[Detection of Salmonella and Enumeration of Hygienic Indicator Bacteria in Dried Wood Ear Mushrooms].

An outbreak of Salmonella Stanley in the United States associated with dried wood ear mushrooms imported from China prompted us to conduct serotyping of Salmonella isolated from dried wood ear mushrooms in voluntary testing, and quantitative test for Salmonella along with enumeration of hygienic indicator bacteria in positive samples in order to evaluate the risk of Salmonella outbreak from dried wood ear mushrooms. The major serovars of Salmonella isolates obtained from 20 samples were as follows: O3,10 group-London (n=3) and Weltevreden (n=5) etc, totaling 9 strains; O4 serogroup-Saintpaul (n=2), Stanley (n=1), Typhimurium (including monophasic variant; n=3), totaling 6 strains. O7 serogroup (Potsdam) and O8 serogroup (Newport) were one strain each. Qualitative and quantitative tests for Salmonella were conducted on 10 samples with remaining amounts. As a result, one sample was 220 MPN/g, six samples were<0.6 MPN/g, and three samples were negative for Salmonella per 25 g. The mean aerobic bacterial counts and coliforms in these samples were 7.8 and 6.1 log10 CFU/g, respectively. Furthermore, qualitative test for Salmonella and enumeration of hygienic indicator bacteria were conducted on dried wood ear mushroom products (33 domestic and 30 imported products) retailed in Japan. No samples showed positive for Salmonella per 25 g, and the mean aerobic bacterial counts and coliforms were approximately 2 log10 CFU/g lower than those in the 10 samples where Salmonella was isolated during voluntary testing. While no Salmonella was detected in domestically retailed wood ear mushrooms products, the serovars associated with foodborne diseases were isolated from voluntary testing samples. It indicates that potential for consumption of Salmonella contaminated wood ear mushrooms, which is at risk of causing food poisoning.

Isolation of Shiga Toxin-Producing Escherichia coli from the Surfaces of Beef Carcasses in Slaughterhouses in Japan.

Shiga toxin-producing E. coli (STEC) is an important foodborne pathogen worldwide. It is necessary to control and prevent STEC contamination on beef carcasses in slaughterhouses because STEC infection is associated with beef consumption. However, the frequencies of STEC contamination of beef carcasses in various slaughterhouses in Japan are not well known. Herein, we investigated the contamination of beef carcasses with STEC in slaughterhouses to assess the potential risks of STEC. In total, 524 gauze samples were collected from the surfaces of beef carcasses at 12 domestic slaughterhouses from November 2020 to February 2023. The samples were measured for aerobic plate counts and tested for pathogenic genes (stx and eae) and major O-serogroups (O26, O45, O103, O111, O121, O145, and O157) by real-time PCR screening. Subsequently, immunomagnetic separation (IMS) was performed on samples positive for stx, eae, and at least one of the seven O-serogroups of STEC. Isolation process without IMS was performed on samples positive for stx, including those subjected to IMS. STEC O157:H7 and stx-positive E. coli other than serotype O157:H7 were isolated from 0.6% and 4.6% of beef carcass surfaces, respectively. Although the STEC O157:H7 isolation rate was low and stx-positive E. coli other than serotype O157:H7 belonged to minor O-serogroups, the results mean a risk of foodborne illness. Furthermore, a moderate correlation was observed between aerobic plate counts and detection rates of stx-positive samples by real-time PCR screening. The STEC O157:H7 isolated facilities showed higher values on aerobic plate counts and detection rates of stx-positive samples than the mean values of total samples. Therefore, these results suggest that it is important to evaluate hygiene treatments against beef carcasses for the reduction of STEC contamination risk, particularly in facilities with high aerobic plate counts.

Seroepidemiological survey of pathogenic Yersinia in domestic pigs in Chiba Prefecture, Japan.

This study aimed to investigate the prevalence of antibodies against pathogenic Yersinia such as Y. enterocolitica and Y. pseudotuberculosis in domestic pigs. A total of 650 serum samples from pigs in nine regions of the Chiba Prefecture in Japan, were tested using plasmid-encoded Yersinia outer membrane protein (Yops) antigen ELISA. The cutoff value was calculated using 20 pathogenic Yersinia-free pig serum samples. According to the cutoff value, 246 (37.8%) pigs from seven regions were considered seropositive for pathogenic Yersinia during the study period. These results indicate that pathogenic Yersinia is widespread in pigs in Chiba, which may become the source of human yersiniosis in this region.

