial Sensitivity Tests ,medicine.disease_cause ,Microbiology ,Disease Outbreaks ,Evolution, Molecular ,Plasmid ,Virulence plasmid ,Immunology and Microbiology(all) ,Drug Resistance, Bacterial ,medicine ,Prevalence ,Immunology and Allergy ,Animals ,Humans ,Southern blot ,Salmonella Infections, Animal ,General Immunology and Microbiology ,biology ,Foot-and-mouth disease ,Outbreak ,Salmonella enterica ,General Medicine ,biology.organism_classification ,medicine.disease ,Virology ,Anti-Bacterial Agents ,Infectious Diseases ,Foot-and-Mouth Disease ,Salmonella Infections ,Salmonella Choleraesuis ,Antimicrobial ,Plasmids - Abstract
Background/Purpose Salmonella enterica serovar Choleraesuis ( S . Choleraesuis) is a highly invasive zoonotic pathogen that causes bacteremia in humans and pigs. The prevalence of S . Choleraesuis in man has gradually decreased since the outbreak of foot and mouth disease in pigs in 1997 in southern Taiwan. The goal of this study was to investigate the change in prevalence of S . Choleraesuis carrying the virulence plasmid (pSCV) in human and swine isolates collected in 1995–2005 and characterize these. Methods 380 isolates were collected from human and swine blood samples. Large pSCVs were determined by PCR and Southern blot analysis. Antimicrobial susceptibility and resistance genes, and the phylogenetic association of these large pSCV were analyzed. Results The number of isolates harboring the large pSCV was significantly reduced, and their prevalence differed between human and swine isolates. These large pSCVs were a recombinant of original 50-kb pSCV and R plasmid. In addition, some large pSCVs lacked two pSCV-specific deletion regions from pef to repC and from traT to samA . These large pSCVs carried the resistance genes bla TEM, aadA2 , and sulI , as well as class I integrons of 0.65 and/or 1.9 kb in size, but were inconjugatible. Phylogenetic analysis demonstrated that the large pSCV evolves independently in human and swine isolates. Conclusion S . Choleraesuis with large pSCV was significantly reduced after the foot and mouth disease outbreak and may evolve in human and swine specific isolates.
- Published
- 2011
43. Consumption of groundwater as an independent risk factor of Salmonella choleraesuis infection: a case-control study in Taiwan
- Author
-
Tsung-Hsien, Li, Cheng-Hsun, Chiu, Wan-Ching, Chen, Chih-Ming, Chen, Yuan-Man, Hsu, Shyan-Song, Chiou, Chien-Shun, Chiou, and Chao-Chin, Chang
- Subjects
Male ,Meat ,Endemic Diseases ,Swine ,Drinking ,Taiwan ,Fresh Water ,Middle Aged ,Risk Factors ,Case-Control Studies ,Salmonella Infections ,Animals ,Humans ,Salmonella arizonae ,Female ,Water Pollutants ,Water Microbiology ,Health Education ,Aged - Abstract
Infection with Salmonella enterica serovar Choleraesuis (S. Choleraesuis) in humans can be considered as an endemic disease in certain regions of Taiwan, and the number of cases has increased in recent years. The goal of the case-control study discussed in this article was to identify the possible demographic and environmental risk factors associated with S. Choleraesuis infection in Taiwan. During the period of December 2005 to March 2007, the case-control study was conducted in human patients with Salmonella infection from two medical centers. Structured questionnaires were applied to collect information of relevant risk factors after interviewing 13 culture-confirmed S. Choleraesuis cases and 84 controls with other Salmonella serotype infection. After evaluation by univariate and multivariate statistical models, the results suggested that consumption of groundwater could be an independent risk factor associated with S. Choleraesuis in Taiwan. Therefore, appropriate health education needs to be conducted especially in areas where groundwater is used.
