Culturing stool specimens for Campylobacter spp., Pennsylvania, USA.

In 2010, we surveyed 176 clinical laboratories in Pennsylvania regarding stool specimen testing practices for enteropathogens, including Campylobacter spp. Most (96.3%) routinely test for Campylobacter spp. In 17 (15.7%), a stool antigen test is the sole method for diagnosis. We recommend that laboratory practice guidelines for Campylobacter spp. testing be developed.

Laboratory worker knowledge, attitudes and practices towards smallpox vaccine.

BACKGROUND: Recent cases of laboratory-acquired vaccinia virus (VV) infection highlight the need for laboratory safety. AIMS: To determine laboratory worker adherence to the Advisory Committee for Immunization Practices smallpox vaccination recommendations, assess potential barriers to vaccination and determine the influence of training on laboratory worker attitudes. METHODS: Ninety-two laboratory workers in Pennsylvania were contacted and asked to complete an online survey about VV usage; 45 responded. RESULTS: Eighty-seven per cent had received a smallpox vaccination in their lifetime; 73% received vaccination in the past 10 years. More workers had been given training regarding the potential risks, versus the potential benefits of vaccination, and most perceived that adverse outcomes were more likely to occur following vaccination versus accidental infection. CONCLUSIONS: The results of this study suggest that the main barrier to vaccination may be fear associated with possible vaccine adverse effects and a willingness to risk accidental infection rather than be vaccinated. More information and training about the potential benefits of vaccination, as well as the potential adverse outcomes associated with accidental infection, is therefore warranted.

Multidrug-resistant Salmonella isolates from retail chicken meat compared with human clinical isolates.

AIM: To examine the prevalence of antimicrobial-resistant Salmonella in chicken meat and correlate with isolates from ill humans. METHODS: We isolated Salmonella from raw chicken purchased from a randomly selected sample of retail outlets in central Pennsylvania during 2006-2007. Salmonella isolates from meat were compared, using pulsed-field gel electrophoresis, to isolates in the PulseNet database of Salmonella recovered from humans. RESULTS: Of 378 chicken meat samples, 84 (22%) contained Salmonella. Twenty-six (31%) of the Salmonella isolates were resistant to > or = 3 antimicrobials and 18 (21%) were resistant to ceftiofur. All ceftiofur-resistant isolates exhibited reduced susceptibility (minimum inhibitory concentration >2 microg/mL) to ceftriaxone and carried a bla(CMY) gene, as detected by polymerase chain reaction. Among the 28 Salmonella serovar Typhimurium isolates, 20 (71.4%) were resistant to > or = 3 antimicrobials and 12 (42.9%) were resistant to ceftiofur. One ceftiofur-resistant Salmonella serovar Typhimurium poultry isolate exhibited a rare pulsed-field gel electrophoresis pattern indistinguishable from a human isolate in PulseNet; both isolates carried the bla(CMY-2) gene. CONCLUSIONS: These data demonstrate the presence of multidrug-resistant Salmonella in poultry meat, including bla(CMY) plasmid-mediated genes that confer resistance to both ceftiofur, used in poultry, and ceftriaxone, used for treating salmonellosis in humans. This study illustrates the potential for molecular subtyping databases to identify related Salmonella isolates from meat and ill humans, and suggests that chicken could be a source for multidrug-resistant salmonellosis in humans.

Training programs to strengthen Pennsylvania's public health response.

This report describes Pennsylvania's 9-year experience in implementing training programs to strengthen public health response to emerging infectious diseases. During the biannual 3-5-day-long Pennsylvania Public Health Institute (PHI) events, which have been held since 2000, courses have covered topics such as emerging infectious disease outbreaks, monitoring of antimicrobial-resistant pathogens in retail food, and zoonotic diseases commonly associated with companion animals. Core competency courses include the legal basis for public health and epidemiology for nonepidemiologists. Emerging infectious disease seminars offered to clinicians since 2005 have focused on the emergence of community-associated methicillin-resistant Staphylococcus aureus and Clostridium difficile antibiotic-associated diarrhea. Complementing the PHI, the Pennsylvania Department of Health's monthly Epidemiology Journal Club offers additional interactions with presenters from academic institutions and federal agencies. Lunch-time forums also provide a venue for health department staff to share their work with colleagues. Innovative use of modern communication technology increases participation of frontline health workers in Journal Club events, and video conference capability offers flexibility in the selection of presenters. Pennsylvania's experience over the past 9 years demonstrates that with political will, commitment from content experts, and adequate administrative support, modest state and federal resources can be used to sustain public health training programs tailored to local needs.