Salmonella paratyphy B and Salmonella lithcfield outbreaks associated with petturtle exporure in Spain

Introduction: Salmonellosis is an important public health problem. Turtles are increasingly involved in the role of transmitters of this infection to humans. Methods: Salmonella cases are reported to the local Surveillance Agency where interviews are carriedout to address possible exposures. Molecular epidemiology techniques were used to identify species. Results: In this article we report two examples of this type of infection in two places, 300 km apart in Spain. In Barcelona a turtle transmitted the disease to a small baby via her mother, and in Castellón 5 related cases of Salmonella infections were detected, and all were transmitted by imported turtles. Molecular epidemiology techniques confirmed the turtle-person transmissions and showed strong relationships between cases in Castellón and Barcelona. Discussion: These examples represent the tip of the iceberg of what is happening with pet reptiles as regards transmission of this infection. We believe that it is important to assess the impact of this type of infection in each country, in order to subsequently promote prevention strategies such as: regulations for pet shops, and educating/informing families who buy reptiles as pets (AU)

Introducción: La salmonelosis es un problema con un impacto importante en salud pública. Cada día es más importante el papel de las tortugas como transmisoras de esta enfermedad. Métodos: Los casos de salmonelosis son notiflcados a las Agencias de Vigilancia locales que realizan las encuestas pertinentes para valorar fuentes de exposición. Técnicas de epidemiologia molecular son utilizadas para identiflcar las especies. Resultados: En este artículo exponemos ejemplos de este tipo de transmisión en dos puntos de España que distan 300 km. En Barcelona una tortuga transmitió la enfermedad a un bebé a través de su madrey en Castellón se registraron cinco casos de infecciones por Salmonella, todos ellos provocados por el contacto con tortugas. La epidemiologia molecular permitió conflrmar la transmisión tortuga persona y así como una fuerte relación entre los casos de Barcelona y Castellón. Discusión: Estos ejemplos representan la punta del Iceberg en cuanto al papel de los reptiles en la transmisión de Salmonella. Creemos que evaluar el impacto de esta transmisión en los países es básico para poder aplicar y promover medidas preventivas. Normativas específlcas en los puntos de venta de reptiles así como información y educación de las familias que pretenden comprar un animal de este tipo podrían ser muy útiles para disminuir el impacto de esta transmisión (AU)

Salmonella paratyphi B and Salmonella litchfield outbreaks associated with pet turtle exposure in Spain.

INTRODUCTION: Salmonellosis is an important public health problem. Turtles are increasingly involved in the role of transmitters of this infection to humans. METHODS: Salmonella cases are reported to the local Surveillance Agency where interviews are carried out to address possible exposures. Molecular epidemiology techniques were used to identify species. RESULTS: In this article we report two examples of this type of infection in two places, 300 km apart in Spain. In Barcelona a turtle transmitted the disease to a small baby via her mother, and in Castellón 5 related cases of Salmonella infections were detected, and all were transmitted by imported turtles. Molecular epidemiology techniques confirmed the turtle-person transmissions and showed strong relationships between cases in Castellón and Barcelona. DISCUSSION: These examples represent the tip of the iceberg of what is happening with pet reptiles as regards transmission of this infection. We believe that it is important to assess the impact of this type of infection in each country, in order to subsequently promote prevention strategies such as: regulations for pet shops, and educating/informing families who buy reptiles as pets.

[Expanded-spectrum beta-lactamase-producing strains of E. coli: origin, characteristics and incidence in Southern Alicante (Spain) in the period 1999-2003]. / Cepas de Escherichia coli productoras de betalactamasas de espectro extendido: origen, características e incidencia en el sur de la provincia de Alicante en el período 1999-2003.

