Prevalence of Salmonella on chicken carcasses from retail markets in Vietnam.

This study was conducted to estimate the prevalence of Salmonella on chicken carcasses collected from six regions in Vietnam. A total of 1,000 whole, dressed chicken carcasses were collected from five cities and seven provinces across the six regions in Vietnam. Of these, 900 samples were collected from wet markets and 100 from supermarkets. All samples were analyzed for the presence of Salmonella according to a method recommended by the U. S. Department of Agriculture, Food Safety and Inspection Service. The overall Salmonella prevalence was 45.9%. There was no significant difference (P > 0.05) in Salmonella prevalence by (i) location (Ha Noi city, 51.1%; Hai Phong city, 45.6%; Da Nang and Can Tho cities, 45.5%; Bac Ninh province and Ho Chi Minh city, 44.7%; Dong Nai province, 44.6%; Ha Tinh province, 44.4%; Phu Tho province, 43.8%; Lao Cai province, 43.5%; Kien Giang province, 41.9%; and Lam Dong province, 40.9%), (ii) market type (wet market, 46.2%; supermarket samples, 43.0%), and (iii) storage temperature at retail (ambient storage, 46.4%; chilled storage, 45.1%). Hence, Salmonella presence on poultry meat in Vietnam was not associated with a specific city or province, market type, or storage temperature at retail. Strategies to reduce Salmonella levels on raw poultry in Vietnam should be undertaken to improve the safety of poultry products and reduce the incidence of human salmonellosis from poultry consumption.

Prevalence of Salmonella on retail broiler chicken meat carcasses in Colombia.

A cross-sectional study was performed to estimate the prevalence of Salmonella on retail market chicken carcasses in Colombia. A total of 1,003 broiler chicken carcasses from 23 departments (one city per department) were collected via a stratified sampling method. Carcass rinses were tested for the presence of Salmonella by conventional culture methods. Salmonella strains were isolated from 27 % of the carcasses sampled. Logistic regression analysis was used to determine potential risk factors for Salmonella contamination associated with the chicken production system (conventional versus free-range), storage condition (chilled versus frozen), retail store type (supermarket, independent, and wet market), poultry company (integrated company versus nonintegrated company), and socioeconomic stratum. Chickens from a nonintegrated poultry company were associated with a significantly (P < 0.05) greater risk of Salmonella contamination (odds ratio, 2.0) than were chickens from an integrated company. Chilled chickens had a significantly (P < 0.05) higher risk of Salmonella contamination (odds ratio, 4.3) than did frozen chicken carcasses.

Global monitoring of Salmonella serovar distribution from the World Health Organization Global Foodborne Infections Network Country Data Bank: results of quality assured laboratories from 2001 to 2007.

Salmonella enterica is commonly acquired from contaminated food and is an important cause of illness worldwide. Interventions are needed to control Salmonella; subtyping Salmonella by serotyping is useful for targeting such interventions. We, therefore, analyzed the global distribution of the 15 most frequently identified serovars of Salmonella isolated from humans from 2001 to 2007 in laboratories from 37 countries that participated in World Health Organization Global Foodborne Infections Network and demonstrated serotyping proficiency in the Global Foodborne Infections Network External Quality Assurance System. In all regions throughout the study period, with the exception of the Oceania and North American regions, Salmonella serovars Enteritidis and Typhimurium ranked as the most common and second most common serovar, respectively. In the North American and Oceania (Australia and New Zealand) regions, Salmonella serovar Typhimurium was the most common serovar reported, and Salmonella serovar Enteritidis was the second most common serovar. During the study period, the proportion of Salmonella isolates reported from humans that were Salmonella serovar Enteritidis was 43.5% (range: 40.6% [2007] to 44.9% [2003]), and Salmonella serovar Typhimurium was 17.1% (range: 15% [2007] to 18.9% [2001]). Salmonella serovars Newport (mainly observed in Latin and North American and European countries), Infantis (dominating in all regions), Virchow (mainly observed in Asian, European, and Oceanic countries), Hadar (profound in European countries), and Agona (intense in Latin and North American and European countries) were also frequently isolated with an overall proportion of 3.5%, 1.8%, 1.5%, 1.5%, and 0.8%, respectively. There were large differences in the most commonly isolated serovars between regions, but lesser differences between countries within the same region. The results also highlight the complexity of the global epidemiology of Salmonella and the need and importance for improving monitoring data of those serovars of highest epidemiologic importance.

