Salmonella-associated deaths, Sweden, 1997-2003

We examined excess deaths after infection with Salmonella in a registry-based matched cohort study of 25,060 persons infected abroad and 5,139 infected within Sweden. The domestically infected have an increased standardized mortality ratio, whereas those who acquired Salmonella infection abroad had no excess risk of death.     

Gastroenteritis caused by Salmonella from pet snakes

A Salmonella subspecies associated with reptiles (Salmonella enterica subspecies diarizonae) was isolated from the stool of a 19-year-old man with gastroenteritis. The same species was isolated from stool and urine samples taken from terraria found in the home of the patient's parents where snakes were kept. A high percentage of reptiles in the wild and in captivity are asymptomatic carriers of Salmonella species that can be transmitted to humans who come in contact with these animals. Unlike in the United States of America, for example, cases of reptile-associated infections have scarcely been published in the Netherlands and targeted information on the risk of infection is lacking. Because the popularity of exotic pets--and thereby the risk of infection--is increasing in The Netherlands, targeted information for veterinarians, traders and owners of exotic pets is warranted to prevent reptile-associated salmonellosis.     

Legionella pneumophila Subspecies fraseri Infection after Allogeneic Hematopoietic Stem Cell Transplant,China

We describe an immunosuppressed patient with bacteremia and pneumonia caused by Legionella pneumophila subspecies fraseri in China. We confirmed this diagnosis by using nanopore sequencing of positive blood cultures and subsequent recovery from buffered-charcoal yeast extract culture. Nanopore sequencing is an effective tool for early diagnosis of atypical infections.     

上海市黄浦区沙门氏菌感染特征及主要血清型分析

目的 了解上海市黄浦区沙门氏菌感染病例的流行病学特征,菌型分布和发病的潜在危险因素.方法 对3家区监测点医院开展腹泻病人监测,对符合沙门氏菌监测对象定义的病例留便进行血清型检测,并每月采集食品样本开展沙门氏菌血清分型检测.结果 2008 -2011年黄浦区腹泻病例中沙门菌检出率平均为3.30％(287/8695),略高于上海市平均水平(3.13％).检出病例以男性为主,主要检出时间为5～ 10月,血清分型以肠炎(32.06％)和鼠伤寒(14.98％)为优势菌种.食品监测提示动物肉类在夏季每月均有沙门菌检出,其中7月最高(22.50％),8月次之(18.75％),血清分型以伦敦、猪霍乱和德比沙门菌为主.单因素分析结果显示,饮用生水、一周内可疑饮食史、前一周聚餐史为主要危险因素;多因素Logistic回归结果显示,一周内可疑饮食史为主要危险因素(P＜0.001),65.02％的患者发病前一周有不洁饮食史.结论 黄浦区腹泻病人中的沙门菌平均检出率高于上海市平均水平,因此应加强预防控制,做好食品监测并加强食品卫生管理和安全管理的宣传教育.     

沙门菌感染的若干进展

沙门菌感染是全球重大的公共卫生问题,是很多国家的法定传染病.沙门菌感染主要是通过摄入污染的食物或饮水引起.临床上非伤寒沙门菌感染引起的肠胃炎以轻型稀水样腹泻为主,轻症感染者病程呈自限性,重症患者及特殊人群如儿童(2岁以下)、老年人及免疫力低下患者应及早用抗生素治疗.肠热病是伤寒和副伤寒沙门菌感染引起的特殊综合征,通常需要住院观察,并需积极的抗牛素治疗.肠热病的临床表现多种多样,医务人员应重视其特征,加强临测,特别是对来自流行地区的发热患者.此文就沙门菌感染的流行病学、临床表现、诊断和治疗等方面研究现状进行综述.     

Reduced Fluoroquinolone Susceptibility in Salmonella enterica Isolates from Travelers, Finland

We tested the fluoroquinolone susceptibility of 499 Salmonella enterica isolates collected from travelers returning to Finland during 2003–2007. Among isolates from travelers to Thailand and Malaysia, reduced fluoroquinolone susceptibility decreased from 65% to 22% (p = 0.002). All isolates showing nonclassical quinolone resistance were from travelers to these 2 countries.     

