Listeria monocytogenes in Smoked Salmon and Other Smoked Fish at Retail in Italy: Frequency of Contamination and Strain Characterization in Products from Different Manufacturers.

Seven hundred seventy-eight samples of packaged smoked fish (774 smoked salmon and 4 smoked swordfish) on sale in Italy, from 50 different manufacturers located in 12 European Union countries, were purchased from the Italian market between May and December 2011. The surface temperatures of the samples on sale ranged from 0 to 13°C (3.4 ± 1.5°C, mean ± SD). Six hundred eighty (87.4%) of 778 samples were stored at ≤4°C. One hundred fifty-seven samples (20.2%, 95% confidence interval 17.5 to 23.1%) were contaminated by Listeria monocytogenes , with 26 samples (3.3%, 95% confidence interval 2.3 to 4.8%) at levels >100 CFU/g. The maximum level of contamination was 1.3 ×106 CFU/g. The differences in the level of contamination of smoked fish between countries (χ2 = 91.54, P < 0.05) and manufacturers (χ2 = 193.22, P < 0.05) were significant. The frequency of detection for products from different manufacturing premises ranged from 0 to 76.9%. Serotyping by serological agglutination revealed that the main serotypes detected were 1/2a (65.3%) and 1/2b (22.4%). Pulsed-field gel electrophoresis typing with restriction enzymes AscI and ApaI yielded 36 pulsotypes from 144 isolates, clustering into 17 groups. Eight main pulsotypes accounted for 70.8% of the isolates. Three of the main pulsotypes were exclusively from products of a single manufacturer. In general, products from the same manufacturer showed genetic homogeneity, with one strongly prevalent pulsotype. Different manufacturers usually showed very different levels of contamination of the final product, confirming the importance of the management of process hygiene for controlling L. monocytogenes contamination.

Community-wide outbreak of haemolytic uraemic syndrome associated with Shiga toxin 2-producing Escherichia coli O26:H11 in southern Italy, summer 2013.

In summer 2013, an excess of paediatric cases of haemolytic uraemic syndrome (HUS) in a southern region of Italy prompted the investigation of a community-wide outbreak of Shiga toxin 2-producing Escherichia coli (STEC) O26:H11 infections. Case finding was based on testing patients with HUS or bloody diarrhoea for STEC infection by microbiological and serological methods. A case-control study was conducted to identify the source of the outbreak. STEC O26 infection was identified in 20 children (median age 17 months) with HUS, two of whom reported severe neurological sequelae. No cases in adults were detected. Molecular typing showed that two distinct STEC O26:H11 strains were involved. The case-control study showed an association between STEC O26 infection and consumption of dairy products from two local plants, but not with specific ready-to-eat products. E.coli O26:H11 strains lacking the stx genes were isolated from bulk milk and curd samples, but their PFGE profiles did not match those of the outbreak isolates. This outbreak supports the view that infections with Stx2-producing E. coli O26 in children have a high probability of progressing to HUS and represent an emerging public health problem in Europe.

Comparison of two methods for the detection of verotoxin producing E.coli in human faecal samples during an outbreak of HUS in Apulia, Southern Italy.

This study evaluated the diagnostic performances of an ELISA method and a molecular method for the detection of verotoxin in faecal samples during an outbreak of haemolytic-uraemic syndrome (HUS) occurring in Apulia, Southern Italy. Two of the 16 faecal samples were positive for verotoxin when analysed by ELISA and resulted PCR positive for stx1, stx2, eaeA and serogroup O26. The other 14 faecal samples resulted negative with both tests. The detection of verotoxin in faecal samples by ELISA is a simple, sensitive, specific and rapid method (2 hours) of considerable utility for routine clinical testing laboratories without access to more specialized diagnostic procedures.

Primary intraoperative transluminal angioplasty: a new approach to reduce the early failure of distal arteriovenous fistulas.

