Authentication, phytochemical characterization and anti-bacterial activity of twoArtemisiaspecies.

Artemisia species are aromatic herbs used as food and/or ethnomedicine worldwide; however, the use of these plants is often impeded by misidentification. Here, molecular and chemotaxonomic approaches were combined to assist in the morphology-based authentication of Artemisia species, and Artemisia indica and Artemisia argyi were identified. The plant extracts and compounds obtained from these species, 1,8-cineole, carveol, α-elemene, α-farnesene, methyl linolenate, diisooctyl phthalate inhibited the growth of food-borne harmful bacteria. Mechanistic studies showed that the extract and active compounds of A. indica killed Gram-negative and -positive bacteria via destruction of the bacterial membrane. Finally, in vivo data demonstrated that A. indica protected against bacterial infection in mice as evidenced by survival rate, bacterial load in organs, gut pathology, diarrhea, body weight, food consumption, stool weight, and pathology score. A. indica and its active compounds have potential for use as food supplements for food-borne bacterial diseases and thus improve human health.

An economic analysis of salmonella detection in fresh produce, poultry, and eggs using whole genome sequencing technology in Canada.

The study estimates the annual costs of nontyphoidal Salmonellosis (referred to as Salmonellosis from hereon) from fresh produce, poultry and eggs in Canada. It also estimates the economic benefits from introduction of Whole Genome Sequencing (WGS) in detection of Salmonellosis clusters and outbreaks. Monetary and non-monetary costs from Salmonellosis are estimated. Monetary costs are divided into direct healthcare, indirect, federal and producer costs. Probability models are used to account for uncertainty in the cost-of-illness estimates. Two types of non-monetary costs have been estimated: Disability-adjusted Live Years and Quality-adjusted Life Years. These estimates are then used to calculate the economic impact of WGS on detection of Salmonellosis. The estimated incidence of illnesses is 47,082 annually, which represents a cost of $287.78 million (total cases) and $166.28 million (reported cases) from the traditional technology. The total net benefit from introduction of WGS is estimated to range from $5.21 million-$90.25 million. All monetary values are in CAD unless stated otherwise. WGS will help in reducing the economic burden from Salmonellosis. These estimates help will aid policy related decision making.

Salmonella Infection in Middle-Aged and Older Adults: Incidence and Risk Factors from the 45 and Up Study.

BACKGROUND: Salmonella infection is one of the most common foodborne bacterial pathogens, and causes a significant health burden globally. We investigated the incidence and risk factors for notification and hospitalization due to Salmonella infection in older adults. MATERIALS AND METHODS: We used the 45 and Up Study, a large-scale Australian prospective study of adults aged ≥45 years, with record linkage to multiple databases for the years 2006-2012 to estimate the incidence of notification and hospitalization for Salmonella infection and estimate hazard ratios using Cox regression. RESULTS: Over a total follow-up of 1,120,242 person-years, 333 adults had laboratory-confirmed Salmonella infection and 101 were hospitalized; the notification and hospitalization incidence were 29.7 (95% confidence interval [CI]: 26.9-33.3) and 9.0 (95% CI: 7.4-10.9) per 100,000 person-years, respectively. The risk of Salmonella infection notification did not differ by age, but risk of hospitalization increased with age. Elderly males had the highest risk of infection-related hospitalization. The risk of notification was higher for those living in rural or remote areas (adjusted hazard ratio [aHR] 1.7, 95% CI 1.3-2.2), those taking proton pump inhibitors (aHR 1.9, 95% CI 1.4-2.4), and those reporting chicken/poultry intake at least seven times per week (aHR 3.2, 95% CI 1.3-7.9). CONCLUSIONS: Chicken consumption remains a significant risk factor for Salmonella infection, highlighting the importance of reducing contamination of poultry and improving food safety advice for older people.

Time to positivity in blood cultures of adults with nontyphoidal Salmonella bacteremia.