肠道沙门菌双相亚利桑那亚种的一个新血清型17：z52：e,n,x,z15

目的:从眼镜蛇(眼镜蛇,舟山眼镜蛇)的肠内容物中分离出一株沙门菌S9948的血清学分型。方法:对该菌株进行了生化试验、噬菌体裂解试验和抗原分析。结果:结果表明该菌株的抗原式为17:z52:e,n,x,z15。结论:该菌株为肠道沙门菌双相亚利桑那亚种的一个新血清型。     

Severe Case of Rickettsiosis Identified by Metagenomic Sequencing,China

A case of Rickettsia sibirica subspecies sibirica BJ-90 infection in China was identified by metagenomic analysis of an eschar biopsy specimen and confirmed by nested PCR. Seroprevalence of spotted fever group Rickettsia was ≈17.4% among the local population. This report highlights the threat of rickettsioses to public health in the Qinghai–Tibet Plateau.     

A rapid and sensitive method to identify and differentiate Salmonella enterica serotype Typhimurium and Salmonella enterica serotype 4,[5],12:i:- by combining traditional serotyping and multiplex polymerase chain reaction

Salmonella enterica subspecies enterica serotype 4,[5],12:i:- is an emerging serovar considered as a monophasic variant of Salmonella enterica serotype Typhimurium. The antigenic and genetic similarity between Salmonella 4,[5],12:i:- and Salmonella Typhimurium suggests that they may behave in a similar way and represent a comparable threat to public health. As serotyping alone does not necessarily provide for identification of Salmonella 4,[5],12:i:- and its differentiation from Salmonella Typhimurium, a method that combines traditional serotyping and a multiplex polymerase chain reaction has been tested on 208 strains serotyped as Salmonella 4,[5],12:i:-, Salmonella Typhimurium, and similar serovars of serogroup B sharing the same phase-1 antigen "i." For 191 strains, the combined method fully confirmed the results provided by traditional serotyping, whereas for 17 strains of Salmonella 4,[5],12:i:- and Salmonella Typhimurium some inconsistencies emerged between the two methods. The combined method resulted in a more accurate and faster identification of these two relevant serovars.     

Salmonella enterica Serovar Agbeni, British Columbia, Canada, 2011

TO THE EDITOR: Infection with Salmonella enterica serovar Agbeni is rare. In Canada, it was reported 8 times during 2000-2010 and never in the province of British Columbia (2011 population?4.5 million) (Public Health Agency of Canada, unpub. data). In June 2011, an outbreak of S. enterica ser. Agbeni affecting 8 persons was identified in British Columbia; pulsed-field gel electrophoresis patterns for all isolates were identical. Although no specific source was identified, 2 features were noted: 1) diagnosis through urine specimens for 3 of 8 persons and 2) a longer than typical incubation period for Salmonella spp. infection.     

2013年江苏省食源性非伤寒沙门菌疾病负担研究

目的估计江苏省食源性非伤寒沙门菌发病情况及疾病负担。方法根据全省监测点哨点医院主动监测和社区人群急性胃肠炎入户调查,采用疾病负担研究金字塔法,计算食源性非伤寒沙门菌疾病负担。结果 2013年采集感染性腹泻标本6 775例,检出非伤寒沙门菌113株,检出率为1.67%;入户调查10 802人,急性胃肠炎月发病率为4.43%,年发病率为0.59次/人年,病例就诊率为45.09%,标本采集率为45.37%;推算出江苏省2013年食源性非伤寒沙门菌疾病负担是454 614例病例。结论非伤寒沙门菌是重要的食源性致病菌,可造成较重的疾病负担。     

