Emergence of Multidrug-resistant Salmonella Spp. and Isolates with Reduced Susceptibility to Ciprofloxacin in Kuwait and the United Arab Emirates

Kuwait and United Arab Emirates (UAE) are 2 countries with worldwide significance in the context of global epidemiology of antimicrobial resistance. The extent of drug resistance in Salmonella spp. isolated from these countries was investigated by determining their susceptibility to 9 antibiotics using the E-test method. Amikacin, cefotaxime, ceftriaxone, ciprofloxacin, and gentamicin had excellent activities against all Kuwait and UAE isolates with MIC(90)s ranging between 0.056 and 4.5 microg/mL. The resistance rates in Kuwait and UAE to ampicillin were 26.5% and 17.1%, cefotaxime/ceftriaxone 1.6% and 1.6%, ciprofloxacin 1.2% and 0.8%, chloramphenicol 5.6% and 5.7%, and trimethoprim-sulfamethoxazole 26.1% and 8.9%, respectively. A total of 9.8% of the Kuwait isolates were multidrug resistant versus 4.1% of UAE isolates. Reduced susceptibility to ciprofloxacin was observed in 14.2% and 7.4% of the nontyphoidal Salmonella, respectively, as were in 44% of Salmonella enterica serovar typhi and 66.7% Salmonella paratyphi. Salmonella spp. with reduced quinolones susceptibility have emerged in the Gulf region, and this is of concern as it may compromise the treatment of infections caused by invasive strains.