BACKGROUND: Nontyphoidal Salmonella (NTS) is an important bacterial etiology of diarrheal disease, and it causes invasive diseases in immunocompromised hosts. For bacteremia from some species, blood culture with a rapid time to positivity (TTP) is associated with greater mortality. This study investigated TTP of NTS bacteremia and its relationship to clinical parameters and prognosis. METHODS: Adult patients with NTS bacteremia who were admitted to a tertiary care facility in northern Taiwan from January 2010 to December 2012 were enrolled. Demographics, clinical and microbiological characteristics, and treatment response were reviewed. The TTP for each patient was retrieved from the automated machine. RESULTS: Sixty-six adult patients (mean age, 66.1 years; range, 27-96 years) with NTS bacteremia were identified by the following serogroup distributions: serogroup B (23.4%), serogroup C1 (1.6%), serogroup C2 (6.3%), and serogroup D (68.8%). The in-hospital mortality, 14-day mortality, and 30-day mortality were 15.2%, 7.6%, and 12.1%, respectively. The TTP ranged 6.5-41.7 hours (median: 11.5 hours). Patients with rapid TTP (less than 10 hours), compared to patients without rapid TTP, were more likely to have liver cirrhosis (31.6% vs. 6.4%, p = 0.013), endovascular lesions (21.1% vs. 4.3%, p = 0.05), higher bacteremia score, intensive care unit admission (57.9% vs. 25.5%, p = 0.021), and septic shock (63.2% vs. 12.8%, p < 0.001). There were no significant differences in the in-hospital mortality and 14-day mortality between patients with TTP <10 hours and patients with TTP ≥10 hours. CONCLUSION: The TTP of blood cultures, interpreted with a cut-off point of <10 hours, in patients with NTS bacteremia may provide useful diagnostic and prognostic information.

Multistate foodborne disease outbreaks associated with raw tomatoes, United States, 1990-2010: a recurring public health problem.

We examined multistate outbreaks attributed to raw tomatoes in the United States from 1990 to 2010. We summarized the demographic and epidemiological characteristics of 15 outbreaks resulting in 1959 illnesses, 384 hospitalizations, and three deaths. Most (80%) outbreaks were reported during 2000-2010; 73% occurred May-September. Outbreaks commonly affected adult (median age 34 years) women (median 58% of outbreak cases). All outbreaks were caused by Salmonella [serotypes Newport (n = 6 outbreaks), Braenderup (n = 2), Baildon, Enteritidis, Javiana, Montevideo, Thompson, Typhimurium (n = 1 each); multiple serotypes (n = 1)]. Red, round (69% of outbreaks), Roma (23%), and grape (8%) tomatoes were implicated. Most (93%) outbreaks were associated with tomatoes served predominantly in restaurants. However, traceback investigations suggested that contamination occurred on farms, at packinghouses, or at fresh-cut processing facilities. Government agencies, academia, trade associations, and the fresh tomato industry should consider further efforts to identify interventions to reduce contamination of tomatoes during production and processing.

Large outbreak of Salmonella Thompson related to smoked salmon in the Netherlands, August to December 2012.

On 15 August 2012, an increase in the number of Salmonella Thompson cases was noticed by the Salmonella surveillance in the Netherlands. A case­control study was performed, followed by a food investigation. In total 1,149 cases were laboratory-confirmed between August and December 2012 of which four elderly (76­91 years) were reported to have died due to the infection. The cause of the outbreak was smoked salmon processed at a single site. The smoked salmon had been continuously contaminated in the processing lines through reusable dishes, which turned out to be porous and had become loaded with bacteria. This is the largest outbreak of salmonellosis ever recorded in the Netherlands. The temporary closure of the processing site and recall of the smoked salmon stopped the outbreak. An estimated four to six million Dutch residents were possibly exposed to the contaminated smoked salmon and an estimated 23,000 persons would have had acute gastroenteritis with S. Thompson during this outbreak. This outbreak showed that close collaboration between diagnostic laboratories, regional public health services, the national institute for public health and the food safety authorities is essential in outbreak investigations.

Composition of Herba Pogostemonis water extract and protection of infected mice against Salmonella Typhimurium-induced liver damage and mortality by stimulation of innate immune cells.