2010年北京市感染性腹泻病原学监测分析

目的 了解2010年北京市感染性腹泻致病菌的病原构成、流行特征及主要致病菌的血清型分布。方法 收集2010年4—12月期间北京监测哨点的肠道门诊腹泻病例的粪便或肛拭子标本2118份,采用分离培养、生化鉴定和血清分型的方法对其进行霍乱弧菌、副溶血性弧菌、沙门菌、志贺菌和肠致泻性大肠杆菌等多种肠道致病菌的检测,并对其时间分布、感染者年龄分布及血清型别构成进行分析。结果在2118份标本中,共分离到478株菌,检出率为22.6％。其中志贺菌位居阳性检出菌的首位,占40.8％( 195/478),副溶血性弧菌、沙门菌和肠致泻性大肠杆菌分别占23.8％(114/478)、19.0％(91/478)和4.8％(23/478)。肠道致病菌的人群分布主要集中在20 ～ 39岁的成年组,其中30 ～39岁检出率最高,检出率为27.2％(92/338)。不同病原菌的人群年龄分布不同。病原菌的检出具有明显季节性,7-10月检出率较高,检出率分别为23.5％( 114/486)、32.8％(176/536)、36.1％ (90/249)、25.9％(29/112),其余月份检出率＜16.O％。检出的志贺菌以宋内志贺菌为优势血清型,占83.1％(162/195);副溶血性弧菌以O3∶K6为优势血清型,占63.2％ (72/114)。沙门菌以肠炎和鼠伤寒沙门菌为优势血清型,分别占13.2％( 12/91)、12.1％(11/91)。肠致泻性大肠杆菌以肠致病性大肠杆菌、肠产毒性大肠杆菌2种菌群为主,分别占69.6％( 16/23)、30.4％(7/23)。结论北京市感染性腹泻主要致病菌依次为志贺菌、副溶血性弧菌和沙门菌等。其中志贺菌和沙门菌血清型构成发生了变迁。     

The use of bulk tank milk samples to monitor trends in antimicrobial resistance on dairy farms

The routine monitoring of bacteria obtained from bulk tank milk (BTM) may be an important tool for detecting farm-level trends in antimicrobial resistance on dairy farms. This study describes and compares antimicrobial susceptibility patterns of Salmonella enterica subspecies enterica (Salmonella) and Escherichia coli recovered from dairy BTM. BTM from more than 400 dairies in a dairy-intense region of California were sampled eight times at 2- to 3-month intervals over a 29-month period. From Salmonella positive and Salmonella negative herds any one Salmonella and three E. coli isolates per sample were tested for susceptibility to 12 antimicrobials. The prevalence of multiple drug resistant (MDR) E. coli was assessed in relation to Salmonella on the farm, farm size, season, MDR Salmonella, and serovar. At each sampling period, 10-21% and 54-77% of the dairy farms were positive for Salmonella and E. coli, respectively. The most commonly recovered Salmonella serovars were Montevideo (33%), Typhimurium (14%), Dublin (13%), and Give (11%). Two-thirds, respectively, of 478 Salmonella and 1577 E. coli isolates were pan-susceptible. The antimicrobial resistance patterns of MDR Salmonella tended to be serovar dependent and were different from the antimicrobial resistance patterns of MDR E. coli. MDR E. coli were more likely to be recovered from dairies with MDR Salmonella. There were no associations between MDR E. coli and season, Salmonella serovar detected in the BTM, or dairy herd size. Bulk milk E. coli and Salmonella could be valuable to monitor the dynamics of antimicrobial resistance in dairy milk production.     

Extended-Spectrum Cephalosporin-Resistant Salmonella enterica serovar Heidelberg Strains,the Netherlands

Extended-spectrum cephalosporin-resistant Salmonella enterica serovar Heidelberg strains (JF6X01.0022/XbaI.0251, JF6X01.0326/XbaI.1966, JF6X01.0258/XbaI.1968, and JF6X01.0045/XbaI.1970) have been identified in the United States with pulsed-field gel electrophoresis. Our examination of isolates showed introduction of these strains in the Netherlands and highlight the need for active surveillance and intervention strategies by public health organizations.     

Quadrennial report of the National Salmonella Center on the origin and distribution by serotypes of strains isolated in continental France during the years 1980 to 1983

This work summarizes the informations regarding 67,767 Salmonella strains isolated in continental France from 1981 to 1983. The frequencies of O groups, of subspecies, of the 62 serotypes most frequently isolated among the 376 identified are reported. The graphs representing the annual occurrence of some serotypes show that some serotypes are considerably expanding, some disappeared after being quite frequent, and some show marked fluctuations by successive waves.     

2006-2011年福建省沙门菌监测菌株血清型分布及耐药性分析

目的分析福建省沙门菌监测病人菌株血清型分布和耐药性情况。方法依据我省制定的沙门菌监测方案,在全省5个地市设立沙门菌监测点开展工作。结果2006～2011年共分离出449株沙门菌,均为肠道沙门菌内的亚种I和亚种HIb,分属于10个群（11个亚群）,39个血清型,其中A～F群占98．89％,鼠伤寒和肠炎沙门菌是我省检出率最高的2种血清型。同时我省新增了1个P群及10个血清型（变种）。鼠伤寒沙门菌仍是我省严重耐药的血清型,沙门菌多数菌株对萘啶酸、链霉素、磺胺、甲氧苄啶、复方新诺明、四环素、氨苄西林有不同程度的耐药,对三代头孢、环丙沙星、阿莫西林＋棒酸多数菌株敏感。结论鼠伤寒和肠炎沙门菌为我省2个主要的血清型,多数菌株对萘啶酸、链霉素、磺胺类、四环素、氨苄西林有不同程度的耐药。     