Laboratory-based surveillance of nontyphoidal Salmonella infections in China.

Foodborne infections are an important public health problem in China. In 2008, we conducted surveillance for laboratory-confirmed nontyphoidal Salmonella to monitor trends for this infection in China and to build capacity for rapid detection and response to foodborne outbreaks. Salmonella isolates from patients with diarrhea were sent from hospitals to local public health laboratories for confirmation, serotyping, and antimicrobial susceptibility testing. A total of 126 hospitals in 44 cities and counties from 8 provinces provided isolates and epidemiologic data for analysis. Of 23,140 stool specimens submitted to clinical laboratories, 662 (3%) grew Salmonella enterica. Salmonella were most commonly detected between April and October. The median age of infected patients was 27 years; 34% of infections occurred in patients <5 years old. Of the 662 isolates, we found 73 serotypes, of which serotype Enteritidis (31%) and serotype Typhimurium (26%) were the most common. The prevalence of resistance was high for clinically important antimicrobial agents, including ampicillin (41%) and ciprofloxacin (6%). More than 60% of isolates, including 35% of all Typhimurium, were resistant to three or more antimicrobial agents. In this first multiprovince surveillance report of laboratory-confirmed Salmonella infections in China, we found that Enteritidis and Typhimurium are the most common serotypes and that efforts to reduce antimicrobial resistance among Salmonella in China are needed. Although no outbreaks were detected using this system, efforts to improve this system's capacity to do so are underway.

Results of use of WHO Global Salm-Surv external quality assurance system for antimicrobial susceptibility testing of Salmonella isolates from 2000 to 2007.

An international External Quality Assurance System (EQAS) for antimicrobial susceptibility testing of Salmonella was initiated in 2000 by the World Health Organization (WHO) Global Salm-Surv in order to enhance the capacities of national reference laboratories to obtain reliable data for surveillance purposes worldwide. Seven EQAS iterations have been conducted from 2000 to 2007. In each iteration, participating laboratories submitted susceptibility results from 10 to 15 antimicrobial agents for eight Salmonella isolates and an Escherichia coli reference strain (ATCC 25922). A total of 287 laboratories in 102 countries participated in at least one EQAS iteration. A large number of laboratories reported results for the E. coli ATCC 25922 reference strain which were outside the quality control ranges. Critical deviations for susceptibility testing of the Salmonella isolates varied from 4% in 2000 to 3% in 2007. Consistent difficulties were observed in susceptibility testing of amoxicillin-clavulanic acid, cefotaxime, ceftazidime, streptomycin, sulfonamides, and tetracycline. Regional variations in performance were observed, with laboratories in central Asia, Africa, and the Middle East not performing as well as those in other regions. Results from the WHO Global Salm-Surv EQAS show that most laboratories worldwide are capable of correctly performing antimicrobial susceptibility testing of Salmonella isolates, but they also indicate that further improvement for some laboratories is needed. In particular, further training and dissemination of information on quality control, appropriate interpretive criteria (breakpoints), and harmonization of the methodology worldwide through WHO Global Salm-Surv and other programs will contribute to the generation of comparable and reliable antimicrobial susceptibility data.

Association between tetracycline consumption and tetracycline resistance in Escherichia coli from healthy Danish slaughter pigs.

It has been recognized that exposure to antimicrobial agents can exert a selective pressure for the emergence of antimicrobial resistance. The objective of this study was to investigate an association between the probability of isolating a tetracycline-resistant Escherichia coli isolate from the intestinal tract of healthy pigs and patterns of tetracycline consumption in the herds of origin, together with other risk factors. Data on antimicrobial resistance, antimicrobial consumption, and pig herd demographics were obtained from different Danish surveillance programs. Descriptive statistics were performed for the risk factors in relation to the susceptibility status. Logistic regression analysis was performed to identify risk factors with significant effect on the log odds of tetracycline resistance of E. coli isolates. The model showed that an increase in the interval between last prescription and sampling date would decrease the probability of isolating a resistant E. coli isolate (p-value = 0.01). Also, a direct association between treatment incidence rate in a herd and probability of resistance was detected (p-value = 0.03). Other risk factors found to have a significant effect in the isolate susceptibility status were number of produced animals in the year and year of sampling. Other antimicrobial consumption risk factors, such as number of prescriptions and amount prescribed, although not included in the final model, presented indirect impact in the tetracycline resistance probability. From this study, we can infer that tetracycline usage, the time span between last treatment and sampling date, together with herd size and the proportion of animals being treated in a herd, increase the probability of obtaining a resistant isolate.

