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

Figures & data

Table 1 Clinical Samples from Which Salmonella Was Isolated

Salmonella Groups/Species	No. of Isolates in						Total No. of Isolates
	Stool	Blood	Urine	CSF	Other Samples ^b	Unknown Samples
Salmonella grp. B	140	11	3	0	9	1	164
Salmonella grp. C	140	6	1	0	6	1	154
Salmonella grp. D	203	45	10	1	4	0	263
Salmonella grp. E	27	1	2	0	0	0	30
Salmonella grp. G	11	3	0	0	0	0	14
Salmonella Typhi	4	40	2	0	0	0	46
Salmonella Paratyphi (A, B, C)	6	6	0	0	0	0	12
Miscellaneous ^a	12	3	0	0	2	0	17
Total Salmonella spp.	543	115	18	1	21	2	700

Notes: ^aMiscellaneous: Salmonella group F (6); Salmonella group A (3); Salmonella group I (2); Salmonella group O (2); Salmonella group J (2); Salmonella group H (1); and Salmonella enterica subsp. diarizonae (1). ^b Other samples: pus (7), tissue (4), pleural fluid (2), ascetic fluid (2), bedsore (1), synovial fluid (1), bile (1), eye swab (1), wound (1), and fine needle aspirate (1).

Abbreviation: CSF, cerebrospinal fluid.

Table 2 Age and Gender Distribution of Patients from Whom Salmonella Was Isolated

Salmonella Group/Species	Total No. of Isolates	Gender		Age ^b
		Male	Female	Mean (Years)	Range
Total Salmonella spp.^a	700	393	306	28.3	23 Days- 90Y
Salmonella grp. D ^a	263	151	111	28.6	23 Days - 90Y
Salmonella grp. B	164	91	73	30.2	3 months- 86Y
Salmonella grp. C	154	86	68	30.3	1 month - 78 Y
Salmonella Typhi	46	23	23	18.6	2 Y - 75 Y
Salmonella grp. E	30	14	16	29.6	6 months- 46Y
Miscellaneous	17	9	8	23	1 Y - 80 Y
Salmonella grp. G	14	11	3	16	1 Y - 51 Y
Salmonella Paratyphi	12	7	5	19.7	11 months - 44 Y

Notes: ^aGender was unknown for one sample. ^b Ages were not available for: Total Salmonella spp. (232), S. group B (70); S. group C (55); S. group D (49); S. Typhi (23); S. group E (19); miscellaneous group (5); S. group G (9); S. Paratyphi (2).

Abbreviations: M, month; Y, years.

Figure 1 Resistance of all Salmonella groups during different years. Significant difference between periods for prevalence of resistance for antibiotics is as follows: 2015–2017 vs 2018–2020 for ampicillin (P=0.03); 2006–2008 vs 2018–2020 (P=0.002) and 2015–2017 vs 2018–2020 (P=0.02) for trimethoprim; 2006–2008 vs 2015–2018 (P=0.05) for gentamicin; 2006–2008 vs 2018–2020 (P=0.0001) and 2009–2011 vs 2018–2020 (P=0.0001) for ciprofloxacin; 2006–2008 vs 2018–2020 (P=0.0001), 2009–2011 vs 2018–2020 (P=0.0001), 2015–2017 vs 2018–2020 (P=0.0001), and 2012–2014 vs 2018–2020 (P=0.0008) for tigecycline.

Figure 2 Resistance of Salmonella groups B and D for the five periods against ampicillin. Significant difference between periods for prevalence of resistance for ampicillin is as follows: 2006–2008 vs 2009–2011 (P=0.03) in Salmonella group B; and 2009–2011 vs 2015–2017 (P=0.02) and 2015–2017 vs 2018–2020 (P=0.02) in Salmonella group D.

Figure 3 Resistance of Salmonella group D for the five periods against ciprofloxacin. Significant difference between periods for prevalence of resistance for ciprofloxacin is as follows: 2006–2008 vs 2018–2020 (P=0.0004); 2009–2011 vs 2012–2014 (P=0.03); 2009–2011 vs 2015–2017 (P=0.01); 2009–2011 vs 2018–2020 (P=0.0001); 2012–2014 vs 2015–2017 (P=0.02); and 2015–2017 vs 2018–2020 (P=0.0002).

Figure 4 Resistance of Salmonella groups B, C and D for the five periods against tigecycline. Significant difference between periods for prevalence of resistance for tigecycline is as follows: 2006–2008 vs 2009–2011 (P=0.03) and 2006–2008 vs 2018–2020 (P=0.0005) in Salmonella group B; 2006–2009 vs 2018–2020 (P=0.002) and 2009–2011 vs 2018–2020 (P=0.01) in Salmonella group C; and 2006–2008 vs 2018–2020 (P=0.04), 2012–2014 and 2018–2020 (P=0.02) and 2015–2017 vs 2018–2020 (P=0.005) in Salmonella group D.

Table 3 Resistance Phenotypes of All 700 Salmonella Isolates

Resistance Phenotypes	No. of Isolates
TGC	173
Cip	82
Cip, TGC	79
Amp, Cip, TGC	16
Amp, Gn, Cip, TGC	15
Chl, Amp, Cip	11
Chl, Amp, TS, Cip	10
Amp, TGC	9
TS, TGC	8
TS, Cip, TGC	8
Amp	7
Chl, Cip, TGC	6
Amp, TS, Cip, TGC	6
Amp, Cip	5
Amp, TS, TGC	5
Chl, Amp, TS, TGC	5
TS, Cip	4
Chl, Amp, Cip, TGC	4
Amp, TS, Gn, Cip, TGC	4
Amp, TS	3
Chl, Amp, TS, Gn, TGC	3
Chl, TS, Gn, Cip, TGC	3
Chl, Amp, TS, Gn, Cip, TGC	3
Chl, TS, TGC	2
Amp, Gn, Cip	2
Gn, Cip, TGC	2
Chl, Amp, CT, Cip	2
Amp, TS, Gn, TGC	2
Amp, CT, Cip, TGC	2
Chl, Amp, Gn, Cip, TGC	2
Chl	1
Chl, TGC	1
Amp, CTX	1
Amp, Gn, TGC	1
TS, Gn, Cip, TGC	1
Chl, TS, Gn, Cip	1
Chl, Amp, TS, Cip, TGC	1
Amp, Gn, CT, Cip, TGC	1
Chl, Amp, TS, Gn, CT, TGC	1

Abbreviations: Chl, chloramphenicol; Amp, ampicillin; Cip, ciprofloxacin; TGC, tigecycline; TS, trimethoprim/sulfamethoxazole; CTX, cefotaxime; Gn, gentamicin.