- Published
- 2010
44. Emergence of Qnr determinants in human Salmonella isolates in Taiwan
- Author
-
Jiunn Jong Wu, Chien-Shun Chiou, Li Ron Wang, Wen Chien Ko, Hung Mo Chen, and Jing Jou Yan
- Subjects
Microbiology (medical) ,Serotype ,DNA, Bacterial ,Salmonella typhimurium ,Salmonella ,Molecular Sequence Data ,Taiwan ,Quinolones ,Integron ,medicine.disease_cause ,Polymerase Chain Reaction ,Microbiology ,law.invention ,Plasmid ,Bacterial Proteins ,law ,Sequence Homology, Nucleic Acid ,Drug Resistance, Bacterial ,medicine ,Humans ,Pharmacology (medical) ,Polymerase chain reaction ,Antibacterial agent ,Pharmacology ,biology ,Nucleic acid sequence ,Sequence Analysis, DNA ,biology.organism_classification ,Enterobacteriaceae ,Anti-Bacterial Agents ,Infectious Diseases ,Salmonella enteritidis ,Salmonella Infections ,biology.protein ,Plasmids - Abstract
Objectives: The aim of this study was to determine the prevalence and characteristics of qnr-carrying Salmonella isolates from humans in southern Taiwan. Methods: A total of 446 Salmonella isolates collected between 2003 and 2006 were screened for qnrA, qnrB and qnrS by PCR experiments. Genetic structures of qnr were determined by PCR-based methods or direct sequencing of plasmid DNA. Results: qnrB2 and qnrS1 were detected in two serovar Enteritidis isolates and two serovar Typhimurium isolates, respectively. One qnrS1-positive isolate was found to produce the CMY-2 AmpC enzyme. qnrS1 was identified on a 10 kb plasmid, which exhibited >99% nucleotide sequence identity with plasmid TPqnrS-1a reported from the UK. qnrB2 was found in a complex sul1-type class 1 integron on a >100 kb plasmid. Conclusions: This study demonstrated the occurrence of qnrB2 and qnrS1 in Salmonella for the first time in Taiwan and characterized their genetic structures.
- Published
- 2008
45. Molecular epidemiology and antimicrobial susceptibility of Salmonella enterica serotype Stanley isolates in Taiwan
- Author
-
Kuan Ying, Huang, Yi Wen, Hong, Mei Hwei, Wang, Chishih, Chu, Lin Hui, Su, Chien Shun, Chiou, and Cheng Hsun, Chiu
- Subjects
Adult ,DNA, Bacterial ,Male ,Molecular Epidemiology ,Genotype ,Enterocolitis ,Age Factors ,Taiwan ,Infant ,Salmonella enterica ,Microbial Sensitivity Tests ,Middle Aged ,DNA Fingerprinting ,beta-Lactamases ,Anti-Bacterial Agents ,Bacterial Typing Techniques ,Electrophoresis, Gel, Pulsed-Field ,Risk Factors ,Child, Preschool ,Drug Resistance, Bacterial ,Salmonella Infections ,Humans ,Female ,Plasmids - Abstract
Salmonella enterica serotype Stanley became the third most common non-typhoidal Salmonella serotype among human isolates in 2004. The present study was conducted to gain further understanding of the epidemiology and antimicrobial suseptibility of S. Stanley.A total of 20 culture-confirmed cases were retrieved from the Center for Disease Control collection and analyzed. Clinical features and demographic data of the cases were analyzed. Laboratory investigation of the isolates included antimicrobial susceptibility testing and molecular typing by pulsed-field gel electrophoresis. Ceftriaxone-non-susceptible isolates were further examined by polymerase chain reaction, sequencing, and Southern blot hybridization.The cases studied were distributed widely across Taiwan, suggesting that the infection was an island-wide problem. S. Stanley predominantly caused infections in patients under the age of 5 years (75%). The most common type of illness was uncomplicated enterocolitis. Molecular typing showed 1 predominant genotype with 5 subtypes among these isolates. Antimicrobial resistance to ampicillin (75%), chloramphenicol (95%), and trimethoprim-sulfamethoxazole (95%) was common. Two isolates expressed non-susceptibility to ceftriaxone, and a bla(CMY-2) gene was identified on an 80-kb plasmid in both isolates.The increase in S. Stanley infections may be associated with the spread of an epidemic clone, although this requires further epidemiological surveillance. In view of the high rate of antimicrobial resistance, especially the emergence of resistance to third-generation cephalosporins, continued surveillance of the infections caused by this bacterium should be undertaken.
