Trends in Salmonella enterica serotypes isolated from human, food, animal, and environment in Tunisia, 1994–2004

Climate Change and Nutrition: Implications for the Eastern Mediterranean Region

The Eastern Mediterranean Region (EMR) is considered among the world's most vulnerable to the dire impacts of climate change. This review paper aims at (1) characterizing climate change in countries of the EMR; (2) examining the potential effects of climate change on the nutritional and health status of the population; and (3) identifying the most vulnerable population groups. The paper explored several climate change indicators including daily temperatures, extreme temperature, daily precipitation, extreme precipitation (flooding, drought, storms, etc.), humidity, CO₂ concentrations and sea surface temperature in EMR countries. Findings suggest that climate change will exert a significant adverse effect on water and food security and showed that the nutritional status of the population, which is already characterized by the triple burden of malnutrition, is likely to worsen via three main pathways mediated by climate change, namely, its impact on food security, care and health. Women, infants, children, those living in poor households and those experiencing displacement will be among the most vulnerable to the nutritional impacts of climate change. The paper concludes with a set of recommendations from the Initiative on Climate Action and Nutrition, which can support the region in tackling the critical nexus of climate change and nutrition.

Study of Virulence Genes, Antimicrobial Resistance, and Genetic Relatedness of Foodborne Salmonella Isolates from Tunisia

ABSTRACT

Nontyphoidal Salmonella strains are among the major foodborne pathogens with emerging multidrug-resistant phenotypes. In this study, antimicrobial susceptibility testing of a collection of Salmonella isolates (n = 54) recovered from poultry and bivalve molluscs was performed. The study also investigated profiling of virulence and resistance genes as well as phylogenetic relationships through pulsed-field gel electrophoresis (PFGE) and enterobacterial repetitive intergenic consensus (ERIC)-PCR fingerprinting. Results revealed the presence of multiple virulence genes among Salmonella isolates. Salmonella intestinal infection A (siiA), Salmonella outer protein (sopB and sopE), putative 4-hydroxybutyrate coenzyme A transferase (cat2), Salmonella atypical fimbria C (safC), and Salmonella Enteritidis fimbria B (sefB) were present in most (83.32 to 100%) of the isolates, whereas the remaining tested genes (Salmonella plasmid virulence [spvC and spvB]), and the sopE gene, were exclusively detected within the serotype Enteritidis. The highest resistance rates were observed for oxacillin (94.4%), ampicillin (37%), and nalidixic acid (27.7%), followed by cefotaxime and amoxicillin-clavulanic acid (14.8%), trimethoprim-sulfamethoxazole (9.3%), and ciprofloxacin (5.5%). The results indicate that the Salmonella Enteritidis serotype possessed the widest range of virulence determinants and increasing levels of resistance. Such high-risk clones should be particularly controlled in Tunisia. Overall, increased resistance and virulence confer a selective advantage for the evolution of these bacteria and represent an alarming problem for global public health. The genetic study via PFGE and ERIC-PCR showed the high diversity of the clonal origins of these bacteria and the sources of contamination and revealed the great capacity of Salmonella to diversify within food-producing animals.

HIGHLIGHTS

Quinolone resistance among Salmonella Kentucky and Typhimurium isolates in Tunisia: first report of Salmonella Typhimurium ST34 in Africa and qnrB19 in Tunisia

AIMS

Characterization of quinolone-resistant Salmonella Kentucky and Typhimurium isolates in Tunisia from various sources, detection of some plasmid-mediated quinolone resistance genes and the genetic relatedness.