Development of detection methods by multiplex real-time PCR for highly pathogenic Yersinia enterocolitica, low pathogenic Yersinia enterocolitica, and Yersinia pseudotuberculosis based on SYBR Green and TaqMan probes.

This study aimed to develop multiplex real-time PCR methods using SYBR Green and TaqMan probes for rapid and sensitive diagnosis, differentiating three pathogenic Yersinia groups such as highly pathogenic Y. enterocolitica, low pathogenic Y. enterocolitica, and Y. pseudotuberculosis. Specific primer and probe combinations for differentiating three pathogenic Yersinia groups were designed from three chromosomally encoded genes (ail, fyuA, and inv). Twenty-six stains of pathogenic Yersinia species including 6 strains of low pathogenic Y. enterocolitica serotypes, 7 strains of highly pathogenic Y. enterocolitica serotypes, and 13 strains of pathogenic Y. pseudotuberculosis were used for specificity testing. Specific patterns of real-time amplification signals distinguished three pathogenic Yersinia groups. A detection limit of approximately 101 colony forming units (CFU) /reaction of genomic DNA was determined based on plate counts. Furthermore, the multiplex real-time PCR methods also detected Y. enterocolitica O:8 from the DNA extracted from spiked rabbit blood samples and potentially infected wild rodent fecal samples. These results demonstrated that the multiplex real-time PCR methods developed in this study are useful for rapid detection and differentiation of three pathogenic Yersinia groups. Therefore, these methods provide a new monitoring and detection capability to understand the epidemiology of pathogenic Yersinia and to diagnose three pathogenic Yersinia groups.

Diversity of Chlamydiales detected in pet birds privately kept in individual homes in Japan.

Chlamydia-related bacteria of the Chlamydiales order have recently been described as emerging pathogens that cause pneumonia and abortion in animals and humans. We investigated the presence of Chlamydiales using real-time polymerase chain reaction (PCR) by targeting the 16S rRNA gene of a broad range of Chlamydiales in 827 fecal samples from pet birds kept in individual homes in Japan. Of the 827 samples, 493 (59.6%) tested positive for the Chlamydiales 16S rRNA gene in the real-time PCR assay. We determined the nucleic acid sequences of PCR products from 17 Chlamydiales strains. A homology search and phylogenetic analysis using these sequences confirmed that the detected Chlamydiales included C. pecorum and a broad range of Chlamydia-related bacteria. To the best of our knowledge, this is the first study to detect a wide range of Chlamydia-related bacteria in birds.

Multiplex PCR method for differentiating highly pathogenic Yersinia enterocolitica and low pathogenic Yersinia enterocolitica, and Yersinia pseudotuberculosis.

A multiplex PCR method for rapid and sensitive diagnosis, differentiating three pathogenic Yersinia groups such as the highly pathogenic Y. enterocolitica, including serotype O8, low pathogenic Y. enterocolitica, and Y. pseudotuberculosis, was developed. Four primer pairs were chosen to detect the genes fyuA, ail, inv, and virF, responsible for the virulence in pathogenic Yersinia species. Under the multiplex PCR conditions, the unique band patterns for the highly pathogenic Y. enterocolitica, low pathogenic Y. enterocolitica, and Y. pseudotuberculosis were generated from Yersinia strains. The detection limit of this method was 101-103 CFU per reaction tube. This multiplex PCR method could detect highly pathogenic Y. enterocolitica O8 from the wild rodent fecal samples that were culture-positive. Therefore, the new multiplex PCR method developed in this study is a useful tool for rapid and sensitive diagnosis, distinguishing three pathogenic Yersinia groups.

Prevalence and Genetic Relationship of Predominant Escherichia coli Serotypes Isolated from Poultry, Wild Animals, and Environment in the Mekong Delta, Vietnam.

