Origins and consequences of antimicrobial-resistant nontyphoidal Salmonella: Implications for the use of fluoroquinolones in food animals

Human Salmonella infections are common; most infections are self-limiting, however severe disease may occur. Antimicrobial agents, while not essential for the treatment of Salmonella gastroenteritis, are essential for the tre atment of thousands of patients each year with invasive infections, Fluoroq uinolones and third-generation cephalosporins are the drugs-of-choice for i nvasive Salmonella infections in humans; alternative antimicrobial choices are limited by increasing antimicrobial resistance, limited efficacy, and l ess desirable pharmacodynamic properties. Antimicrobial-resistant Salmonell a results from the use of antimicrobial agents in food animals, and these a ntimicrobial resistant Salmonella are subsequently transmitted to humans, u sually through the food supply. The antimicrobial resistance patterns of is olates collected from persons with Salmonella infections show more resistan ce to antimicrobial agents used in agriculture than to antimicrobial agents used for the treatment of Salmonella infections in humans. Because of the adverse health consequences in humans and animals associated with the incre asing prevalence of antimicrobial-resistant Salmonella, there is an urgent need to emphasize non-antimicrobial infection control strategies, such as i mproved sanitation and hygiene, to develop guidelines for the prudent usage of antimicrobial agents, and establishment of adequate public health safeg uards to minimize the development and dissemination of antimicrobial resist ance and dissemination of Salmonella resistant to these agents.