METHODS

A total of 1404 isolates of S. Kentucky (n = 1059)/S. Typhimurium (n = 345) from various sources from all over Tunisia were tested for quinolone resistance by disk diffusion method. Minimum inhibitory concentrations of nalidixic acid, ciprofloxacin and ofloxacin were determined. Quinolone-resistant isolates were screened for plasmid-mediated quinolone-resistance genes (qnrA,qnrB,qnrS, aac(6')-Ib-cr and qepA) by polymerase chain reaction (PCR). Mutations in the quinolone-resistance-determining regions of the gyrA and parC genes were detected by PCR and DNA sequencing. Pulsed-field gel electrophoresis and multilocus sequence typing were accomplished for isolates harbouring plasmid-mediated quinolone-resistance genes.

RESULTS

According to our selection criteria (NAL = resistance phenotype; CIP = resistant with diameter 0, or intermediate), only 63 S. Kentucky/41 S. Typhimurium isolates were investigated: 49% (5/104) were multidrug resistant. Two S. Typhimurium isolates harboured qnrB19 with different PFGE profiles. A mutation was detected in the gyrA gene for each of these two isolates. MLST revealed the presence of ST313 and ST34, an endemic sequence type.

CONCLUSION

Our study highlights the presence of quinolone multidrug-resistant Salmonella in humans and animals in Tunisia. This is the first report of S. Typhimurium ST34 in Africa and qnrB19 in Tunisia.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report that describes not only the current epidemiological situation of the quinolone resistance in S. Kentucky and Typhimurium isolated from various sources and regions in Tunisia, but also, the genetic resistance determinants associated with phenotypic antibiotic resistance and the molecular mechanisms of their quinolone-resistance. Also, we provide the first report of S. Typhimurium ST34 in Africa, and the first report of qnrB19 in Salmonella in Tunisia.

Prevalence, Serotype, Antibiotic Susceptibility, and Genotype of Salmonella in Eggs From Poultry Farms and Marketplaces in Yangling, Shaanxi Province, China

Poultry products such as eggs provide essential nutrients to the human body and thus play vital roles in the human food network. Salmonella is one of the most notorious foodborne pathogens and has been found to be prevalent in eggs. To better understand the characteristics of Salmonella in eggs, we investigated the prevalence of Salmonella spp. in 814 fresh eggs collected from poultry farms and retail marketplaces in Yangling, Shaanxi Province, China. The serotype, genotype, and antibiotic susceptibilities of 61 Salmonella isolates recovered from the eggs were analyzed. The average detection rate of Salmonella-positive eggs was 5.6%, with 6.6% of the eggs collected from poultry farms and 5.1% from marketplaces. Thirteen serotypes were identified from the 61 isolates, among which Salmonella Typhimurium (24.5%) and Salmonella Indiana (22.9%) were the most prevalent serotypes. Other dominant serotypes included Salmonella Thompson (13.1%) and Salmonella Enteritidis (11.4%), with the remaining nine serotypes detected at low rates (1.6-4.9%). All the Salmonella isolates tested were resistant to sulfisoxazole (100.0%). The majority (77.1%) of the isolates were resistant to nalidixic acid, amoxicillin-clavulanate, and ampicillin, while nearly two-thirds (63.9-68.9%) were resistant to trimethoprim-sulfamethoxazole, kanamycin, tetracyclines, and chloramphenicol. The rate of resistance to ciprofloxacin was 40.1%; the resistance rates to streptomycin, ceftiofur, and ceftriaxone ranged from 21.3 to 26.2%; and those to gentamicin, amikacin, and cefoxitin were relatively low (3.3-16.4%). Forty-nine (80.3%) Salmonella isolates exhibited resistance to multiple antibiotics, 20 (32.8%) of which were resistant to at least 10 antibiotics. Subtyping by pulse-field gel electrophoresis revealed a close genetic relatedness of Salmonella isolates from poultry farms, in striking contrast to the high diversity of the isolates obtained from marketplaces. Isolates of the same serotype always shared identical genotype and antibiotic resistance profiles, even the ones that were recovered from eggs sampled at different locations and times. These findings indicate that diverse Salmonella spp. with high rates of multidrug resistance are prevalent in fresh eggs in the study area. More attention should be paid to egg production, transportation, and storage to prevent foodborne outbreaks caused by Salmonella.