- Published
- 2007
46. Change of serotype pattern of Group D non-typhoidal Salmonella isolated from pediatric patients in southern Taiwan
- Author
-
Kuo Sheng, Tsai, Yao Jong, Yang, Shih Min, Wang, Chien Shun, Chiou, and Ching Chuan, Liu
- Subjects
Male ,Genotype ,Taiwan ,Infant ,Anti-Bacterial Agents ,Gastroenteritis ,Risk Factors ,Salmonella ,Child, Preschool ,Drug Resistance, Bacterial ,Salmonella Infections ,Humans ,Female ,Serotyping ,Child ,Retrospective Studies - Abstract
Group D non-typhoidal Salmonella infection is increasing in Taiwan. This study aimed to investigate the changing serotypes and antibiotic resistance of childhood group D Salmonella infection.From 1998 through 2004, children (16 years) infected with group D Salmonella were retrospectively reviewed. Demographic data, clinical and laboratory features, and risk factors of bacteremia were analyzed. Enrolled patients were classified as acute gastroenteritis with bacteremia (Group I) and acute gastroenteritis without bacteremia (Group II). The minimal inhibitory concentrations were determined by agar dilution method. Genotyping was performed by use of pulsed-field gel electrophoresis (PFGE).Eighty one children (Group I, n = 15; Group II, n = 66) were enrolled with a mean (+/- standard deviation) age of 3.1 +/- 2.6 years. Group I patients were younger and had a longer duration of fever prior to admission (or =5 days, 40% vs 9.2%; p=0.003) and total fever duration (8.3 vs 4.1 days, p0.001) than Group II. Salmonella enterica serotype Enteritidis (80%) was the most common serotype, followed by Salmonella Panama (7%). The antibiotic resistance rates of S. Enteritidis were: tetracycline (36.5%), trimethoprim-sulfamethoxazole (25.4%), ampicillin (14.3%), and chloramphenicol (12.7%). S. Panama was associated with a higher rate of bacteremia. All strains were susceptible to quinolone and third-generation cephalosporins. PFGE study showed a single genotype of S. Enteritidis and diverse genotypes of S. Panama circulating in the area.S. Enteritidis was the predominant serotype of group D Salmonella that caused pediatric infection in southern Taiwan during the study period from 1998 to 2004. S. Panama is associated with higher rates of bacteremia and antimicrobial resistance.
- Published
- 2007
47. Foodborne disease outbreaks caused by sucrose-nonfermenting and beta-galactosidase-deficient variants of Vibrio cholerae
- Author
-
Chia-Min Lin, Chien-Shun Chiou, Yu-Lan Wang, Yen-Chi Wu, Lih-Ling Chern, and Shiao-Wun Wei
- Subjects
Sucrose ,Sequence analysis ,Taiwan ,Food Contamination ,Biology ,medicine.disease_cause ,Microbiology ,Polymerase Chain Reaction ,Disease Outbreaks ,Cholera ,Vibrionaceae ,medicine ,Humans ,Gene ,Vibrio cholerae ,Molecular Epidemiology ,Virulence ,Cholera toxin ,Outbreak ,Hemolysin ,General Medicine ,biology.organism_classification ,beta-Galactosidase ,Fermentation ,Food Microbiology ,Bacteria ,Food Science - Abstract
We reported four foodborne disease outbreaks in Taiwan caused by sucrose-nonfermenting and by β-galactosidase-deficient variants of non-O1, non-O139 Vibrio cholerae. The sucrose-nonfermenting vibrios collected from three outbreaks were biochemically identified to be V. mimicus and the β-galactosidase-deficient vibrios from an outbreak to be V. alginolyticus. However, molecular methods including DNA–DNA hybridization, fatty acid profile analysis, and sequence analysis of 16S rRNA, oriC, pyrH, recA, and rpoA indicated that these vibrios should be V. cholerae. These V. cholerae variants carried two hemolysin genes, hlyA and hlx, but contained neither cholera toxin gene, ctx, V. mimicus hemolysin gene, vmh, nor thermo-directed hemolysin, tdh. The sucrose-nonfermenting variants of V. cholerae shared a high level of genetic relatedness; they could derive from a common clone. In our record from 1995 to date, this was the first time that V. cholerae variants were discovered as etiologic agents for foodborne disease outbreaks in Taiwan.
