Epidemiology, Serogroups and Resistance of Salmonella During a 15-Year Period (2006-2020) in Kuwait

Purpose: The aim of the study was to investigate the changing pattern in serogroup distribution and antimicrobial resistance of all Salmonella spp. isolated from patients attending the Mubarak Al Kabeer Hospital (MAK), Kuwait from 2006 to 2020. Patients and Methods: A retrospective study of all enrolled patients attending the MAK with culture-positive Salmonella spp. was undertaken. Data on age, gender, culture sample and serogroup were obtained from the laboratory information system. A prospective antimicrobial susceptibility of all stock isolates was carried out using E test. The trend rates of Salmonella serogroups and antimicrobial resistance were compared among 5 periods: 2006- 2008, 2009-2011, 2012-2014, 2015-2017, and 2018-2020. Results: A total of 700 isolates were identified. The majority of the isolates were from the stool (77.6%), followed by the blood (16.4%). The most common serogroups were serogroup D (37.6%) and B (23.4%). There was a significant rise in ciprofloxacin resistance from 32.2% during 2006-2008 to 54.3% during 2018-2020 and from 32.5% during 2009-2011 to 54.3% during 2018-2020 (P=0.0001, respectively). The resistance trend to cefotaxime was at relatively low levels ranging from 0% to 3.4% through 2006-2008 to 2018-2020. There was a significant drop of the resistance to ampicillin from 23.6% in 2015-2017 to 12.3% in 2006-2008 to 2018-2020 (P=0.03). Trimethoprim/sulfamethoxazole resistance dropped significantly from 14.5 to 3.6% (P=0.002) during 2006-2008 to 2018-2020 and then from 13.5 to 3.6% (P=0.02) during 2015-2017 to 2018-2020. One hundred and seventeen (16.7%) isolates were multidrug-resistant. Conclusion: Continuous surveillance of Salmonella and its antimicrobial resistance is important for antibiotic policy formulation for invasive Salmonella infections.