Ubiquitous waterborne pathogens

Water is one of the most important substances on earth and without it life cannot exist. However, poor water quality in many parts of the world has increased the number of water-related diseases, making it the leading cause of disease and death globally for both young and old. Waterborne pathogens cause diseases in humans through two major exposure pathways: drinking water and recreational waters. This chapter on waterborne pathogens will be starting with an introduction, followed by descriptions on classical waterborne pathogens; bacteria, viruses, protozoans, and helminths placing emphasis on the World Health Organization guidelines. Further to conventional waterborne pathogens, fresh organisms and new strains from already known pathogens are being identified and that present important additional challenges to both the water and public health sectors. Hence later part of the chapter focuses on the potential waterborne pathogens and will conclude with a summary of the content.

Prevalence of enteric non-typhoidal Salmonella in humans in the Middle East and North Africa: A systematic review and meta-analysis

To enhance efforts related to controlling foodborne pathogens in the Middle East and North Africa (MENA), information on epidemiology of non-typhoidal Salmonella enterica (hereafter termed "Salmonella") is limited. We quantified the overall regional and country-specific Salmonella prevalence in different human populations and identified the most common serotypes. Published literature of Salmonella prevalence was systematically reviewed and reported following the Preferred Items for Systematic Reviews and Meta-Analysis (PRISMA) guidelines. Pooled Salmonella prevalence measures were estimated using a random-effects model. We identified 46 research reports that reported 84 Salmonella prevalence measures in 15 out of 24 countries in MENA. There were 252,831 tested humans with 6,356 Salmonella-positive cases. The pooled Salmonella prevalence in MENA was estimated at 6.6% (95% confidence interval (CI): 5.4%-7.9%). The highest pooled Salmonella prevalence measures were in Morocco (17.9%, 95% CI: 5.7%-34.8%, 1997-2012), Tunisia (10.2%, 95% CI: 4.3%-18.0%, 1988-2009) and Sudan (9.2%, 95% CI: 6.5%-12.2%, 2006-2008), while the lowest were in Jordan (1.1%, 95% CI: 0.1%-3.0%, 1993-2010), Oman (1.2%, 95% CI: 1.2%-1.3%, 1998-2002) and Palestine (1.2%, 95% CI: 0.4%-2.1%, 1999-2011). In MENA, Salmonella pooled prevalence in gastrointestinal symptomatic, gastrointestinal asymptomatic and food handlers population groups was 13.0% (95% CI: 7.6%-19.6%), 11.4% (95% CI: 2.2%-25.7%) and 3.8% (95% CI: 1.0%-8.0%), respectively. Salmonella prevalence was 14.5% (95% CI: 8.7%-26.1%) in studies tested <100 subjects, whereas 4.6% (95% CI: 3.6%-5.8%) in studies tested ≥100 subjects. Salmonella Enteritidis (29.8%) and Typhimurium (23.6%) were the most common serotypes. Salmonella was a common foodborne pathogen in MENA countries, particularly in North African countries. Findings inform the scientific community, the public and the decision-makers with Salmonella prevalence and gaps in evidence in MENA to support control and prevention strategies and could leverage more research studies.

Occurrence and Phenotypic and Molecular Characterization of Antimicrobial Resistance of Salmonella Isolates from Food in Tunisia

HIGHLIGHTS

Multidrug-resistant Salmonella isolates have been recovered from food in Tunisia. Salmonella isolates from food are resistant to fluoroquinolones and cephalosporins. Surveillance of the antimicrobial susceptibility of foodborne bacteria is needed in Tunisia.