Avian pathogenic Escherichia coli (APEC) is the main causative agent of avian colibacillosis, which is an important systemic disease of profound economic and clinical consequences for the poultry industry worldwide. In this study, 975 E. coli strains were isolated from 2,169 samples collected from cloacal swabs of chickens, in-farm wild animals (ants, geckos, flies, and rats), and environment. The highest proportion of E. coli isolation was obtained from chicken cloacal swabs with 71.05% (95% confidence interval (CI) 66.69-75.05%) followed by the proportions of 38.15% (95% CI 35.41-40.97%) and 38.11% (95% CI 34.15-42.24%) from wild animals or environment, respectively. Distribution of O-antigen serotypes of the E. coli isolates, including O1, O2, O18, and O78, was determined by PCR. The most predominant serotype was O18 (10.56%) followed by O2 (9.44%), O1 (7.79%), and O78 (6.56%). Of note, serotype O18 was more likely distributed in the examined wild animals, especially in geckos. Polymorphic DNA fingerprints, generated by ERIC-PCR, of representative E. coli strains of each serotype revealed genetic heterogeneity of the examined E. coli, and O18 was more divergent with 63 clusters formed from 66 isolates. Furthermore, several E. coli strains from different sample sources shared high DNA fingerprint relatedness, suggesting that there exists complex transmission of E. coli from chickens to wild animals and environment and vice versa in poultry husbandry settings. Although pathotypes of the examined E. coli were not determined in this study, our results provided important findings of epidemiological and genetic characteristics of E. coli in the Mekong Delta and highlighted the prerequisite of stricter biocontainment to reduce the prevalence and consequences of APEC in poultry production.

A long-term observation for ecology of pathogenic Yersinia in wild rodents living in Fukushima Prefecture, Japan.

From 2012 to 2021, prevalence of pathogenic Yersinia in wild rodents captured in Fukushima Prefecture, Japan was investigated twice a year to clarify the ecology of this pathogen in wild rodent populations. Pathogenic Yersinia enterocolitica O8 was isolated from 13 (1.7%) of 755 wild rodents. The Y. enterocolitica O8 isolates harbored three virulent genes (ail, fyuA, and virF). This pathogen was isolated repeatedly from wild rodents in April 2015, 2016, and 2017, in June and November 2020, and in April 2021, which was 6 of 19 times of observations. All Y. enterocolitica O8 isolates showed the same PFGE patterns. These results indicated that the same clone of pathogenic Y. enterocolitica O8 has been maintained in wild rodent populations in Fukushima Prefecture. Therefore, wild rodent populations contribute substantially to the continuous transmission of Y. enterocolitica O8 and its persistence in the ecosystem. This is the first report on the isolation of pathogenic Y. enterocolitica O8 in wild rodents in Fukushima Prefecture, Japan.

[Contamination of Pathogenic Escherichia coli in Retail Fresh Vegetables in the Mekong Delta, Vietnam].

From July 2017 to January 2019, total of 645 retail fresh vegetables collected from 19 retail shops and markets was investigated to know the contamination of enterohemorrhagic Escherichia coli (EHEC) and enterotoxigenic E. coli (ETEC). Of 645 samples, 2 samples (0.3%) were positive for pathogenic E. coli. Of 2 pathogenic E. coli positive samples, 1 was EHEC (stx2 positive) and the other was ETEC (sta positive). Two pathogenic E. coli strains were isolated from crisphead lettuce. EHEC strain was not serotyped by commercial antisera and ETEC was serotyped as O20. EHEC and ETEC strains showed multi-drug resistance against 4 and 7 antibiotics, respectively. These results indicate that retail fresh vegetables seem to be not an important source of human EHEC and ETEC infection in the Mekong Delta, Vietnam.

Wild geckos considered as the natural reservoir of Salmonella Weltevreden in Southeast Asian countries.

A total of 1,318 wild geckos were collected in Cambodia, Thailand and Vietnam (Hue and the Mekong Delta) from 2012 to 2015 to determine the prevalence of Salmonella Weltevreden. Those geckos belong to three species: common house gecko (Hemidactylus frenatus), flat-tailed house gecko (Hemidactylus platyurus) and four-clawed gecko (Gehyra mutilata). Of 1,318 gecko samples, 293 (22.2%) samples were positive for Salmonella in this study. The prevalence of Salmonella in geckos was 46.0% in Thailand, 17.3% in Cambodia and 16.3% in Vietnam. Among the Salmonella isolates, S. Weltevreden was the most predominant serovar (32.1%) isolated from wild geckos in these countries. There was no significant difference in the prevalence of Salmonella among gecko species. All S. Weltevreden isolates (100%) were susceptible to the nine antibiotics examined in this study. The PFGE assay by XbaI enzyme identified 19 different patterns from 75 S. Weltevreden isolates. These isolates showed high genetic heterogenicity, and there were specific types prevalent in each region. Furthermore, S. Weltevreden has been prevalent since the ancient times in this region. The results indicate that wild gecko seems to be an important natural reservoir for S. Weltevreden as well as a source of Salmonella infections in humans in Southeast Asian countries.