GC-MS analysis of a hot water extract of Herba Pogostemonis (HP) revealed the presence of 131 compounds. HP slightly inhibited Salmonella Typhimurium bacteria in culture and stimulated uptake of the bacteria into RAW 264.7 murine macrophage cells as indicated by both increased fluorescence from internalized FITC-dextran and increased colony-forming unit (CFU) counts of the lysed macrophages. Postinfection, the HP-treated cells showed lower bacterial counts than the control. HP elicited altered morphology, elevated inducible NO synthase (iNOS) mRNA, and reduced pro-inflammatory cytokine expression in macrophage cells. Salmonella induced increased expression of iNOS mRNA, cognate polypeptides, and NO. Histology of mice infected with a sublethal dose (1 × 10(4) CFU) of Salmonella showed that intraperitoneally administered HP protected against necrosis of the liver, a biomarker of in vivo salmonellosis. The lifespan of mice infected with a lethal dose (1 × 10(5) CFU) was significantly extended. These results suggest that the activity of HP against bacterial infection in mice occurs through the activation of innate immune macrophage cells. The relationship of composition of HP to bioactivity is discussed.

Prevalence of Salmonella serovars and antimicrobial resistance profiles in poultry of Savar area, Bangladesh.

Salmonellosis is one of the major concerns in the poultry industry and some serovars of Salmonella involve in zoonosis. This study determines the seroprevalence of Salmonella in poultry and their drug-resistant patterns, variability in infectivity and mortality rate of birds, and predilection of some serovars to cause zoonoses. The average seroprevalance of Salmonella in three different age groups was found to be 37.9%. A total of 503 samples were examined over a period of 1 year from five different poultry farms of a semiurban area of Savar, Dhaka, Bangladesh. The prevalence of Salmonella was recorded to be 21.1%. Salmonella was found high in dead birds (31.2%) than live birds (18.1%). Salmonella infection was higher (23.6%) in summer than in winter (12.9%) season. Among the 106 isolates, 46 belong to serogroup B (43%) and 60 isolates to serogroup D (57%). The highest Salmonella infection was recorded as 47.9% on the 30-35-week-old birds. A total of 106 Salmonella isolates were used for antimicrobial susceptibility test against 10 common antibiotics and 17 multiple drug resistance patterns were found. Among the isolates, 69 (65%) harbored plasmids 1-4 with size variation between >1.63 and >40 kb and rest 37 (35%) isolates were plasmid free but showed resistance against 5-10 antibiotics. The results of the present investigation suggested that multiple drug resistance is common among the Salmonella isolates of poultry and some of these isolates may have zoonotic implications.

Foodborne Salmonella-caused outbreaks in Catalonia (Spain), 1990 to 2003.

In most developed countries, nontyphoid Salmonella is an important cause of sporadic cases and outbreaks of foodborne gastroenteritis. The aim of this study was to investigate the trend of foodborne Salmonella-caused outbreaks and number of cases, hospitalizations, and deaths and compare them with those caused by other infectious agents. The study was carried out in Catalonia, a region in northeastern Spain with a population of 6.5 million inhabitants, in 2002. All information on reported outbreaks of foodborne disease from 1990 to 2003 was reviewed. For each outbreak, the following variables were collected: year; setting (household, restaurant, school, hospital, nursing home, and others); number of cases, hospitalizations, and deaths; causal agent; and food vehicle involved. Of 1652 reported outbreaks, 1078 had a known causal agent. Among them, 871 (80.8%) were caused by Salmonella, with 14,695 cases, 1534 hospitalizations, and 4 deaths. The rate of hospitalization was higher in outbreaks due to Salmonella than in those caused by other infectious agents (rate ratio, 2.54; 95% confidence interval, 2.20 to 2.94). Forty-eight percent of Salmonella-caused outbreaks were eggborne, compared with 5.3% of those caused by other infectious agents (rate ratio, 1.40; 95% confidence interval, 1.33 to 1.48). The annual number of cases in household outbreaks of eggborne Salmonella rose over time (R2 = 0.82), but the number of outbreaks produced in other settings did not. Eggborne outbreaks caused by Salmonella in households are a major cause of disease, and increased preventive efforts are necessary, especially consumer education and awareness of the risk of eating food containing raw or slightly cooked eggs.

[Accumulated occurrence of illnesses with Salmonella enteritidis in hospitals and nursing homes in the district Oberallgaeu, Bavaria, in July 2004]. / Gehäuftes Auftreten von Erkrankungen mit Salmonella Enteritidis in Krankenhäusern und Altenheimen im Landkreis Oberallgäu (Bayern) im Juli 2004.