Endocarditis following Consumption of Cereal Associated with Salmonella enterica Subtype Mbandaka Outbreak

A 69-year-old immunocompromised man developed mitral valve endocarditis due to Salmonella enterica serotype Mbandaka, contracted from the cereal outbreak. The patient had a history of HLA-matched related hematopoietic stem cell transplant with persistent graft-versus-host disease (GVHD). This case report discusses prior international outbreaks that occurred due to Salmonella enterica subtype Mbandaka, the risks of developing endovascular infections from salmonellosis, and persistent infections that may develop more frequently with S. enterica serotype Mbandaka. The patient received a six-week course of intravenous antibiotics and remains on oral suppressive antibiotics, with his length of therapy to be determined based on his GVHD treatment.

Synergistic Effect of the Lactoperoxidase System and Cinnamon Essential Oil on Total Flora andSalmonellaGrowth Inhibition in Raw Milk

Despite its antibacterial and antipathogenic effects, the heat treatment of milk induces undesirable changes that can be noted in the overall properties of ultrahigh temperature (UHT) milk, such as changes in nutritional and organoleptic properties. Our goal is to find new nonthermal antibacterial technologies for the preservation of raw milk (RM). This study investigates the possible synergistic effect of using a combination of the lactoperoxidase system (LS) and 3 μg mL−1of cinnamon essential oil (cinnamon EO) to inactivate the total flora of milk andSalmonellaHadar (S. Hadar). The LS was activated with 30 mg L−1sodium percarbonate and 14 mg L−1of sodium thiocyanate. Using this approach, we obtained a synergistic effect with a complete inhibition of the activity of the total flora of the milk andS.Hadar after 12 hours at 25°C. In addition, the attainment of synergy was defined when the inhibitory effect of the two compounds together was greater than the effect observed by each compound added alone. Moreover, the monitoring of the synergistic effect at 4°C for 5 days showed complete inhibition of total flora for 3 days and forS. Hadar it was up to 5 days. To summarize, the current study clearly identified a new inhibitory combination that may be used in food-based applications.

Salmonella Serogroup C: Current Status of Vaccines and Why They Are Needed

Nontyphoidal Salmonella (NTS; i.e., Salmonella enterica organisms that do not cause typhoid or paratyphoid) are responsible for 94 million infections and 155,000 deaths worldwide annually, 86% of which are estimated to be foodborne. Although more than 50 serogroups and 2,600 serovars have been described, not all Salmonella serovars cause disease in humans and animals. Efforts are being made to develop NTS vaccines, with most approaches eliciting protection against serovars Typhimurium and Enteritidis (serogroups B [O:4] and D [O:9], respectively), as they are widely considered the most prevalent. Here, we show that serogroup C (O:6,7, O:6,8, or O:8 epitopes) is the most common serogroup in the United States, and the prevalence of serovars from this serogroup has been increasing in Europe and the United States over the last decade. They are also the most commonly isolated serovars from healthy cattle and poultry, indicating the underlying importance of surveillance in animals. Four out of the 10 most lethal serovars in the United States are serogroup C, and reports from African countries suggest that strains within this serogroup are highly antibiotic resistant. Serogroup C consists of highly diverse organisms among which 37 serovars account for the majority of human cases, compared to 17 and 11 serovars for serogroups B and D, respectively. Despite these concerning data, no human vaccines targeting serogroup C NTS are available, and animal vaccines are in limited use. Here, we describe the underestimated burden represented by serogroup C NTS, as well as a discussion of vaccines that target these pathogens.

Genotyping of Salmonella with lineage-specific genes: correlation with serotyping

BACKGROUND

The bacterial genus Salmonella encompasses a large number of serotypes that are genetically very similar but biologically quite different, especially in pathogenic properties and host specificity. Serotyping has been used for the classification, identification, and epidemiological investigation due to its excellent discriminating power, but it cannot distinguish the different pathogenic lineages within a polyphyletic serotype. Additionally, very few institutions have the comprehensive set of antisera for typing. Therefore various studies have been performed to explore alternative assays to differentiate Salmonella isolates, such as the search for genes that can be used as potential molecular substitutes for serotyping. However, the genes tested so far have often given inconsistent results.