Inguinal Ulceroglandular Tularemia Caused by Francisella tularensis Subspecies holarctica,Canada

Tularemia is a zoonotic disease caused by the gram-negative coccobacillus Francisella tularensis, a Biosafety Level 3 pathogen and potential agent of bioterrorism. We describe 2 cases of perigenital ulcer disease caused by Francisella tularensis subspecies holarctica in Manitoba, Canada. These cases caused inadvertent exposure among laboratory personnel.     

Salmonella control programs in Denmark

We describe Salmonella control programs of broiler chickens, layer hens, and pigs in Denmark. Major reductions in the incidence of foodborne human salmonellosis have occurred by integrated control of farms and food processing plants. Disease control has been achieved by monitoring the herds and flocks, eliminating infected animals, and diversifying animals (animals and products are processed differently depending on Salmonella status) and animal food products according to the determined risk. In 2001, the Danish society saved U.S.$25.5 million by controlling Salmonella. The total annual Salmonella control costs in year 2001 were U.S.$14.1 million (U.S.$0.075/kg of pork and U.S.$0.02/kg of broiler or egg). These costs are paid almost exclusively by the industry. The control principles described are applicable to most industrialized countries with modern intensive farming systems.     

临床分离沙门菌的耐药性及超广谱β-内酰胺酶类耐药基因

目的研究北京地区2012—2015年沙门菌临床分离株的血清型分布、耐药状况及超广谱β-内酰胺酶(ESBLs)耐药基因特征。方法采用最小抑菌浓度法测定北京市肠道门诊分离的677株沙门菌株对16种抗菌药物的耐药情况,采用聚合酶链反应(PCR)方法对244株β-内酰胺酶类耐药菌株进行耐药基因检测。结果677株沙门菌分为68种血清型,其中肠炎沙门菌、鼠伤寒沙门菌和山夫登堡沙门菌位居前3位。沙门菌对氨苄西林和阿莫西林/克拉维酸的耐药率分别为42.54%、40.77%,至少耐3种以上抗菌药物的菌株占57.16%。244株对氨苄西林和阿莫西林/克拉维酸耐药的沙门菌,携带至少一种ESBLs基因的菌株174株(71.31%),146株bla_(TEM-1)型,30株bla_(OXA-1)型,18株bla_(CTX-M)型(其中7株bla_(CTX-M-15),6株bla_(CTX-M-55)和5株bla_(CTX-M-14));20株同时携带2种耐药基因。结论该地区沙门菌携带ESBLs耐药基因水平较高,以bla_(TEM-1)为主,同时伴有bla_(OXA-1)和3种bla_(CTX-M)基因亚型,呈现基因多样性。     

A Markov model to estimate Salmonella morbidity, mortality, illness duration, and cost

Approximately 690000-1790000 Salmonella cases, 20000 hospitalizations, and 400 deaths occur in the USA annually, costing approximately $2.6bn. Existing models estimate morbidity, mortality, and cost solely from incidence. They do not estimate illness duration or use time as an independent cost predictor. Existing models may underestimate physician visits, hospitalizations, deaths, and associated costs. We developed a Markov chain Monte Carlo model to estimate illness duration, physician/emergency room visits, inpatient hospitalizations, mortality, and resultant costs for a given Salmonella incidence. Interested parties include society, third-party payers, health providers, federal, state and local governments, businesses, and individual patients and their families. The marginal approach estimates individual disease behavior for every patient, explicitly estimates disease duration and calculates separate time-dependent costs. The aggregate approach is a Markov equivalent of the existing models; it assumes average disease behavior and cost for a given morbidity/mortality. Transition probabilities were drawn from a meta-analysis of 53 Salmonella studies. Both approaches were tested using the 1993 Salmonella typhimurium outbreak in Gideon, Missouri. This protocol can be applied to estimate morbidity, mortality and cost of specific outbreaks, provide better national Salmonella burden estimates, and estimate the benefits of reducing Salmonella risk.