Antimicrobial resistance and molecular epidemiology of Salmonella Rissen from animals, food products, and patients in Thailand and Denmark.

Recently we reported increases in both the number of Salmonella infections due to Salmonella Rissen in Thailand and the isolation of this serovar from pork products in Thailand. The objectives of the present study were to determine the genetic diversity and antimicrobial resistance of Salmonella Rissen isolates recovered from humans, food products, and animals in Denmark and Thailand. Additionally, risk factors due to travel and consumption of specific food products were analyzed and evaluated. A total of 112 Salmonella Rissen isolates were included in this study from Thailand and Denmark. Thai isolates were recovered from humans, uncooked food, and ready-to-eat food. Danish isolates were obtained from humans (with and without a history of travel to Thailand prior to the infection), Danish pig or pork products, imported pig or pork products, turkeys, and animal feed. A total of 63 unique XbaI PFGE patterns were observed. The predominant pattern was shared by 22 strains. Limited antimicrobial resistance was observed in the Danish strains, and a higher degree of resistance was observed in strains originating from Thailand. Virtually all isolates were resistant to tetracycline. The tet A gene was detected in tetracycline-resistant isolates. Statistical analysis and molecular subtyping identified the combination of travel to Thailand and consumption of imported pig or pork products as well consumption of as pig or pork products produced in Denmark as risk factors for Salmonella Rissen infection among the Danish patients. The outcome of this study might be used as a supplement for future Salmonella Rissen investigations and outbreak detection.

Shigella from humans in Thailand during 1993 to 2006: spatial-time trends in species and serotype distribution.

In Thailand during 1993-2006, a total of 9063 Shigella isolates from different medical centers were serotyped and trends over time and spatial clustering analyzed. Of 3583 cases with age information, 1315 (37%) cases were from children between 0 and 4 years and 684 (19%) from children between 5 and 8 years. Most infections were recorded during 1993-1994 (> 1500 per year), decreasing to < 200 in 2006. The relative species distribution also changed. During 1993-1994, Shigella flexneri accounted for 2241 (65%) of 3474 isolations. This proportion decreased to 64 (36%) of 176 infections in 2006. Most infections occurred during July and August, and fewest in December. S. flexneri clustered around Bangkok, and Shigella sonnei in southern Thailand. Most S. flexneri infections were caused by serotype 2a (1590 of 4035) followed by serotype var X (1249). For both serotypes, a pronounced decrease in the number of isolates occurred over time. A much smaller decrease was observed for serotype 3a isolates. Phase I S. sonnei was initially most common, but shifted gradually over phase I, II, to only phase II. No differences in spatial distribution were found. The three most common S. flexneri serotypes all clustered in, around, and west of Bangkok. Serotypes 2a and 3a also clustered in southern Thailand, whereas var X clustered north and northeast of Bangkok. In conclusion, looking at Shigella species, Thailand changed from being a developing country to a developed country between 1995 and 1996. In addition, major shifts in the types of S. sonnei were observed as were differences in spatial clustering of S. flexneri and S. sonnei and S. flexneri serotypes.

International spread of multidrug-resistant Salmonella Schwarzengrund in food products.

We compared 581 Salmonella enterica serotype Schwarzengrund isolates from persons, food, and food animals in Denmark, Thailand, and the United States by antimicrobial drug susceptibility and pulsed-field gel electrophoresis (PFGE) typing. Resistance, including resistance to nalidixic acid, was frequent among isolates from persons and chickens in Thailand, persons in the United States, and food imported from Thailand to Denmark and the United States. A total of 183 PFGE patterns were observed, and 136 (23.4%) isolates had the 3 most common patterns. Seven of 14 isolates from persons in Denmark had patterns found in persons and chicken meat in Thailand; 22 of 390 human isolates from the United States had patterns found in Denmark and Thailand. This study suggests spread of multidrug-resistant S. Schwarzengrund from chickens to persons in Thailand, and from imported Thai food products to persons in Denmark and the United States.

Salmonella serovars from humans and other sources in Thailand, 1993-2002.

We serotyped 44,087 Salmonella isolates from humans and 26,148 from other sources from 1993 through 2002. The most common serovar causing human salmonellosis in Thailand was Salmonella enterica Weltevreden. Serovars causing human infections in Thailand differ from those in other countries and seem to be related to Salmonella serovars in different food products and reservoirs.