METHODS

In this study, the discriminating power of seven genes to differentiate 309 Salmonella strains representing 26 serotypes was evaluated and the results were compared with those of other methods.

RESULTS

The seven newly selected genes have a good power to differentiate different serovars. The tree based on the concatenated sequences of these genes revealed phylogenetic relationships of the bacteria consistent with that of the whole genome tree.

CONCLUSION

Individual Salmonella lineages each have specific genes that can be used to differentiate Salmonella isolates on a phylogenetic basis.

Molecular typing, antibiotic resistance, virulence gene and biofilm formation of different Salmonella enterica serotypes

Salmonella enterica isolates representing commonly isolated serotypes in Tunisia were analyzed using genotyping and phenotyping methods. ERIC and ITS-PCR applied to 48 Salmonella spp. isolates revealed the presence of 12 and 10 different profiles, respectively. The distribution of profiles among serotypes demonstrated the presence of strains showing an identical fingerprinting pattern. All Salmonella strains used in this study were positive for the sdiA gene. Three Salmonella isolates belonging to serotypes Anatum, Enteritidis and Amsterdam were negative for the invA gene. The spvC gene was detected in thirteen isolates belonging to serotypes Anatum, Typhimurium, Enteritidis, Gallinarum and Montevideo. Antibiotic resistance was frequent among the recovered Salmonella isolates belonging to serotypes Anatum, Typhimurium, Enteritidis, Zanzibar and Derby. The majority of these isolates exhibited resistance to at least two antibiotic families. Four multidrug-resistant isolates were recovered from food animals and poultry products. These isolates exhibited not only resistance to tetracycline, sulphonamides, and ampicillin, but also have shown resistance to fluoroquinolones. Common resistance to nalidixic acid, ciprofloxacin and ofloxacin in two S. Anatum and S. Zanzibar strains isolated from raw meat and poultry was also obtained. Furthermore, wastewater and human isolates exhibited frequent resistance to nalidixic acid and tetracycline. Of all isolates, 33.5% were able to form biofilm.

Complete Genome of Salmonella enterica Serovar Enteritidis Myophage Marshall

Salmonella enterica serovar Enteritidis is a food-borne pathogen that causes salmonellosis in the United States. Bacteriophages are emerging as viable biocontrol agents against this pathogen. Here, we present the complete annotated genome sequence of Salmonella Enteritidis T4-like myophage Marshall, which has potential as a phage therapy agent.

Genetic diversity of food-isolated Salmonella strains through Pulsed Field Gel Electrophoresis (PFGE) and Enterobacterial Repetitive Intergenic Consensus (ERIC-PCR)

All over the world, the incidence of Salmonella spp contamination on different food sources like broilers, clams and cow milk has increased rapidly in recent years. The multifaceted properties of Salomnella serovars allow the microorganism to grow and multiply in various food matrices, even under adverse conditions. Therefore, methods are needed to detect and trace this pathogen along the entire food supply network. In the present work, PFGE and ERIC-PCR were used to subtype 45 Salmonella isolates belonging to different serovars and derived from different food origins. Among these isolates, S. Enteritidis and S. Kentucky were found to be the most predominant serovars. The Discrimination Index obtained by ERIC-PCR (0.85) was slightly below the acceptable confidence value. The best discriminatory ability was observed when PFGE typing method was used alone (DI = 0.94) or combined with ERIC-PCR (DI = 0.93). A wide variety of profiles was observed between the different serovars using PFGE or/and ERIC-PCR. This diversity is particularly important when the sample origins are varied and even within the same sampling origin.