Retail fresh vegetables as a potential source of Salmonella infection in the Mekong Delta, Vietnam.

From July 2017 to Jan 2019, a total of 572 retail fresh vegetables were collected to clarify the contamination of Salmonella in the Mekong Delta, Vietnam. Salmonella was isolated from 74 (12.9%) of 572 samples. The isolation rate of Salmonella from retail fresh vegetables in the rainy season (15.3%) was significantly higher than that in the dry season (7.6%) (P < 0.05). Of 74 Salmonella isolates, Salmonella Weltevreden was the most predominant serovar (35.1%) identified from retail fresh vegetables in all of the wet markets. All S. Weltevreden isolates (100%) were susceptible to nine antibiotics examined. Thus, retail fresh vegetables were considered as an important potential vehicle of Salmonella transmission to humans in the Mekong Delta. These results provide important data for preventing and controlling human salmonellosis in this area.

Septic shock due to Yersinia pseudotuberculosis infection in an adult immunocompetent patient: a case report and literature review.

BACKGROUND: Yersinia pseudotuberculosis infection can occur in an immunocompromised host. Although rare, bacteremia due to Y. pseudotuberculosis may also occur in immunocompetent hosts. The prognosis and therapeutic strategy, especially for immunocompetent patients with Y. pseudotuberculosis bacteremia, however, remains unknown. CASE PRESENTATION: A 38-year-old Japanese man with a mood disorder presented to our hospital with fever and diarrhea. Chest computed tomography revealed consolidation in the right upper lobe with air bronchograms. He was diagnosed with pneumonia, and treatment with intravenous ceftriaxone and azithromycin was initiated. The ceftriaxone was replaced with doripenem and the azithromycin was discontinued following the detection of Gram-negative rod bacteria in 2 sets of blood culture tests. The isolated Gram-negative rod bacteria were confirmed to be Y. pseudotuberculosis. Thereafter, he developed septic shock. Doripenem was switched to cefmetazole, which was continued for 14 days. He recovered without relapse. CONCLUSIONS: We herein report a case of septic shock due to Y. pseudotuberculosis infection in an adult immunocompetent patient. The appropriate microorganism tests and antibiotic therapy are necessary to treat patients with Y. pseudotuberculosis bacteremia.

Development of an indirect ELISA based on soluble antigen produced from virus-infected cells for detection of porcine hemagglutinating encephalomyelitis virus.

Porcine hemagglutinating encephalomyelitis virus (PHEV) is a member of the genus Betacoronavirus and is the etiologic agent of encephalomyelitis or vomiting and wasting disease in neonatal pigs. Although there are only a few epidemiological studies that document the seroprevalence of PHEV infection, there are reports of sporadic outbreaks, including recent documentation of an influenza-like respiratory disease associated with PHEV in the United States. To address this issue, we have developed a new indirect enzyme linked immunosorbent assay (ELISA) for use in sero-epidemiological research of PHEV infection. One hundred and fifty porcine serum samples that were determined as antibody-positive or antibody-negative in virus neutralization (VN) tests were used in conjunction with PHEV-specific antigen extracted from virus-infected FS-L3 cells using RBS buffer containing 0.2 % NP-40 to develop this assay. The ELISA showed a high sensitivity (95.35 %) and specificity (96.88 %) by receiver operating characteristic (ROC) analysis, with an area under the curve (AUC) of 0.996 attesting to its accuracy. Our results revealed a strong correlation between the results of the indirect ELISA and VN test (R = 0.850, P < 0.05), with near-perfect agreement (kappa value = 0.932). These results indicate that this new indirect ELISA might be useful for diagnosis and sero-epidemiological tracking of PHEV infection.

Prevalence and antibiotic resistance of Salmonella isolated from poultry and its environment in the Mekong Delta, Vietnam.