PURPOSE: About 8 years ago, we approached an intraoperative transluminal angioplasty (ITA) performed during the arteriovenous fistula (AVF) creation, to treat arterial or venous stenosis diagnosed by a preliminary ultrasound examination. Objective of this study is to validate the efficacy of ITA. METHODS: Early failure (EF) and failure to mature (FTM) were evaluated in 69 AVFs with ITA created in 58 patients in the last 3 years. In the same period, 160 patients received 188 AVFs without ITA and were considered control group. Of the two groups, age, comorbid factors, sex, primary and secondary patency rate (PR) were also analysed. RESULTS: The two groups were homogeneous for gender and age (70.4 + 11.1 years of ITA group vs. 66.3 + 14.4, p = 0.059). The incidence of diabetes, heart disease and peripheral artery disease was higher in the ITA group (43% vs. 17%, p<0.0001, 35% vs. 6%, p<0.0001 and 56% vs. 15%, p<0.0001, respectively). EF and FTM occurred in seven and eight cases in the ITA group and in 15 and 13 cases in the controls, respectively. Total failure occurred in 24% of ITA group and 14% of the controls (p = 0.2). The primary PR at 6, 12 and 24 months was 78%, 72% and 59% for ITA group and 85%, 78% and 78 % for control group (p<0.01). The secondary PR at 6, 12 and 24 months was 91%, 86% and 80% for ITA group and 95%, 95% and 92% for the controls (p<0.01). CONCLUSIONS: Our ITA approach has allowed satisfactory results in patients at a high risk of AVF failure.

Draft Genome Sequences of Six Listeria monocytogenes Strains Isolated from Dairy Products from a Processing Plant in Southern Italy.

Here we announce the draft genome sequences of 6 Listeria monocytogenes strains from ricotta cheese produced in a dairy processing plant located in southern Italy and potentially involved in a multistate outbreak of listeriosis in the United States.

Microbiological quality of Burrata cheese produced in Puglia region: southern Italy.

Burrata cheese is a popular typical Italian food product, produced in Puglia (an administrative region of southern Italy), and this study investigated the microbiological quality of 404 samples of this cheese. The samples were analyzed in order to quantify Escherichia coli and to detect the presence of Staphylococcus aureus, Salmonella spp., and Listeria monocytogenes. No sample exceeded the values of E. coli set by EC Regulation 1441/07 for some dairy products, while 15 (3.7%) samples tested coagulase-positive staphylococci positive, with values greater than 10(3) CFU/g. One strain of S. aureus was identified and characterized from each of these positive samples, and of these strains, 7 (46.6%) produced staphylococcal enterotoxin A, 5 (33.3%) produced staphylococcal enterotoxin C, 2 (13.3%) produced staphylococcal enterotoxin D, and 1 (6.6%) produced both staphylococcal enterotoxins A and D. All strains were mecA negative. The 15 S. aureus isolates were tested for their antimicrobial resistance patterns, and all analyzed strains showed antimicrobial resistance properties for at least one of the tested antibiotics. Testing for the other pathogens mentioned above gave negative results. The results of our study mean that the microbiological quality of Burrata cheese can be assumed to be good, although care must be taken with raw materials and good hygiene during processing in order to guarantee greater food safety.

Diagnosis of Coxiella burnetii-related abortion in Italian domestic ruminants using single-tube nested PCR.

Coxiella burnetii, an obligate intracellular parasite with a worldwide distribution, is the causative agent of acute and chronic Q fever in humans. Although infection is often unapparent in cattle, sheep and goats, there is increasing evidence that C. burnetii infection in these species is associated with abortion and stillbirth. This paper describes the introduction of a single-tube nested PCR protocol for the diagnosis of C. burnetii-related abortion in domestic ruminants in Italy. A total of 514 aborted foetuses from cattle (n = 138) and sheep and goat (n = 376), collected from 301 farms, were analyzed from January 2001 to March 2005. Ninety-seven of 514 (18.9%) animals tested PCR-positive, with 16/138 (11.6%) cattle and 81/376 (21.5%) sheep and goat. Eleven of 102 (10.8%) farms with reproductive disorders in cattle and 37/199 (18.6%) farms with reproductive disorders in sheep and goats were infected with C. burnetii. A greater incidence was observed in three of the seven investigated provinces (p < 0.01), with rates of infected farms of up to 23.8%. Data showed that almost all the C. burnetii-related abortions were recorded between October and April (p < 0.01). These findings suggest that Q fever in humans is largely underestimated in Italy, probably because its occurrence is obscured by flu-like symptoms in acute forms.