{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,23]],"date-time":"2026-07-23T02:47:17Z","timestamp":1784774837038,"version":"3.55.0"},"reference-count":15,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T00:00:00Z","timestamp":1568419200000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"},{"start":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T00:00:00Z","timestamp":1568419200000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"funder":[{"DOI":"10.13039\/501100001343","name":"University of Pretoria","doi-asserted-by":"crossref","award":["Grant number: A0702"],"award-info":[{"award-number":["Grant number: A0702"]}],"id":[{"id":"10.13039\/501100001343","id-type":"DOI","asserted-by":"crossref"}]},{"name":"National Health Laboratory Services","award":["Grant number: 94445"],"award-info":[{"award-number":["Grant number: 94445"]}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["BMC Infect Dis"],"published-print":{"date-parts":[[2019,12]]},"abstract":"<jats:title>Abstract<\/jats:title>\n              <jats:sec>\n                <jats:title>Background<\/jats:title>\n                <jats:p>Non-typhoidal salmonellae (NTS) have been associated with invasive disease, notably meningitis, in immunocompromised individuals. Infections of this nature carry high rates of morbidity and mortality. Colistin resistance in salmonellae is a rare finding, more so in an invasive isolate such as cerebrospinal fluid (CSF). Colistin resistance has important infection control implications and failure to manage this phenomenon may lead to the loss of our last line of defence against multi-drug resistant Gram-negative organisms. To our knowledge, this is the first reported clinical case of colistin-resistant <jats:italic>Salmonella<\/jats:italic> Enteritidis meningitis in South Africa.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Case presentation<\/jats:title>\n                <jats:p>We report a case of a young male patient with advanced human immunodeficiency virus (HIV) infection who presented to hospital with symptoms of meningitis. Cerebrospinal fluid (CSF) cultured a <jats:italic>Salmonella<\/jats:italic> Enteritidis strain. Antimicrobial susceptibility testing (AST) of the isolate, revealed the strain to be colistin resistant. Despite early and aggressive antimicrobial therapy, the patient succumbed to the illness after a short stay in hospital. Subsequent genomic analysis of the isolate showed no presence of the <jats:italic>mcr<\/jats:italic> genes or resistance-conferring mutations in <jats:italic>phoPQ, pmrAB, pmrHFIJKLME\/arnBCADTEF, mgrB,<\/jats:italic> and <jats:italic>acrAB<\/jats:italic> genes, suggesting the presence of a novel colistin resistance mechanism.<\/jats:p>\n              <\/jats:sec>\n              <jats:sec>\n                <jats:title>Conclusion<\/jats:title>\n                <jats:p>Invasive non-typhoidal salmonellae infection should be suspected in patients with advanced immunosuppression who present with clinical features of meningitis. Despite early and appropriate empiric therapy, these infections are commonly associated with adverse outcomes to the patient. Combination therapy with two active anti-<jats:italic>Salmonella<\/jats:italic> agents may be a consideration in the future to overcome the high mortality associated with NTS meningitis. Colistin resistance in clinical <jats:italic>Salmonella<\/jats:italic> isolates, although a rare finding at present, has significant public health and infection control implications. The causative mechanism of resistance should be sought in all cases.<\/jats:p>\n              <\/jats:sec>","DOI":"10.1186\/s12879-019-4391-7","type":"journal-article","created":{"date-parts":[[2019,9,14]],"date-time":"2019-09-14T05:02:37Z","timestamp":1568437357000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":23,"title":["A rare case of Colistin-resistant Salmonella Enteritidis meningitis in an HIV-seropositive patient"],"prefix":"10.1186","volume":"19","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-5549-2987","authenticated-orcid":false,"given":"Roxanne","family":"Rule","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nontombi","family":"Mbelle","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9508-984X","authenticated-orcid":false,"given":"John Osei","family":"Sekyere","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marleen","family":"Kock","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anwar","family":"Hoosen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mohamed","family":"Said","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"297","published-online":{"date-parts":[[2019,9,14]]},"reference":[{"issue":"4","key":"4391_CR1","doi-asserted-by":"publisher","first-page":"901","DOI":"10.1128\/CMR.00002-15","volume":"28","author":"JA Crump","year":"2015","unstructured":"Crump JA, Sj\u00f6lund-Karlsson M, Gordon MA, Parrye CM. Epidemiology, clinical presentation, laboratory diagnosis, antimicrobial resistance, and antimicrobial Management of Invasive Salmonella Infections. Clin Microbiol Rev. 2015 Oct;28(4):901\u201337.","journal-title":"Clin Microbiol Rev"},{"issue":"9835","key":"4391_CR2","doi-asserted-by":"publisher","first-page":"2489","DOI":"10.1016\/S0140-6736(11)61752-2","volume":"379","author":"NA Feasey","year":"2012","unstructured":"Feasey NA, Dougan G, Kingsley RA, Heyderman RS, Gordon MA. Invasive non-typhoidal salmonella disease: an emerging and neglected tropical disease in Africa. Lancet. 2012;379(9835):2489\u201399.","journal-title":"Lancet."},{"issue":"Suppl 4","key":"4391_CR3","doi-asserted-by":"publisher","first-page":"S272","DOI":"10.1093\/cid\/civ685","volume":"61","author":"KH Keddy","year":"2015","unstructured":"Keddy KH, et al. Clinical and microbiological features of Salmonella meningitis in a south African population, 2003 \u2013 2013. 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