We report on the investigation of a Salmonella enteritidis outbreak in hospitals and nursing homes in the district Oberallgaeu, Bavaria, in July 2004. Affected by this outbreak were hospital patients, inhabitants of nursing homes, kitchen coworkers and maintenance personnel. Within this outbreak six deaths were observed. A forensic medical investigation of four deaths revealed two cases of Salmonella enteritis as the primary cause of death, another cause of death was due to other causes and one cause of death remained unclear. The microbiological investigation of stool samples linked all positive samples to an outbreak during this period. The epidemiological outbreak curve pointed towards a foodborne transmission of the pathogen. The infection period could be limited to the weekend of the 3./4.7.2004. All affected institutions were supplied by a catering service with several sites. All tested food samples were negative for Salmonella enteritis. Epidemiological investigations revealed that a contaminated pudding was probably responsible for the outbreak.

Foodborne infections in France.

To quantify the impact of foodborne diseases on health, and set priorities for data collection, prevention and control of these diseases, we compiled and analyzed information from surveillance systems and other sources on the morbidity and mortality due to foodborne infectious diseases in mainland France in the last decade of the 20th century. Illness due to 13 bacteria, two viruses, and eight parasites were studied. The number of foodborne infections, hospitalizations, and deaths were estimated from multiple data sources. For each agent, several estimates were derived from the different sources. Estimates were ranked according to their plausibility, based on an assessment of the validity of the data source, and are presented as a "plausible interval" consisting of a low and high estimate. We estimate that these pathogens caused 10,200-17,800 hospitalizations per year. Salmonella is the most frequent cause (5,700-10,200 cases), followed by Campylobacter (2,600-3,500 cases) and Listeria (304 cases). Toxoplasmosis accounts for the majority of hospitalizations (426 cases) attributable to the studied parasitic infections. The number of deaths related to foodborne infection was estimated between 228 and 691. Bacterial pathogens account for the majority (191 to 652) of deaths of which 92 to 535 are attributable to salmonellosis, ranking as the first cause of death, and 78 to listeriosis, the second cause. Salmonella, Campylobacter, and Listeria are the main causes of severe foodborne illness in France. For several pathogens, data are insufficient to derive exact estimates of the disease burden. Nevertheless, it has been possible to derive plausible estimates for the majority, and to rank them according to their impact on public health.

Hospitalizations and deaths due to Salmonella infections, FoodNet, 1996-1999.

Nontyphoidal Salmonella causes a higher proportion of food-related deaths annually than any other bacterial pathogen in the United States. We reviewed 4 years (1996-1999) of population-based active surveillance data on laboratory-confirmed Salmonella infections from the Emerging Infections Program's Foodborne Diseases Active Surveillance Network (FoodNet), to determine the rates of hospitalization and death associated with Salmonella infection. Overall, 22% of infected persons were hospitalized, with the highest rate (47%) among persons aged >60 years. Fifty-eight deaths occurred, for an estimated annual incidence of 0.08 deaths/100,000 population. These deaths accounted for 38% of all deaths reported through FoodNet from 1996 through 1999, and they occurred primarily among adults with serious underlying disease. Although Salmonella infection was seldom listed as a cause of death on hospital charts and death certificates, our chart review suggests that Salmonella infection contributed to these deaths.

Salmonella enteritidis infections, United States, 1985-1999.

Salmonella enterica serotype Enteritidis emerged as an important illness during the 1980s. Investigations showed that consumption of undercooked eggs was the major risk factor for disease, and a variety of prevention and control efforts were initiated during the 1990s. We describe sporadic infections and outbreaks of S. Enteritidis in the United States from 1985 through 1999 and discuss prevention and control efforts. After reaching a high of 3.9 per 100,000 population in 1995, S. Enteritidis infections declined to 1.98 per 100,000 in 1999. While the total number of outbreaks decreased by half, those in the western states tripled. Outbreaks of S. Enteritidis phage type 4 infections accounted for 49% of outbreaks in 1999. Outbreak-associated deaths in health facilities decreased from 14 in 1987 to 0 in 1999. Overall, rates of sporadic S. Enteritidis infection, outbreaks, and deaths have declined dramatically. For further reductions, control measures should continue to be applied along the entire farm-to-table continuum.