- Published
- 2007
48. PCR detection of Staphylococcal enterotoxins (SEs) N, O, P, Q, R, U, and survey of SE types in Staphylococcus aureus isolates from food-poisoning cases in Taiwan
- Author
-
Chin-Ming Fan, Hau-Yang Tsen, Yu-Cheng Chiang, Wan-Wen Liao, Pai Wan-Yu, and Chien-Shun Chiou
- Subjects
DNA, Bacterial ,Staphylococcus aureus ,Micrococcaceae ,Genotype ,Molecular Sequence Data ,Taiwan ,chemical and pharmacologic phenomena ,Food Contamination ,Enterotoxin ,Biology ,medicine.disease_cause ,Microbiology ,Polymerase Chain Reaction ,Sensitivity and Specificity ,law.invention ,Enterotoxins ,law ,medicine ,Superantigen ,Humans ,Polymerase chain reaction ,DNA Primers ,Toxin ,Reverse Transcriptase Polymerase Chain Reaction ,Toxic shock syndrome toxin ,General Medicine ,biology.organism_classification ,body regions ,Staphylococcal Food Poisoning ,Food Science - Abstract
Staphylococcal enterotoxins (SEs) are superantigenic toxins. They are five major classical types, i.e., SEA, SEB, SEC, SED, SEE, and new SEs or SE-like superantigens, such as SEG to SEU. Only the staphylococcal superantigens (SAgs) that induce emesis following oral administration in a monkey model are designated as SEs while other related toxins are called SE-like (SEl) superantigens. To survey the enterotoxin genotypes for S. aureus strains isolated from food-poisoning cases in Taiwan, we developed PCR primers specific for SEN, SEO, SEP, SEQ, SER, and SEU genes. The complete SE sequences and their expression potential for strains positive to sen, seo, sep, seq, ser, and seu specific primers were also determined. These strains were used as reference strains. With the PCR primers specific for all SEs or SAgs, including toxic shock syndrome toxin I (TSST-1), we assayed the genotypes of 147 S. aureus strains isolated from patients associated with staphylococcal food-poisoning outbreaks occurred during 2001–2003. For these147 strains, 135 (91.8%) were found positive for one or more SE or SAg genes. For classical enterotoxin and TSST-1 types, the major one was tsst-1 (59.1%) following by sea (29.2%), seb (19.7%), sec (6.8%), and sed (2.0%). For new SE and SAg types, the major one was sei (29.9%) and sep (27.9%) followed by, sek (16.3%), seo (14.3%), seu (14.2%), sem (11.6%), sen (10.9%), seq (10.9%), seh (8.2%), sel (6.8%), and ser (5.4%) etc. This report reveals the whole SE and SAg genotypes for S. aureus strains isolated from staphylococcal food-poisoning cases in Taiwan.
