Characterization of an unusual Salmonella phage type DT7a and report of a foodborne outbreak of salmonellosis.

Salmonella enterica subsp. enterica serovar 4,[5],12,i:- is a monophasic variant of Salmonella Typhimurium and its occurrence has markedly increased in several European countries in the last ten years. In June 2011, an outbreak of Salmonella 4,[5],12,i:- was reported among attendees of a wedding reception in the North-East of Italy. The source of this outbreak was identified as a cooked pork product served during the wedding reception. All Salmonella isolates from humans and the contaminated pork products were identified as Salmonella 4,[5],12,i:- and phage typed as DT7a. Afterwards, the farm where the pigs were raised was identified and sampled, and Salmonella Typhimurium was isolated from swine fecal samples. Despite the difference in serovar, these Salmonella Typhimurium isolates were also phage typed as DT7a. In the present study, Salmonella isolates from animals, humans and pork products during the outbreak investigation were subtyped by pulsed-field gel electrophoresis (PFGE), Multiple-Locus Variable number tandem repeats Analysis (MLVA), and resistance patterns, aiming to identify the most suitable subtyping methods to characterize isolates associated with this outbreak. In addition, a collection of epidemiologically unrelated strains of Salmonella 4,[5],12,i:- and Salmonella Typhimurium sharing the same phage type (DT7a) was similarly characterized in order to investigate their genetic relationship. This study provides a first snapshot of a rare Salmonella phage type, DT7a, associated with both Salmonella 4,[5],12,i:- and Salmonella Typhimurium. Moreover, the study demonstrated that in this specific context MLVA could be a reliable tool to support outbreak investigations as well as to assess the genetic relatedness among Salmonella isolates.

Application of the Random Forest method to analyse epidemiological and phenotypic characteristics of Salmonella 4,[5],12:i:- and Salmonella Typhimurium strains.

Salmonella enterica 4,[5],12:i:- is a monophasic variant of S. Typhimurium. In the last decade, its prevalence rose sharply. Although S. 4,[5],12:i:- and S. Typhimurium are known to pose a considerable public health risk, there is no detailed information on the circulation of these serovars in Italy, particularly as far as veterinary isolates are concerned. For this reason, a data set of 877 strains isolated in the north-east of Italy from foodstuffs, animals and environment was analysed during 2005-2010. The Random Forests (RF) method was used to identify the most important epidemiological and phenotypic variables to show the difference between the two serovars. Both descriptive analysis and RF revealed that S. 4,[5],12:i:- is less heterogeneous than S. Typhimurium. RF highlighted that phage type was the most important variable to differentiate the two serovars. The most common phage types identified for S. 4,[5],12:i:- were DT20a, U311 and DT193. The same phage types were also found in S. Typhimurium isolates, although with a much lower prevalence. DT7 and DT120 were ascribed to the two serovars at comparable levels. DT104, DT2 and DT99 were ascribed exclusively to S. Typhimurium, and almost all the other phage types identified were more related to the latter serovar. Such data confirm that phage typing can provide an indication of the biphasic or monophasic state of the strains investigated and could therefore support serotyping results. However, phage typing cannot be used as the definitive method to differentiate the two serovars, as part of the phage types were detected for both serovars and, in particular, all phage types found for S. 4,[5],12:i- were found also for S. Typhimurium.