Shigella from humans in Thailand during 1993 to 2006: spatial-time trends in species and serotype distribution.

In Thailand during 1993-2006, a total of 9063 Shigella isolates from different medical centers were serotyped and trends over time and spatial clustering analyzed. Of 3583 cases with age information, 1315 (37%) cases were from children between 0 and 4 years and 684 (19%) from children between 5 and 8 years. Most infections were recorded during 1993-1994 (> 1500 per year), decreasing to < 200 in 2006. The relative species distribution also changed. During 1993-1994, Shigella flexneri accounted for 2241 (65%) of 3474 isolations. This proportion decreased to 64 (36%) of 176 infections in 2006. Most infections occurred during July and August, and fewest in December. S. flexneri clustered around Bangkok, and Shigella sonnei in southern Thailand. Most S. flexneri infections were caused by serotype 2a (1590 of 4035) followed by serotype var X (1249). For both serotypes, a pronounced decrease in the number of isolates occurred over time. A much smaller decrease was observed for serotype 3a isolates. Phase I S. sonnei was initially most common, but shifted gradually over phase I, II, to only phase II. No differences in spatial distribution were found. The three most common S. flexneri serotypes all clustered in, around, and west of Bangkok. Serotypes 2a and 3a also clustered in southern Thailand, whereas var X clustered north and northeast of Bangkok. In conclusion, looking at Shigella species, Thailand changed from being a developing country to a developed country between 1995 and 1996. In addition, major shifts in the types of S. sonnei were observed as were differences in spatial clustering of S. flexneri and S. sonnei and S. flexneri serotypes.

Reproducible infection model for Clostridium perfringens in broiler chickens.

Experiments were carried out to establish an infection and disease model for Clostridium perfringens in broiler chickens. Previous experiments had failed to induce disease and only a transient colonization with challenge strains had been obtained. In the present study, two series of experiments were conducted, each involving four groups of chickens with each group kept in separate isolators. A coccidial vaccine given at 10 times the prescribed dosage was used to promote the development of necrotic enteritis. In the first experiment, cultures of C. perfringens were mixed with the feed at day 9, 10, 11, and 12, and the coccidial vaccine was given at day 10, whereas in the second experiment, C. perfringens cultures were mixed with the feed at day 17, 18, 19, and 20, and the coccidial vaccine was given at day 18. Chickens were examined at day 9, 11, 12, and 15 (Experiment 1), and at day 17, 18, 20, and 24 (Experiment 2). There was no mortality in any of the groups; however, chickens in the groups receiving both coccidial vaccine and C. peifringens developed the subclinical form of necrotic enteritis, demonstrated by focal necroses in the small intestine, whereas chickens in control groups or groups receiving only coccidial vaccine or only C. perfringens cultures developed no necroses. The results underline the importance of predisposing factors in the development of necrotic enteritis.

The attribution of human infections with antimicrobial resistant Salmonella bacteria in Denmark to sources of animal origin.

Based on the Danish Salmonella surveillance in 2000-2001, we developed a mathematical model for quantifying the contribution of each major animal-food sources to human salmonellosis caused by antimicrobial resistant bacteria. Domestic food products accounted for 53.1% of all cases, mainly caused by table eggs (37.6%). A large proportion (19%) of cases were travel related, while 18% could not be associated with any source. Imported food products accounted for 9.5% of all cases; the most important source being imported chicken. Multidrug and quinolone resistance was rarely found in cases acquired from Danish food, but was common in cases related to imported products (49.7% and 35.6% of attributable cases) and travelling (26.5% and 38.3% of attributable cases). For most serovars, the quinolone-resistant isolates were found to be associated with relatively more human infections than that of resistant isolates, which in turn was higher than that of susceptible isolates. This may be due to quinolone-resistant isolates having a higher ability to survive food processing and/or cause disease. This study showed domestic food to be the most important source of Salmonella infections in Denmark, but infections with multidrug- and quinolone-resistant isolates were more commonly caused by imported food products and travelling, emphasizing the need for a global perspective on food safety and antimicrobial usage.

Web-based surveillance and global Salmonella distribution, 2000-2002.