BACKGROUND AND AIM: Salmonella is one of the leading causes of zoonotic and foodborne infectious outbreaks in humans and poultry and its associated environment is a potential reservoir of Salmonella. In recent years, the antibiotic resistance of bacteria, including Salmonella, has been increasing. This study aimed to investigate the prevalence and antibiotic resistance of Salmonella isolated from poultry, its environment, and the pest animals found at poultry farms and households of the Mekong Delta, Vietnam. MATERIALS AND METHODS: A total of 3,055 samples were collected from the broiler farms and households of the Mekong Delta from 2017 to 2020. Salmonella was isolated using conventional methods (culturing on selective agar - BPLS and biochemical test) and the isolates were examined for antibiotic resistance against 14 antibiotics using the disk diffusion method. RESULTS: Salmonella was isolated from 181 samples (5.92%), which included chicken feces (7.67%), pest animals (5.98%), and environmental samples (4.33%). The environmental samples comprised bedding (5.88%), feed (5.48%), and drinking water (0.70%). The prevalence of Salmonella was the highest in rats (15.63%) and geckos (12.25%) followed by ants (2.83%) and cockroaches (2.44%); however, Salmonella was not isolated from any fly species. Most of the isolates exhibited resistance to 1-9 antibiotics. The isolates were relatively resistant to chloramphenicol (62.98%), tetracycline (55.80%), ampicillin (54.14%), and sulfamethoxazole/trimethoprim (53.04%). Sixty-two multiple resistance patterns were found in the isolates, with ampicillin-cefuroxime-chloramphenicol-tetracycline- sulfamethoxazole/trimethoprim being the most frequent (7.18%). CONCLUSION: The chickens, husbandry environment, and pest animals at poultry farms and households were found to be important Salmonella sources in the Mekong Delta. Salmonella isolates from these sources also exhibited a wide-ranging resistance to antibiotics as well as several resistance patterns. Hence, biosecurity should be addressed in poultry farms and households to prevent cross-contamination and reduce the spread of Salmonella infections.

Prevalence of Vibrio parahaemolyticus Causing Acute Hepatopancreatic Necrosis Disease of Shrimp in Shrimp, Molluscan Shellfish and Water Samples in the Mekong Delta, Vietnam.

A total of 481 samples, including 417 shrimp and molluscan shellfish samples from retail shops and farms and 64 water samples from shrimp and molluscan shellfish farms in the Mekong Delta located the southern part of Vietnam, were examined for the presence of Vibrio parahaemolyticus (VpAHPND) caused acute haepatopancreatic necrosic disease (AHPND) in shrimp. VpAHPND strains were isolated in two of 298 (0.7%) molluscan shellfish samples from retail shops, seven of 71 (9.9%) shrimp samples from shrimp ponds, and two of 42 (4.8%) water samples from shrimp ponds. VpAHPND strains were classified into two types of O antigen, including O1 and O3, in which O1 was the predominant. VpAHPND strains isolated showed high resistance rates to colistin (100%), ampicillin (93.8%), and streptomycin (87.5%). These results indicate that VpAHPND is widely prevalent in environment in the Mekong Delta, Vietnam.

Prevalence of Vibrio parahaemolyticus in seafood and water environment in the Mekong Delta, Vietnam.

A total of 449 samples including 385 seafood and 64 water samples in the Mekong Delta of Vietnam collected in 2015 and 2016 were examined. Of 385 seafood samples, 332 (86.2%) samples were contaminated with Vibrio parahaemolyticus and 25 (6.5%) samples were pathogenic V. parahaemolyticus carrying tdh and/or trh genes. The tdh gene positive V. parahaemolyticus strains were detected in 22 (5.7%) samples and trh gene positive V. parahaemolyticus strains were found in 5 (1.3%) samples. Of 25 pathogenic V. parahaemolyticus strains, two strains harbored both tdh and trh genes and the other 23 strains carried either tdh or trh gene. Of 64 water samples at aquaculture farms, 50 (78.1%) samples were contaminated with V. parahaemolyticus. No tdh gene positive V. parahaemolyticus strains were detected; meanwhile, trh gene positive V. parahaemolyticus strain was detected in 1 (1.6%) sample. Twenty-six pathogenic V. parahaemolyticus strains isolated were classified into 6 types of O antigen, in which the serotype O3:K6 was detected in 4 strains. All pathogenic strains were group-specific PCR negative except for 4 O3:K6 strains. The result of antimicrobial susceptibility test indicated that pathogenic strains showed high resistance rates to streptomycin (84.6%), ampicillin (57.7%) and sulfisoxazole (57.7%). These findings can be used for understanding microbiological risk of seafood in the Mekong Delta, Vietnam.

