A large travel-associated outbreak of iatrogenic botulism in four European countries following intragastric botulinum neurotoxin injections for weight reduction, Türkiye, February to March 2023.

In March 2023, 34 associated cases of iatrogenic botulism were detected in Germany (30 cases), Switzerland (two cases), Austria (one case), and France (one case). An alert was rapidly disseminated via European Union networks and communication platforms (Food- and Waterborne Diseases and Zoonoses Network, EpiPulse, Early Warning and Response System) and the International Health Regulation mechanism; the outbreak was investigated in a European collaboration. We traced sources of the botulism outbreak to treatment of weight loss in Türkiye, involving intragastric injections of botulinum neurotoxin. Cases were traced using a list of patients who had received this treatment. Laboratory investigations of the first 12 German cases confirmed nine cases. The application of innovative and highly sensitive endopeptidase assays was necessary to detect minute traces of botulinum neurotoxin in patient sera. The botulism notification requirement for physicians was essential to detect this outbreak in Germany. The surveillance case definition of botulism should be revisited and inclusion of cases of iatrogenic botulism should be considered as these cases might lack standard laboratory confirmation yet warrant public health action. Any potential risks associated with the use of botulinum neurotoxins in medical procedures need to be carefully balanced with the expected benefits of the procedure.

A global genomic analysis of Salmonella Concord reveals lineages with high antimicrobial resistance in Ethiopia.

Antimicrobial resistant Salmonella enterica serovar Concord (S. Concord) is known to cause severe gastrointestinal and bloodstream infections in patients from Ethiopia and Ethiopian adoptees, and occasional records exist of S. Concord linked to other countries. The evolution and geographical distribution of S. Concord remained unclear. Here, we provide a genomic overview of the population structure and antimicrobial resistance (AMR) of S. Concord by analysing genomes from 284 historical and contemporary isolates obtained between 1944 and 2022 across the globe. We demonstrate that S. Concord is a polyphyletic serovar distributed among three Salmonella super-lineages. Super-lineage A is composed of eight S. Concord lineages, of which four are associated with multiple countries and low levels of AMR. Other lineages are restricted to Ethiopia and horizontally acquired resistance to most antimicrobials used for treating invasive Salmonella infections in low- and middle-income countries. By reconstructing complete genomes for 10 representative strains, we demonstrate the presence of AMR markers integrated in structurally diverse IncHI2 and IncA/C2 plasmids, and/or the chromosome. Molecular surveillance of pathogens such as S. Concord supports the understanding of AMR and the multi-sector response to the global AMR threat. This study provides a comprehensive baseline data set essential for future molecular surveillance.

Detection of Atypical Salmonella Infantis Phenotypes in Broiler Environmental Samples.

In numerous countries, strict and targeted measures concerning Salmonella monitoring and control are implemented and high quality of surveillance is ensured by obligatory investigation of samples from the primary production level of animals according to EN/ISO standards. Here, 2 phenotypic characteristics of Salmonella exhibited on compulsory media are crucial, namely, motility demonstrated on modified semisolid Rappaport Vassiliadis agar (MSRV), and production of hydrogen sulfide (H2S) on xylose lysine deoxycholate agar (XLD). In the present study, we describe the detection of Salmonella Infantis variants found in broiler environmental samples with major alterations in their growth characteristics on MSRV, XLD, and brilliant green-phenol red-agar (BPLS). The variants proved to be non-motile on MSRV and displayed non-confirming colony appearances on the previously mentioned selective agars. The growth spectrum comprised pinhead sized yellow colonies with small black centers, but also pinpoint sized colorless colonies, both colony types of regular shape. Our work contributes to highlight the finding of S. Infantis variants which possess more than one phenotypic deviation from the "typical" growth characteristics and by this limit the detection power of the actual obligatory used media. IMPORTANCE Salmonellosis caused by non-typhoidal Salmonella serovars is the second most frequently reported zoonotic disease in humans in the EU. The transmission of these agents is mainly via contaminated food of animal origin. In this context, poultry products are the main source of infection. Therefore, continuous and standardized surveillance of the prevalence of such Salmonella serovars at the primary production level is essential. Our findings show the phenotypic heterogeneity of the serovar Infantis and provide growth characteristics of atypical variants. Such variants pass unnoticed official screening methods, resulting in incorrect identification and being underrepresented in epidemiological surveillance programs.