[Excess mortality associated with antibiotic resistant Salmonella typhimurium]. / Overdødelighed i relation til antibiotikaresistent Salmonella Typhimurium.

INTRODUCTION: The use of antimicrobials in food production has been associated with drug-resistance in foodborne pathogens such as Salmonella and Campylobacter. However, little is known about the health impact of antimicrobial drug-resistance in these pathogens. In a matched cohort study, we determined the mortality associated with drug-resistance in Salmonella Typhimurium. MATERIAL AND METHODS: Data from the Danish Surveillance Registry for Enteric Pathogens were linked with the Civil Registration System and the Danish National Patient Registry. By survival analysis, the two-year mortality among patients was compared with a matched sample of the general Danish population adjusted for differences in comorbidity. RESULTS: Among 2047 cases of S. Typhimurium, 59 deaths were identified. Patients with pan-susceptible strains of S. Typhimurium were 2.3 times (95 per cent confidence interval [CI] 1.5-3.5) more likely to die in the two-year follow-up period after infection than persons in the general Danish population. Patients infected with strains resistant to ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline were 4.8 times (95 per cent CI 2.2-10.5) more likely to die, whereas quinolone-resistance was associated with a 10.3 times (95 percent CI 2.8-37.8) higher mortality than the general population. DISCUSSION: Overall, infections with S. Typhimurium were associated with excess mortality. Patients infected with multi-drug resistant strains had a tendency towards higher mortality than patients infected with non-multiresistant strains. Particular risk was associated with quinolone-resistance in foodborne S. Typhimurium, and the excess mortality among patients infected with multi-drug resistant S. Typhimurium could be attributed to additional quinolone resistance in many of the multi-drug resistant isolates.

[Epidemiologic public health conclusions from observations of illnesses caused by Salmonella enteritidis]. / Seuchenhygienische Folgerungen aus Beobachtungen bei Erkrankungen durch Salmonella enteritidis.

11 Persons fell ill after having eaten a cream cake, prepared from two hen's eggs just after buying. One of the eggs must have contained about a thousand million of S. enteritidis, according to the concentration of bacteria found in the frozen cream. A 41-year old cook without any predisposition got septicemia by S. enteritidis after tasting a mixture of refrigerator-cooled eggs and minced meat, bought one day previously. 9 of 57 diseased inmates of an old-age home died from S. enteritidis infections after eating a strawberry cream with whipped whites of eggs. The following requirements are mandatory, as concluded from observations made during these incidents: Hen's eggs should be stored in a refrigerator already before they are sold, and the time of storage should be limited to two weeks. Pasteurized egg products should be offered also in the retail trade. To improve detection of sources of infection it would be necessary to store a sample of each lot of feed in farms with layer flocks or with other big livestock and in the feed mills. The most important measure would be the prescription of a general decontamination of the mixed feed just before supplying it to the farmer.

The activity in the chicken alimentary tract of bacteriophages lytic for Salmonella typhimurium.

Bacteriophages lytic for Salmonella typhimurium were isolated in considerable numbers from chickens experimentally infected with S. typhimurium, and in much lower numbers from the chicken feed. Lytic phages were also regularly isolated from human sewerage systems. One of these was used to inoculate S. typhimurium--infected two day-old chickens orally and via the feed. The phage took longer to establish in the caeca than did the Salmonella and it disappeared when the caecal S. typhimurium counts fell to 10(6) CFU/ml. No neutralizing antibodies to the phage were detected in the serum of these chickens. In a second experiment, five of 30 chickens similarly infected with S. typhimurium were inoculated with the phage. Within 3 days, the phage was isolated from 72% of the "in-contact" birds. A second phage, isolated from sewage, when inoculated into newly-hatched chickens simultaneously with any of 3 strains of S. typhimurium, produced a considerable reduction in mortality in the birds. This effect was only produced by inoculation of high concentrations of phage (greater than 10(10) PFU/ml). The phage produced reductions in the viable numbers of S. typhimurium in the crop, small intestine and caeca for up to 12 h after inoculation, with smaller reductions in bacterial numbers in the liver at 24 and 48 h after infection.