The importance of wild gecko as a source of human Salmonella infection.

A total of 201 wild geckos from the region of Mekong Delta, Vietnam were collected to determine the viable number and survival period of Salmonella in their feces. Of the 101 samples examined, 24 (23.8%) were Salmonella positive. These 24 geckos excreted Salmonella in their feces in a range of 1 to 8.6 log CFU/g with a mean of 4.5 ± 3.2 log CFU/g. Among the Salmonella serovars, Salmonella Weltevreden was the most predominant serovar (37.5%). Moreover, Salmonella could survive for 6 weeks in gecko feces at room temperature in Vietnam. These results indicate that the wild gecko seems to play an important role as a reservoir for Salmonella and a source of Salmonella infection in humans in Southeast Asian countries.

Evaluation of Chromogenic Medium for Selective Isolation of Yersinia.

Cefsulodin-irgasan-novobiocin agar (CIN) has been used as a selective agar to detect Yersinia in food or human patients; however, its components can inhibit the growth of some strains of Yersinia enterocolitica serovar O3 and Y. pseudotuberculosis. Recently, a new Yersinia selective agar, CHROMagar Yersinia enterocolitica (CAYe), was developed and evaluated as a novel selective agar for pathogenic Y. enterocolitica. In this research, a total of 251Yersinia strains (176 pathogenic Y. enterocolitica, 59 Y. pseudotuberculosis, and 16 non-pathogenic Yersinia) were cultured on both CIN and CAYe for comparison. Except for 10 of 104 pathogenic Y. enterocolitica O3 strains and 59 Y. pseudotuberculosis strains, 198 Yersinia isolates grew on both media after 48 hr of incubation at 32℃. Of the 10 pathogenic Y. enterocolitica O3 which could not grow on CIN or CAYe, 9 strains could not grow on CIN with supplements and 1 strain could not grow CAYe with supplements. Of 9 strains which did not grow on CIN with supplements, 3 strains could not grow on CIN without supplements. However, 1 strain which did not grow on CAYe with supplements could grow on CAYe without supplements. All of the Y. pseudotuberculosis strains could grow on CIN with/without supplements and on CAYe without supplements. The results indicate that the inhibition of the growth of Y. enterocolitica O3 on CIN is related to the components of CIN; however, the inhibition on CAYe appears to be related to the supplements in CAYe. Therefore, CAYe may be a more useful selective medium than CIN for pathogenic Y. enterocolitica .

Yersiniosis caused by Yersinia pseudotuberculosis in captive toucans (Ramphastidae) and a Japanese squirrel (Sciurus lis) in zoological gardens in Japan.

Two captive Keel-billed toucans and a Chestnut-mandibled toucan in another zoological garden died suddenly without any pre-existing symptoms, and three months later, a Japanese squirrel died of diarrhea. All these animals showed necrotic enteritis and multifocal necrosis in the liver and spleen with Gram negative bacilli. The bacilli showed strong positive immunolabeling for Yersinia pseudotuberculosis O4 in the Keel-billed toucans, Y. pseudotuberculosis O2 in the Chestnut-mandibled toucan and Y. pseudotuberculosis O1 in the Japanese squirrel, while Y. pseudotuberculosis 4b, 2b and 1b were respectively isolated from the lesions. To our knowledge, this might be the first reported case of fatal yersiniosis in a Japanese squirrel in the world as well as in toucans in Japan.

Yersiniosis due to infection by Yersinia pseudotuberculosis 4b in captive meerkats (Suricata suricatta) in Japan.

Two meerkats (Suricata suricatta) housed in the same zoological garden in Japan died due to Yersinia pseudotuberculosis serotype 4b infection. Gross and microscopic lesions included necrotizing enteritis and enlargement of the spleen and liver with multifocal necrosis. Inflammatory cells, primarily neutrophils, and nuclear debris were associated with clusters of Gram-negative bacilli. Additionally, there were aberrant organism forms that were larger than bacilli and appeared as basophilic globular bodies. Immunohistochemical examination showed that the bacilli and globular bodies were strongly positive for Y. pseudotuberculosis O4 antigen. The globular bodies were considered a shape-changed form of Y. pseudotuberculosis, and these morphologically abnormal bacteria could present a diagnostic challenge.