Infection dynamics of Salmonella Infantis strains displaying different genetic backgrounds - with or without pESI-like plasmid - vary considerably.

Food-borne infections with Salmonella are among the most common causes of human diseases worldwide, and infections with the serovar Infantis are becoming increasingly important. So far, diverse phenotypes and genotypes of S. Infantis have been reported. Therefore, the present study aimed to investigate the infection dynamics of two different S. Infantis strains in broilers. For this purpose, 15 birds were infected on day 2 of life with 108 CFU/ml of a pESI+ or a pESI- S. Infantis strain, respectively. Ten uninfected birds served as in-contact birds to monitor transmission. In both groups, an increase of infection was observed from 7 days of age onwards, reaching its peak at 28 days. However, the pESI+ strain proved significantly more virulent being re-isolated from most cloacal swabs and organs by direct plating. In contrast, the pESI- strain could be re-isolated from cloacal swabs and caeca only when enrichment was applied. Although the excretion of this strain was limited, the transmission level to in-contact birds was similar to the pESI+ strain. Differences in infection dynamics were also reflected in the antibody response: whereas the pESI+ strain provoked a significant increase in antibodies, antibody levels following infection with the pESI- strain remained in the range of negative control birds. The actual findings provide for the first time evidence of S. Infantis strain-specific infectivity in broilers and confirm previous observations in the field regarding differences in persistence on farms and resistance against disinfectants.

Presence of ß-Lactamase-producing Enterobacterales and Salmonella Isolates in Marine Mammals.

Marine mammals have been described as sentinels of the health of marine ecosystems. Therefore, the aim of this study was to investigate (i) the presence of extended-spectrum ß-lactamase (ESBL)- and AmpC-producing Enterobacterales, which comprise several bacterial families important to the healthcare sector, as well as (ii) the presence of Salmonella in these coastal animals. The antimicrobial resistance pheno- and genotypes, as well as biocide susceptibility of Enterobacterales isolated from stranded marine mammals, were determined prior to their rehabilitation. All E. coli isolates (n = 27) were screened for virulence genes via DNA-based microarray, and twelve selected E. coli isolates were analyzed by whole-genome sequencing. Seventy-one percent of the Enterobacterales isolates exhibited a multidrug-resistant (MDR) pheno- and genotype. The gene blaCMY (n = 51) was the predominant ß-lactamase gene. In addition, blaTEM-1 (n = 38), blaSHV-33 (n = 8), blaCTX-M-15 (n = 7), blaOXA-1 (n = 7), blaSHV-11 (n = 3), and blaDHA-1 (n = 2) were detected. The most prevalent non-ß-lactamase genes were sul2 (n = 38), strA (n = 34), strB (n = 34), and tet(A) (n = 34). Escherichia coli isolates belonging to the pandemic sequence types (STs) ST38, ST167, and ST648 were identified. Among Salmonella isolates (n = 18), S. Havana was the most prevalent serotype. The present study revealed a high prevalence of MDR bacteria and the presence of pandemic high-risk clones, both of which are indicators of anthropogenic antimicrobial pollution, in marine mammals.

Genomic diversity of Salmonella enterica -The UoWUCC 10K genomes project.