Comparison of five molecular subtyping methods for differentiation of Salmonella Kentucky isolates in Tunisia

Salmonellosis is one of the most common causes of food-borne infection worldwide. In the last decade, Salmonella enterica serovar Kentucky has shown an increase in different parts of the world with the concurrent emergence of multidrug-resistant isolates. These drug-resistant types spread from Africa and the Middle East to Europe and Asia. Although S. Kentucky serovar is of potential human relevance, there is currently no standardized fingerprinting method for it, in Tunisia. In the present study, a collection of 57 Salmonella Kentucky isolates were analyzed using plasmid profiling, pulsed-field gel electrophoresis (PFGE), ribotyping, enterobacterial repetitive intergenic consensus (ERIC) fingerprinting, and Random Amplification of Polymorphic DNA. Plasmid profiling showed a discriminatory index (D) of 0.290, and only 9 out of 57 (16%) isolates carried plasmids, which represents a limitation of this technique. Fingerprinting of genomic DNA by PFGE and ribotyping produced 4 and 5 patterns, respectively. Distinct PFGE patterns (SX1, SX2, SX3, and SX4) were generated for only 28 strains out of 57 (49.1%) with a D value of 0.647. RAPD fingerprinting with primers RAPD1 and RAPD2 produced 4 and 20 patterns, respectively. ERIC fingerprinting revealed 14 different patterns with a high discriminatory index (D) of 0.903. When the methods were combined, the best combination of two methods was ERIC-2 with RAPD2. These results indicates that a single method cannot be relied upon for discriminating between S. Kentucky strains, and a combination of typing methods such ERIC2 and RAPD2 allows further discrimination.

Management of microbial food safety in Arab countries

Microbial food safety remains a major economic and public health concern in Arab countries. Over the past several years, many of these countries have attempted to revise and upgrade food quality control and surveillance programs; however, these systems vary in scope and effectiveness. This review addresses the major reported foodborne outbreaks and multidrug resistance of pathogenic microorganisms isolated from food products. Major foodborne pathogens of concern included Brucella spp., Clostridium botulinum, fecal coliforms, Escherichia coli O157:H7, Listeria monocytogenes, Salmonella, and Staphylococcus aureus. Measures for managing microbial food hazards based on a comprehensive risk analysis also are proposed.

Prevalence and antimicrobial resistance of Salmonella isolated from meat and meat products in Algiers (Algeria)

This study was conducted in order to estimate the proportion of raw meat and processed meat products contaminated by Salmonella in the region of Algiers, Algeria, to identify serovars and to determine the antimicrobial resistance patterns of isolates. Out of the total 314 samples (144 of raw red meat and meat products, 128 of raw poultry meat and poultry products, and 42 of processed meat products) collected from various retail outlets, 61 (19.43%) were tested positive for Salmonella. The most significant occurrences were recorded for the categories of red meat (23.61%, n=34) and poultry (17.97%, n=23). Among the 64 isolates recovered, 21 different serovars were identified and two strains were nontypable. The most prevalent serovars were Salmonella Anatum (14.6%, n=9), Salmonella Altona (12.50%, n=8), Salmonella Corvallis (7.81%, n=5), Salmonella Enteritidis (7.81%, n=5), and Salmonella Typhimurium (7.81%, n=5). Sixty-two Salmonella isolates were tested for their susceptibility to 32 selected antimicrobial agents. Fifty-six (90.32%) isolates were resistant to at least one antimicrobial, of which 20 (32.26%) showed multidrug resistance. Resistance to sulphonamides (87.10%, n=54) was the most common. Resistance rates were lower to nalidixic acid (16.13%, n=10), streptomycin (16.13%, n=10), and tetracycline (12.90%, n=8), while resistance to pefloxacin was estimated at 4.84% (n=3). Fourteen different resistance patterns were observed. The "ACSSuT" pentaresistance pattern was observed in three of the Salmonella Typhimurium strains. The obtained results show that these foodstuffs are a potential source of antimicrobial-resistant Salmonella for human infections.