Salmonellae are a common cause of foodborne disease worldwide. The World Health Organization (WHO) supports international foodborne disease surveillance through WHO Global Salm-Surv and other activities. WHO Global Salm-Surv members annually report the 15 most frequently isolated Salmonella serotypes to a Web-based country databank. We describe the global distribution of reported Salmonella serotypes from human and nonhuman sources from 2000 to 2002. Among human isolates, S. Enteritidis was the most common serotype, accounting for 65% of all isolates. Among nonhuman isolates, although no serotype predominated, Salmonella enterica serovar Typhimurium was reported most frequently. Several serotypes were reported from only 1 region of the world. The WHO Global Salm-Surv country databank is a valuable public health resource; it is a publicly accessible, Web-based tool that can be used by health professionals to explore hypotheses related to the sources and distribution of salmonellae worldwide.

External quality assurance system for antibiotic resistance in bacteria of animal origin in Europe (ARBAO-II), 2003.

Initiated in 2003 by the European Union, ARBAO-II aims to establish a monitoring of antimicrobial susceptibility among the veterinary laboratories in all European countries based on validated methodologies. This includes an external quality control system for the most important bacterial pathogens. In 2003 two trials were performed. The first on Salmonella and Escherichia coli involved 31 laboratories in 18 countries and the second on Staphylococcus and Streptococcus included 22 laboratories in 15 countries. For the E. coli strains, 92.8% of the results complied with the reference MICs, for Salmonella 93.7%, for Streptococcus 80.4% and for Staphylococcus 93.1%. Most problems were observed when testing florfenicol (79.2% correct), gentamicin (84.2%) and amoxicillin + cl (84.9%) in E. coli; streptomycin in Salmonella (62.5%); gentamicin (56.7%), lincomycin (71.4%), clindamycin (75.4%), TMP + sulfonamides (75.7%) and chloramphenicol (78.5%) in Streptococcus; erythromycin (81.5%) and oxacillin (78.2.5%) in Staphylococcus. A few laboratories caused most deviations. However, there was no correlation between good performance for one bacterial group and good performance for other groups. This study showed that most laboratories are capable of performing correct susceptibility testing for E. coli and Salmonella, even though performance of some laboratories can be improved, and that some problems exist for Staphylococcus and Streptococcus. This clearly shows the need for continuous harmonisation of methodologies within the EU.

Attributing illness to food.

Identification and prioritization of effective food safety interventions require an understanding of the relationship between food and pathogen from farm to consumption. Critical to this cause is food attribution, the capacity to attribute cases of foodborne disease to the food vehicle or other source responsible for illness. A wide variety of food attribution approaches and data are used around the world, including the analysis of outbreak data, case-control studies, microbial subtyping and source tracking methods, and expert judgment, among others. The Food Safety Research Consortium sponsored the Food Attribution Data Workshop in October 2003 to discuss the virtues and limitations of these approaches and to identify future options for collecting food attribution data in the United States. We summarize workshop discussions and identify challenges that affect progress in this critical component of a risk-based approach to improving food safety.

Estimating the number of undetected multi-resistant Salmonella Typhimurium DT104 infected pig herds in Denmark.

In Denmark, the detection of multi-resistant Salmonella Typhimurium DT104 (MRDT104)-infected pig herds relies on the national Salmonella surveillance programme at the farm and slaughterhouse levels of production. With the surveillance sampling protocol and the diagnostic methods currently used, some herds might remain undetected. The number of undetected Danish pig herds infected with MRDT104 in the period 1 August 2001-31 July 2002 was estimated and compared with the number of culture-confirmed detected herds. A flow chart was constructed to illustrate where infected herds will go undetected in the surveillance system and Monte Carlo simulation was used to model the actual number of pig herds infected with MRDT1104. We estimated that 52 (90% CI [28, 178]) finisher herds were infected with MRDT104 compared to 23 (44%) detected. Among sow herds with production of weaners or growers, we estimated that 38 (90% CI [23, 74]) were infected with MRDT104 compared to 7 (18%) actually detected. Among breeder and multiplier herds, we estimated that five (90% CI [3, 8]) herds were infected with MRDT104 compared to three (60%) detected. In total, we estimated that 102 pig herds were infected with MRDT104 from 1 August 2001 till 31 July 2002 (90% CI [63, 228]). In comparison, 33 (32%) infected herds were detected in this period. The predicted proportion of undetected herds varied considerably with herd type. We infer that the proportion of detected MRDT104 infected herds depended on the intensity of the combined serological and bacteriological testing.

Principles, application areas and an example of risk assessment conducted at the Danish Institute for Food and Veterinary Research.