Background: Most publicly available genomes of Salmonella enterica are from human disease in the US and the UK, or from domesticated animals in the US. Methods: Here we describe a historical collection of 10,000 strains isolated between 1891-2010 in 73 different countries. They encompass a broad range of sources, ranging from rivers through reptiles to the diversity of all S. enterica isolated on the island of Ireland between 2000 and 2005. Genomic DNA was isolated, and sequenced by Illumina short read sequencing. Results: The short reads are publicly available in the Short Reads Archive. They were also uploaded to EnteroBase, which assembled and annotated draft genomes. 9769 draft genomes which passed quality control were genotyped with multiple levels of multilocus sequence typing, and used to predict serovars. Genomes were assigned to hierarchical clusters on the basis of numbers of pair-wise allelic differences in core genes, which were mapped to genetic Lineages within phylogenetic trees. Conclusions: The University of Warwick/University College Cork (UoWUCC) project greatly extends the geographic sources, dates and core genomic diversity of publicly available S. enterica genomes. We illustrate these features by an overview of core genomic Lineages within 33,000 publicly available Salmonella genomes whose strains were isolated before 2011. We also present detailed examinations of HC400, HC900 and HC2000 hierarchical clusters within exemplar Lineages, including serovars Typhimurium, Enteritidis and Mbandaka. These analyses confirm the polyphyletic nature of multiple serovars while showing that discrete clusters with geographical specificity can be reliably recognized by hierarchical clustering approaches. The results also demonstrate that the genomes sequenced here provide an important counterbalance to the sampling bias which is so dominant in current genomic sequencing.

Listeriosis outbreak likely due to contaminated liver pâté consumed in a tavern, Austria, December 2018.

In late December 2018, an outbreak of listeriosis occurred after a group of 32 individuals celebrated in a tavern in Styria, Austria; traditional Austrian food (e.g. meat, meat products and cheese) was served. After the celebration, 11 individuals developed gastrointestinal symptoms, including one case with severe sepsis. Cases had consumed mixed platters with several meat products and pâtés originating from a local production facility (company X). Human, food and environmental samples taken from the tavern and company X were tested for L. monocytogenes. Whole genome sequence-based typing detected a novel L. monocytogenes strain of serotype IVb, sequence type 4 and CT7652 in 15 samples; 12 human, two food and one environmental sample from company X with an allelic difference of 0 to 1. Active case finding identified two further cases who had not visited the tavern but tested positive for the outbreak strain. In total, 13 cases (seven females and six males; age range: 4-84 years) were identified. Liver pâté produced by company X was identified as the likely source of the outbreak. Control measures were implemented and since the end of December 2018, no more cases were detected.

Cross-Border Transmission of Salmonella Choleraesuis var. Kunzendorf in European Pigs and Wild Boar: Infection, Genetics, and Evolution.

Salmonella enterica subspecies enterica serotype Choleraesuis is a swine adapted serovar. S. Choleraesuis variant Kunzendorf is responsible for the majority of outbreaks among pigs. S. Choleraesuis is rare in Europe, although there have been serious outbreaks in pigs including two outbreaks in Denmark in 1999-2000 and 2012-2013. Here, we elucidate the epidemiology, possible transmission routes and sources, and clonality of European S. Choleraesuis isolates including the Danish outbreak isolates. A total of 102 S. Choleraesuis isolates from different European countries and the United States, covering available isolates from the last two decades were selected for whole genome sequencing. We applied a temporally structured sequence analysis within a Bayesian framework to reconstruct a temporal and spatial phylogenetic tree. MLST type, resistance genes, plasmid replicons, and accessory genes were identified using bioinformatics tools. Fifty-eight isolates including 11 out of 12 strains from wild boars were pan-susceptible. The remaining isolates carried multiple resistance genes. Eleven different plasmid replicons in eight plasmids were determined among the isolates. Accessory genes were associated to the identified resistance genes and plasmids. The European S. Choleraesuis was estimated to have emerged in ∼1837 (95% credible interval, 1733-1983) with the mutation rate of 1.02 SNPs/genome/year. The isolates were clustered according to countries and neighbor countries. There were transmission events between strains from the United States and European countries. Wild boar and pig isolates were genetically linked suggesting cross-border transmission and transmission due to a wildlife reservoir. The phylogenetic tree shows that multiple introductions were responsible for the outbreak of 2012-2013 in Denmark, and suggests that poorly disinfected vehicles crossing the border into Denmark were potentially the source of the outbreak. Low levels of single nucleotide polymorphisms (SNPs) differences (0-4 SNPs) can be observed between clonal strains isolated from different organs of the same animal. Proper disinfection of livestock vehicles and improved quality control of livestock feed could help to prevent future spread of S. Choleraesuis or other more serious infectious diseases such as African swine fever (ASF) in the European pig production system.