INTRODUCTION: In the last years, we have verified the increasing emergence of bacteria, specially Escherichia coli, that produce expanded spectrum beta-lactamases (ESBL), enzymes which confer resistance to all cephalosporins (except cephamycins) and aztreonam. These bacteria are frequently resistant also to non-beta-lactam antibiotics, a fact which poses an important clinical problem. METHODS: Descriptive study of ESBL-producing strains of E. coli isolated in all kind of specimens in two hospitals of Southern Alicante (Spain), throughout a period of 57 months (January 1999 to September 2003), paying a close attention to their origin (outpatients or admitted patients), co-resistance to non beta-lactam antibiotics and evolution of their incidence. RESULTS: Respectively, 3% and 2.25% of E. coli strains isolated in each hospital produce ESBL (3.83% and 2.85% of strains from admitted and 2.74% and 2.1% from outpatients). 30.73% and 24.58% of strains ESBL were isolated in admitted patients. We found in both hospitals much higher percentages of co-resistance to ciprofloxacin, gentamicin and trimetoprim-sulfamethoxazole in ESBL-producing strains. CONCLUSION: The percentage of ESBL-producing E. coli is high in our environment, but it is even more noteworthy its clear trend to increase. It is very remarkable the high percentage of ESBL-producing strains isolated from outpatients. Finally, we emphasize the high percentages of co-resistance to non-beta-lactam antibiotics.

Cepas de Escherichia coli productoras de betalactamasas de espectro extendido: origen, características e incidencia en el sur de la provincia de Alicante en el período 1999-2003 / Expanded-spectrum beta-lactamase-producing strains of E. coli: origin, characteristics and incidence in Southern Alicante (Spain) in the period 1999-2003

INTRODUCCIÓN. En los últimos años observamos la aparición, cada vez más frecuente, de bacterias, y singularmente de Escherichia coli, productoras de betalactamasas de espectro extendido (BLEE), que confieren resistencia a las cefalosporinas (excepto cefamicinas) y aztreonam. Estas bacterias son frecuentemente resistentes también a antibióticos no betalactámicos, lo que plantea un importante problema clínico. MÉTODOS. Estudio descriptivo de las cepas de E. colip roductoras de BLEE aisladas en todo tipo de muestras en dos hospitales del sur de la provincia de Alicante en un período de 57 meses (de enero de 1999 a septiembre de 2003), con especial atención a su origen (intrahospitalario o extrahospitalario), a las corresistencias a antibióticosno betalactámicos y a la evolución cronológica de su incidencia. RESULTADOS. Respectivamente, 3 y 2,25% de las cepas de E. coli aisladas en cada hospital son productoras de BLEE(3,83 y 2,85% de las cepas procedentes de ingresados y 2,74 y 2,1% de las de pacientes ambulatorios). El 30,73y 24,58% de las cepas productoras de BLEE se aislaronen pacientes hospitalizados. En ambos hospitales se encontraron porcentajes de corresistencia a ciprofloxacino, gentamicina y cotrimoxazol muy superiores en cepas productoras de BLEE.CONCLUSIÓN. El porcentaje de cepas de E. coli productoras de BLEE es elevado en nuestro medio, pero es más notable su clara tendencia al incremento. Es reseñable el elevado porcentaje de cepas productoras procedentes del ámbito extrahospitalario. Por último, resaltamos los elevados índices de corresistencia a antibióticos no betalactámicos (AU)

INTRODUCTION. In the last years, we have verified the increasing emergence of bacteria, specially Escherichia coli, that produce expanded spectrum beta-lactamases (ESBL),enzymes which confer resistance to all cephalosporins(except cephamycins) and aztreonam. These bacteria are frequently resistant also to non-beta-lactam antibiotics,a fact wich poses an important clinical problem. METHODS. Descriptive study of ESBL-producing strains of E. coli isolated in all kind of specimens in two hospitals of Southern Alicante (Spain), troughout a period of 57 months (January 1999 to September 2003), paying a close attention to their origin (outpatients or admitted patients), co-resistance to non beta-lactam antibiotics and evolution of their incidence. RESULTS. Respectively, 3% and 2.25% of E. coli strains isolated in each hospital produce ESBL (3.83% and 2.85% of strains from admitted and 2.74% and 2.1% from out patients). 30.73% and 24.58% of strains ESBL were isolated in admitted patients. We found in both hospitals much higher percentages of co-resistance to ciprofloxacin, gentamicin and trimetoprim-sulfamethoxazole in ESBL-producing strains. CONCLUSION. The percentage of ESBL-producing E. coli is high in our environment, but it is even more note worthy its clear trend to increase. It is very remarkable the high percentage of ESBL-producing strains isolated from outpatients. Finally, we emphasize the high percentages of co-resistance to non-beta-lactam antibiotics (AU)

Variabilidad en la prescripción de antibióticos / Variability in the prescription of antibiotics

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