The Department for Epidemiology and Risk Analysis at the Danish Institute for Food and Veterinary Research (DFVF) is concerned with risk analyses in the areas of food safety, zoonoses, antimicrobial resistance and OIE (World Organisation for Animal Health) list A and B diseases. The DFVF is responsible for the risk assessment component of the risk analysis process and provides advice and support for the risk management and risk communication component, which is generally under the auspices of the Danish Veterinary and Food Administration (DVFA). The paper presents guidelines for the conduct of risk assessments at the DFVF. Important elements of these guidelines are the independence between risk assessment and risk management, the commitment to science-based, transparent and fully documented procedures and adherence to a protocol that regulates the cooperation between DFVF and DVFA. Typical steps of a quantitative risk assessment are the description of the risk scenario, information retrieval, mathematical modelling with stochastic simulation, final risk estimation with a sensitivity analysis and reporting. The procedure is exemplified using a Monte Carlo simulation model for the assessment of the risk of BSE transmission to calves by tallow-based calf milk replacer.

Salmonella serovars from humans and other sources in Thailand, 1993-2002.

We serotyped 44,087 Salmonella isolates from humans and 26,148 from other sources from 1993 through 2002. The most common serovar causing human salmonellosis in Thailand was Salmonella enterica Weltevreden. Serovars causing human infections in Thailand differ from those in other countries and seem to be related to Salmonella serovars in different food products and reservoirs.

The effects of tertiary wastewater treatment on the prevalence of antimicrobial resistant bacteria.

The effects of tertiary wastewater treatment on the prevalence of antimicrobial resistant bacteria were investigated in two large-scale municipal treatment plants during a period of six months. Total and relative numbers of resistant bacteria were determined in raw sewage, treated sewage and anaerobically digested sludge by bacteriological counts on media selective for coliforms (MacConkey agar) and Acinetobacter spp. (Baumann agar). In addition, the level of antimicrobial susceptibility was determined by the disc-diffusion method in 442 Acinetobacter isolates identified by colony hybridisation with a genus-specific DNA probe. Independent of the different antibiotics and media used, the total numbers of resistant bacteria in treated sewage were 10-1000 times lower than in raw sewage. Based on linear regression analysis of data on bacteriological counts, the prevalences of antimicrobial-resistant presumptive coliforms and Acinetobacter spp. in treated sewage and digested sludge were not significantly higher compared with raw sewage. On the contrary at one plant, statistically significant decreases were observed in the prevalence of ampicillin-resistant presumptive Acinetobacter spp. (p = 0.0188) following sewage treatment, and in the prevalence of either ampicillin-resistant presumptive Acinetobacter spp. (p = 0.0013) or ampicillin- and gentamicin-resistant presumptive coliforms (p = 0.0273 and p = 0.0186) following sludge treatment. The results obtained by bacteriological counts were confirmed by antimicrobial susceptibility testing of Acinetobacter isolates. Based on logistic regression analysis, isolates from treated sewage and digested sludge were generally not significantly more resistant compared with isolates from raw sewage. Based on these evidences, it was concluded that tertiary wastewater treatment did not result in a selection of antimicrobial resistant bacteria.

Differences and similarities among experts' opinions on Salmonella enterica dynamics in swine pre-harvest.

A workshop was conducted to elicit expert opinion on infection status and transmission of salmonella in pigs at the farm of origin, during transport and during lairage. A second objective was to compare opinions regarding risk factors for salmonella introduction and control at the farm level between experts from different countries. Thirty-six experts from 11 countries filled in a paper-and-pencil questionnaire during an international conference. Experts from all countries agreed on the risk of salmonella introduction related to live animals and the importance of general hygiene and all-in/all-out management for salmonella control. However, workshop participants from Denmark put more weight on factors related to feed while experts from USA rated factors related to rodents and people contact higher. The experts believed that 21-33% of pigs coming from a chronically infected farm would be infected with salmonella, but only one-third of the infected pigs would be shedders. Regarding transport and lairage, the US participants believed that contamination was occurring in the majority of pigs regardless of initial infection status and particularly during lairage; in contrast, the Danish experts were more optimistic with respect to the contamination and infection risk. US experts believed that the incidence of salmonella shedding would be high among pigs infected during transport and lairage and that an important proportion of 'carrier' pigs would start shedding. Our results reflect the differences in the level of salmonella infection and implemented control strategies between countries as well as the different philosophies that professionals have. The differences in opinion regarding salmonella dynamics could be due either to true differences in risk as a consequence of distinct management and transport practices in Denmark and USA or to a difference in perception.