Re-evaluation of a 2014 multi-country European outbreak of Salmonella Enteritidis phage type 14b using recent epidemiological and molecular data.

A European multi-country outbreak of Salmonella Enteritidis phage type (PT) 14b occurred from March to November 2014 associated with the consumption of eggs. The outbreak involved more than 400 human cases from France, Luxembourg, Austria and the United Kingdom. In 2016-2017, it has been re-evaluated combining recent epidemiological results with latest molecular data. The outbreak was traced back to one large Bavarian egg producer with four distinct premises, three located in Bavaria, one in the Czech Republic. The outbreak isolates of S. Enteritidis PT 14b were grouped into three closely related clades by whole genome sequencing. Two of these clades could be referred to two Bavarian premises of the egg producer on the basis of epidemiological and molecular data, while epidemiological data presumably linked the third clade to another premises of the egg producer. Interestingly and in contrast to the situation in other European countries where several outbreaks were documented, all notified 91 laboratory-confirmed cases of S. Enteritidis PT 14b from Bavaria were sporadic, singular cases not belonging to any epidemiological outbreaks. In conclusion, as demonstrated here, the resolution of food-related outbreaks with such a high discriminatory power is rare in outbreak investigation.

Multi-laboratory validation study of multilocus variable-number tandem repeat analysis (MLVA) for Salmonella enterica serovar Enteritidis, 2015.

Multilocus variable-number tandem repeat analysis (MLVA) is a rapid and reproducible typing method that is an important tool for investigation, as well as detection, of national and multinational outbreaks of a range of food-borne pathogens. Salmonella enterica serovar Enteritidis is the most common Salmonella serovar associated with human salmonellosis in the European Union/European Economic Area and North America. Fourteen laboratories from 13 countries in Europe and North America participated in a validation study for MLVA of S. Enteritidis targeting five loci. Following normalisation of fragment sizes using a set of reference strains, a blinded set of 24 strains with known allele sizes was analysed by each participant. The S. Enteritidis 5-loci MLVA protocol was shown to produce internationally comparable results as more than 90% of the participants reported less than 5% discrepant MLVA profiles. All 14 participating laboratories performed well, even those where experience with this typing method was limited. The raw fragment length data were consistent throughout, and the inter-laboratory validation helped to standardise the conversion of raw data to repeat numbers with at least two countries updating their internal procedures. However, differences in assigned MLVA profiles remain between well-established protocols and should be taken into account when exchanging data.

Cattle-derived Salmonella enterica serovar Dublin Infections in Red Foxes ( Vulpes vulpes ) in Tyrol, Austria.

Salmonella enterica serovar Dublin is endemic in the cattle population in some areas of the Austrian province Tyrol, and each year single dairy farms have experienced clinical infections. To ascertain if Tyrolean red foxes ( Vulpes vulpes ) act as a reservoir for Salmonella spp., we tested hepatic tissue and intestinal content from foxes hunted in the years 2015-16 by using microbiological methods. In addition, we included several fox fecal samples collected on a mountain pasture near chamois carcasses in the investigation. Of 434 foxes tested, nine animals (2.1%) were positive for Salmonella spp. Serotyping revealed five foxes positive with S. Dublin, demonstrating that this serovar exists in the Tyrolean fox population. The fecal samples collected in the area surrounding skeletonized chamois ( Rupicapra rupicapra ) also tested positive for S. Dublin. These chamois were probably victims of a waterborne outbreak caused by S. Dublin-shedding cattle. Our results indicate that the S. Dublin infections in red foxes were primarily acquired through ingestion of infected cattle material such as abortion tissues, but also by feeding on dead chamois. The findings underline the importance of interspecies transmission in this domestic/wildlife interface.

