肠沙门氏菌是一种新兴的食源性和人畜共患沙门氏菌，对全球健康具有重要意义。近年来,在美国，婴儿链球菌感染的患病率有所增加，欧洲,拉丁美洲,由于鸡肉和其他食物被污染。婴儿链球菌的一个基本特征是对多种抗生素的抗性，包括至关重要的第三代头孢菌素和喹诺酮类药物，破坏有效的医疗，特别是在低资源环境中。我们描述了多药耐药(MDR)婴儿链球菌的出现，专注于人类，动物,环境,和食物。我们进行了系统回顾(1979-2021)，选定的183项研究，并分析了起源，来源,抗菌素耐药性，以及在报告的分离物中出现的婴儿链球菌（pESI）的接合质粒的存在。美国婴儿已经在世界范围内被发现，自2011年以来大幅增长。我们发现美洲的隔离数量最高(42.9%)，欧洲（29.8%），西太平洋（17.2%），东地中海（6.6%），非洲（3.4%），和东南亚（0.1%）。美国婴儿在所有来源都显示出MDR模式和许多抗性基因。MDRS.Infantis的主要来源是肉鸡及其肉；然而，这种新出现的病原体也存在于其他水库中，如食物，野生动物,和环境。已经在儿童和成人中报道了MDRS.Infantis的临床病例。婴儿链球菌的全球出现与具有抗生素，砷和汞抗性基因的质粒（pESI）有关。此外,一种新的大质粒(pESI样)，携带blaCTX-M-65和抗生素抗性基因的祖先版本报道，在肉鸡中检测到，人类,和鸡肉分离。携带pESI样的菌株主要在美洲和欧洲观察到。MDRS.Infantis已经在全球传播，可能成为主要的公共卫生威胁，特别是在低收入和中等收入国家。
Salmonella enterica serovar Infantis is an emergent foodborne and zoonotic Salmonella serovar with critical implications for global health. In recent years, the prevalence of S. Infantis infections has increased in the United States, Europe, and Latin America, due to contaminated chicken and other foods. An essential trait of S. Infantis is its resistance to multiple antibiotics, including the critically important third-generation cephalosporins and quinolones, undermining effective medical treatment, particularly in low-resource settings. We describe the emergence of multidrug-resistant (MDR) S. Infantis, focusing on humans, animals, the environment, and food. We conducted a systematic
review (1979-2021), selected 183 studies, and analyzed the origin, source, antimicrobial resistance, and presence of a conjugative plasmid of emerging S. Infantis (pESI) in reported isolates. S. Infantis has been detected worldwide, with a substantial increase since 2011. We found the highest number of isolations in the Americas (42.9 %), Europe (29.8 %), Western Pacific (17.2 %), Eastern Mediterranean (6.6 %), Africa (3.4 %), and South-East Asia (0.1 %). S. Infantis showed MDR patterns and numerous resistant genes in all sources. The primary source of MDR S. Infantis is broiler and their meat; however, this emerging pathogen is also present in other reservoirs such as food, wildlife, and the environment. Clinical cases of MDR S. Infantis have been reported in children and adults. The global emergence of S. Infantis is related to a plasmid (pESI) with antibiotic and arsenic- and mercury-resistance genes. Additionally, a new megaplasmid (pESI-like), carrying blaCTX-M-65 and antibiotic-resistant genes reported in an ancestral version, was detected in the broiler, human, and chicken meat isolates. Strains harboring pESI-like were primarily observed in the Americas and Europe. MDR S. Infantis has spread globally, potentially becoming a major public health threat, particularly in low- and middle-income countries.