- Published
- 2007
49. Epidemiology and evolution of genotype and antimicrobial resistance of an imported Shigella sonnei clone circulating in central Taiwan
- Author
-
Hsiao-Lun Wei, Chun-Chin Li, You-Wen Wang, Sheng Kai Tung, and Chien-Shun Chiou
- Subjects
Microbiology (medical) ,DNA, Bacterial ,Shigellosis ,Clone (cell biology) ,Taiwan ,Shigella sonnei ,Microbial Sensitivity Tests ,Microbiology ,Evolution, Molecular ,Shigella flexneri ,Antibiotic resistance ,Genotype ,medicine ,Pulsed-field gel electrophoresis ,Cluster Analysis ,Humans ,Typing ,Dysentery, Bacillary ,Molecular Epidemiology ,biology ,General Medicine ,biochemical phenomena, metabolism, and nutrition ,bacterial infections and mycoses ,biology.organism_classification ,medicine.disease ,Virology ,Anti-Bacterial Agents ,Bacterial Typing Techniques ,Electrophoresis, Gel, Pulsed-Field ,Infectious Diseases ,DNA Transposable Elements ,DNA, Intergenic ,Polymorphism, Restriction Fragment Length - Abstract
Shigella sonnei replaced Shigella flexneri to become the predominant species for shigellosis in 2001 to 2003 in central Taiwan. A total of 425 S. sonnei isolates collected from 1996 to 2004 were available for characterization by pulsed-field gel electrophoresis (PFGE), inter-IS1 spacer typing (IST), and antimicrobial susceptibility testing. The results showed that at least 21 IST clones had emerged for the S. sonnei infections in 1996 to 2004. Most IST clones lasted for a short time; some circulated for 2 to 3 years. An IST1 clone, detected for the first time in 2000, was the most prevalent and responsible for the shigellosis epidemic in 2001 to 2003. Over 3 years of sustained transmission, the IST1 clone evolved into many strains with different PFGE genotypes and antibiograms. The ancestor, with a J16N09.0019 PFGE genotype, remained to be the predominant circulating strain in the period studied; however, new strains with certain PFGE genotypes and antibiograms could become major circulating strains for subsequent infections.
- Published
- 2006
50. Epidemiologic relationship between fluoroquinolone-resistant Salmonella enterica Serovar Choleraesuis strains isolated from humans and pigs in Taiwan (1997 to 2002)
- Author
-
Yi Hsuan Lin, Chien-Shun Chiou, Maw-Sheng Chien, Yuan-Man Hsu, Chao Chin Chang, Cheng-Hsun Chiu, Kuang Sheng Yeh, Chishih Chu, Chao-Fu Chang, and Li Shu Tsai
- Subjects
Microbiology (medical) ,Serotype ,Salmonella ,Swine ,Taiwan ,Microbial Sensitivity Tests ,medicine.disease_cause ,Microbiology ,Antibiotic resistance ,Drug Resistance, Bacterial ,Pulsed-field gel electrophoresis ,medicine ,Enrofloxacin ,Animals ,Humans ,Norfloxacin ,Swine Diseases ,Salmonella Infections, Animal ,biology ,Salmonella enterica ,Bacteriology ,biology.organism_classification ,Virology ,Anti-Bacterial Agents ,Electrophoresis, Gel, Pulsed-Field ,Ciprofloxacin ,Salmonella Infections ,medicine.drug ,Fluoroquinolones - Abstract
The emergence of ciprofloxacin-resistantSalmonella entericaserovar Choleraesuis in recent years has become an important public health issue in Taiwan. The resistant strains that cause human infections are considered to be from pigs. In this study, we characterized 157 swine and 42 humanSalmonellaserovar Choleraesuis isolates by pulsed-field gel electrophoresis (PFGE) and drug susceptibility testing to investigate the epidemiologic relationship among the isolates. By PFGE analyses, two major clusters (clusters GA and GB) were identified. Isolates in cluster GA were of both human and swine origins, while those in cluster GB were from pigs only. Among the various genotypes identified, genotype gt-1a was the most prevalent, which was found in 71% (30 of 42) and 48% (76 of 157) of human and swine isolates, respectively. The susceptibility tests for the 106 gt-1a isolates identified 44 susceptibility profiles and showed that 73% of human isolates and 34% of swine isolates were resistant to three fluoroquinolones (ciprofloxacin, enrofloxacin, and norfloxacin). Our findings indicate that a clonal group ofSalmonellaserovar Choleraesuis may have been circulating in human and swine populations in Taiwan for years and that the fluoroquinolone-resistantSalmonellaserovar Choleraesuis strains most likely evolved from a gt-1a clone that emerged in 2000 and that then caused widespread infections in humans and pigs. Nevertheless, it is still debatable whether thoseSalmonellainfections in humans are caused by isolates derived from pigs, on the basis of the higher fluoroquinolone and other antimicrobial resistance percentages in human isolates than in pig isolates.
- Published
- 2005
Catalog
Discovery Service for Jio Institute Digital Library
For full access to our library's resources, please sign in.