Phylogenetic structure of European Salmonella Enteritidis outbreak correlates with national and international egg distribution network.

Outbreaks of Salmonella Enteritidis have long been associated with contaminated poultry and eggs. In the summer of 2014 a large multi-national outbreak of Salmonella Enteritidis phage type 14b occurred with over 350 cases reported in the United Kingdom, Germany, Austria, France and Luxembourg. Egg supply network investigation and microbiological sampling identified the source to be a Bavarian egg producer. As part of the international investigation into the outbreak, over 400 isolates were sequenced including isolates from cases, implicated UK premises and eggs from the suspected source producer. We were able to show a clear statistical correlation between the topology of the UK egg distribution network and the phylogenetic network of outbreak isolates. This correlation can most plausibly be explained by different parts of the egg distribution network being supplied by eggs solely from independent premises of the Bavarian egg producer (Company X). Microbiological sampling from the source premises, traceback information and information on the interventions carried out at the egg production premises all supported this conclusion. The level of insight into the outbreak epidemiology provided by whole-genome sequencing (WGS) would not have been possible using traditional microbial typing methods.

[Implementation and results of the EU-wide baseline studies on the prevalence of Salmonella spp. in slaughter and breeding pigs in Austria]. / Umsetzung und Ergebnisse der EU-weiten Grundlagenerhebung zur Prävalenz von Salmonella spp. in Schlacht- und Zucht- schweinen in Osterreich.

The Member States of the European Union are following a common strategy on the control of Salmonella and other foodborne pathogens (Anonym, 2003). Within that framework baseline studies on the most relevant animal populations have been carried out. This paper describes the implementation and the results of the baseline studies on Salmonella spp. in slaughter and breeding pigs in Austria. A total of 647 slaughter pigs were sampled in 28 slaughterhouses between October 2006 and September 2007. Samples were taken from the ileocaecal lymphnodes to detect infection in pigs and from the surface of the carcasses to detect contamination. Out of the 617 datasets included in the final analysis, Salmonella prevalences of 2% in lymphnodes and 1.1% on the carcass surface were observed. S. Derby, S. Enteritidis and S. Typhimurium were the three most frequently identified serovars. In an additional study, a total of 252 holdings with breeding pigs has been sampled between January and December combined multiplier herds. Respectively prevalences of 5, 8, 5, 3 and 9.1% were obtained, with S. Typhimurium being the most frequently isolated serovar. Overall, compared to neighbouring Member States a rather low prevalence of Salmonella spp. in pigs was documented for Austria, in particular in slaughter pigs.The serovar distribution seemed to be similar throughout the pig populations, some also being represented in Austrian human isolates. Contamination of feed seems to play a minor role considering the overall low prevalence, but nevertheless has to be taken into account in any future control or monitoring strategy for Salmonella spp. in pigs.

[Implementation and results of the EU-wide baseline study on the prevalence of Salmonella spp. in flocks of turkeys in Austria]. / Umsetzung und Ergebnisse der EU-weiten Grundlagenstudie zur Prävalenz von Salmonella spp. in Putenherden in Osterreich.

The member states of the European Union (EU) are following a common strategy on the control of Salmonella and other foodborne zoonotic pathogens (Anonym, 2003). In order to establish the prevalence of Salmonella (S.) spp. in turkeys, a baseline survey was organised in between October 2006 and September 2007. In Austria a total of 202 turkey flocks in 104 holdings was included. By doing so, all holdings with fattening turkeys were covered by the sampling scheme, whereas breeding turkey flocks did not exist in the survey period. A prevalence of Salmonella spp. of 17.3% in flocks or 25% of holdings was obtained. A total of nine different serovars were identified, S. Hadar being the most frequently isolated with eleven flocks infected representing 31.4% of all. S. Montevideo and S. Saintpaul were both found in eight flocks, and S. Senftenberg in six flocks. Two flocks were colonized with S. Newport, while one flock each had S. Typhimurium, S. Derby, S. Blockley and a monophasic strain of Salmonella group B. Of the two serovars of highest relevance for human health, S. Typhimurium was detected in only 0.5% of flocks or 1% of holdings tested and S. Enteritidis was not detected at all. Taking into account the high prevalence of the various Salmonella serovars however control measures to prohibit horizontal transmission and entry of Salmonella spp. from the turkey reservoir into the food chain in Austria seem justified.

A 2010 Austrian Salmonella enteritidis PT4 outbreak associated with a laying hen holding previously involved in an S. enteritidis PT4 cluster: pitfalls of regulatory responses in risk management.

We report on an outbreak caused by Salmonella enteritidis phage type 4 (PT4) among 143 participants at a soccer camp in Austria in August 2010. The outbreak affected 34 persons, including 24 epidemiologically related cases and 10 laboratory-confirmed cases. Food-specific cohort analyses revealed spaetzle (homemade noodles) (relative risks (RR): 2.68; 95% CI: 1.13-6.45), hamburger (RR: 2.70; 95% CI: 1.13-6.45) and potato salad (RR: 2.91; 95% CI: 1.69-5.02) as the most biologically plausible infection sources. Eggs used as ingredients were considered to be the vehicle of infection for the outbreak strain. The sole egg producer supplying the hotel that housed the soccer camp participants with table eggs operated two flocks. One flock had been epidemiologically and microbiologically related to a previous S. enteritidis PT4 outbreak affecting the same Austrian province in the four months preceding the August outbreak. We hypothesize that eggs from this flock, already condemned for industrial use only, were falsely declared table eggs and sold among eggs from the non-banned flock causing the subsequent outbreak. In Austria, the illegal distribution of eggs designated for industrial use (i.e., false declaration of these eggs as table eggs) has been previously documented. Our findings underscore the potential of proper epidemiological outbreak investigation to identify the pitfalls of regulatory responses in risk management.

The First Case(s) of Botulism in Vienna in 21 Years: A Case Report.

UNLABELLED: We describe two linked cases of botulinum toxin intoxication to provide the clinician with a better idea about how botulism cases may present since early diagnosis and treatment are crucial in botulism. Botulinum toxin is the strongest neurotoxin known. METHODS: We review the available literature, the compiled clinical data, and observations. RESULTS: After a slow onset of clinical signs a married couple living in Vienna presented with dysphagia, difficulties in accommodation, inability to sweat, urinary and stool retention, dizziness, and nausea. They suffered intoxication with botulinum toxin type B. Botulism is a rarely occurring disease in Austria. In the last 21 years there were only twelve reported cases. CONCLUSION: Both patients went to a general practitioner as well as several specialists before they were sent to and correctly diagnosed at our outpatient department. To avoid long delays between intoxication and diagnosis we think it is crucial to advert to the complex symptoms a nonsevere intoxication with botulinum toxin can produce, especially since intoxications have become rare occurrences in the industrialized societies due to the high quality of industrial food production.

Prevalence of Salmonella spp. in Austrian broiler flocks in the context of the EU-wide baseline survey 2005-2006.

In Austria an EU-wide baseline survey on the prevalence of Salmonella spp. in broilers organized by the EU commission was conducted from October 2005 to September 2006. The aim of this study was to produce comparable data on the prevalence of Salmonella in broiler flocks and holdings for all member states and for the EU-Commission to set EU-wide targets for the control of Salmonella in the broiler populations. A randomised sampling plan was designed according to EU-commission parameters (p = 50%; CI = 95%, a = 5%). Sampling was carried out regularly throughout the whole year. On every farm one flock was sampled with five pairs of boot swabs and analysed in the lab according to appendix D of ISO 6579 (2002). In Austria, 363 flocks on farms consisting of at least 5000 broilers each were tested. 28 flocks (7.7%) showed infections with Salmonella spp., eight flocks (2.2%) had either S. Enteritidis (six flocks) or S. Typhimurium (two flocks). In detail, S. Enteritidis (1.7%), S. Typhimurium (0.6%), S. Montevideo (4.1%), S. Infantis 0.6%, S. Senftenberg, S. Tennessee and S. Virchow (0.3% each) have been found. Data indicated that the risk of vertical transmission of Salmonella spp. to broiler flocks has almost been kept at bay; however, the risk of horizontal transmission still needs attention. Contamination of feeding stuff, possible persistence, spreading between barns of a farm as well as introduction of Salmonella spp. through individuals or materials are important factors for future control strategies.

One-step triplex high-resolution melting analysis for rapid identification and simultaneous subtyping of frequently isolated Salmonella serovars.

Salmonellosis is one of the most important food-borne diseases worldwide. For outbreak investigation and infection control, accurate and fast subtyping methods are essential. A triplex gene-scanning assay was developed and evaluated for serotype-specific subtyping of Salmonella enterica isolates based on specific single-nucleotide polymorphisms in fragments of fljB, gyrB, and ycfQ. Simultaneous gene scanning of fljB, gyrB, and ycfQ by high-resolution melting-curve analysis of 417 Salmonella isolates comprising 46 different serotypes allowed the unequivocal, simple, and fast identification of 37 serotypes. Identical melting-curve profiles were obtained in some cases from Salmonella enterica serotype Enteritidis and Salmonella enterica serotype Dublin, in all cases from Salmonella enterica serotype Ohio and Salmonella enterica serotype Rissen, from Salmonella enterica serotype Mbandaka and Salmonella enterica serotype Kentucky, and from Salmonella enterica serotype Bredeney, Salmonella enterica serotype Give, and Salmonella enterica serotype Schwarzengrund. To differentiate the most frequent Salmonella serotype, Enteritidis, from some S. Dublin isolates, an additional single PCR assay was developed for specific identification of S. Enteritidis. The closed-tube triplex high-resolution melting-curve assay developed, in combination with an S. Enteritidis-specific PCR, represents an improved protocol for accurate, cost-effective, simple, and fast subtyping of 39 Salmonella serotypes. These 39 serotypes represent more than 94% of all human and more than 85% of all nonhuman Salmonella isolates (including isolates from veterinary, food, and environmental samples) obtained in the years 2008 and 2009 in Austria.

Phage-type specific markers identified by Diversity Arrays Technology (DArT) analysis of Salmonella enterica ssp. enterica serovars Enteritidis and Typhimurium.

Diversity Arrays Technology (DArT) was applied to differentiate between S. enterica serovar Enteritidis and Typhimurium strains, respectively. Ten and eleven, mainly phage and plasmid-related markers were identified for serovars Enteritidis and Typhimurium. In combination, these markers can be used for subtyping among and within phage types.

Emergence of multidrug-resistant salmonella concord infections in Europe and the United States in children adopted from Ethiopia, 2003-2007.

BACKGROUND: Multidrug-resistant Salmonella serovar Concord infections have been reported from children adopted from Ethiopia. We interviewed patients, characterized the isolates, and gathered information about adoptions from Ethiopia to assess public health implications. METHODS: Information about Salmonella Concord cases and adoptions were provided from Austria, Denmark, England (and Wales), Ireland, the Netherlands and the United States. Patients from Denmark and the United States were interviewed to determine the orphanages of origin; orphanages in Ethiopia were visited. Isolates were subtyped by pulsed-field gel electrophoresis and antimicrobial susceptibility; specific antimicrobial resistance genes were characterized. RESULTS: Salmonella Concord was isolated from 78 persons from 2003 to 2007. Adoption status was known for 44 patients 2 indistinguishable isolates; one isolate from an Ethiopia adoptee. Antimicrobial susceptibility was performed on 43 isolates; 81% were multidrug-resistant (>or=3 agents). Multidrug-resistant isolates were from Ethiopian adoptees and were resistant to third and fourth generation cephalosporins and 14% had decreased susceptibility to ciprofloxacin. CONCLUSIONS: Improved hygiene and sanitation and more appropriate use of antimicrobial agents are needed in orphanages in Ethiopia. Culturing of stool specimens of children adopted from Ethiopia and appropriate hygiene may prevent further disease transmission.