Presence of Salmonella pathogenicity island 2 genes in seafood-associated Salmonella serovars and the role of the sseC gene in survival of Salmonella enterica serovar Weltevreden in epithelial cells

The type III secretion system encoded by the Salmonella pathogenicity island 2 (SPI-2) has a central role in the pathogenesis of systemic infections by Salmonella. Sixteen genes (ssaU, ssaB, ssaR, ssaQ, ssaO, ssaS, ssaP, ssaT, sscB, sseF, sseG, sseE, sseD, sseC, ssaD and sscA) of SPI-2 were targeted for PCR amplification in 57 seafood-associated serovars of Salmonella. The sseC gene of SPI-2 was found to be absent in two isolates of Salmonella enterica serovar Weltevreden, SW13 and SW39. Absence of sseC was confirmed by sequencing using flanking primers. SW13 had only 66 bp sequence of the sseC gene and SW39 had 58 bp sequence of this gene. A clinical isolate, S. Weltevreden – SW3, 10 : r : z6 – was used to construct a deletion mutant for the sseC gene. Significant reduction in the survival of SW3, 10 : r : z6 ΔsseC and natural mutants SW13 and SW39 in HeLa cells suggests that sseC has a crucial role in the intracellular survival of S. Weltevreden. Expression of sseC was upregulated during the intracellular phase of both S. enterica serovar Typhimurium and clinical isolate S. Weltevreden SW3, 10 : r : z6, suggesting a crucial role for this gene in the survival of S. Weltevreden inside host cells.

Water microbiology. Bacterial pathogens and water

Water is essential to life, but many people do not have access to clean and safe drinking water and many die of waterborne bacterial infections. In this review a general characterization of the most important bacterial diseases transmitted through water—cholera, typhoid fever and bacillary dysentery—is presented, focusing on the biology and ecology of the causal agents and on the diseases’ characteristics and their life cycles in the environment. The importance of pathogenic Escherichia coli strains and emerging pathogens in drinking water-transmitted diseases is also briefly discussed. Microbiological water analysis is mainly based on the concept of fecal indicator bacteria. The main bacteria present in human and animal feces (focusing on their behavior in their hosts and in the environment) and the most important fecal indicator bacteria are presented and discussed (focusing on the advantages and limitations of their use as markers). Important sources of bacterial fecal pollution of environmental waters are also briefly indicated. In the last topic it is discussed which indicators of fecal pollution should be used in current drinking water microbiological analysis. It was concluded that safe drinking water for all is one of the major challenges of the 21st century and that microbiological control of drinking water should be the norm everywhere. Routine basic microbiological analysis of drinking water should be carried out by assaying the presence of Escherichia coli by culture methods. Whenever financial resources are available, fecal coliform determinations should be complemented with the quantification of enterococci. More studies are needed in order to check if ammonia is reliable for a preliminary screening for emergency fecal pollution outbreaks. Financial resources should be devoted to a better understanding of the ecology and behavior of human and animal fecal bacteria in environmental waters.

Source attribution of food-borne zoonoses in New Zealand: a modified Hald model

A Bayesian approach was developed by Hald et al.((1)) to estimate the contribution of different food sources to the burden of human salmonellosis in Denmark. This article describes the development of several modifications that can be used to adapt the model to different countries and pathogens. Our modified Hald model has several advantages over the original approach, which include the introduction of uncertainty in the estimates of source prevalence and an improved strategy for identifiability. We have applied our modified model to the two major food-borne zoonoses in New Zealand, namely, campylobacteriosis and salmonellosis. Major challenges were the data quality for salmonellosis and the inclusion of environmental sources of campylobacteriosis. We conclude that by modifying the Hald model we have improved its identifiability, made it more applicable to countries with less intensive surveillance, and feasible for other pathogens, in particular with respect to the inclusion of nonfood sources. The wider application and better understanding of this approach is of particular importance due to the value of the model for decision making and risk management.

Food contamination with salmonella species in the Republic of Macedonia

OBJECTIVES

To evaluate contamination with Salmonella of food products from food markets in the Republic of Macedonia by assessment of the most frequently contaminated food products and the most frequently isolated serotypes of Salmonella.

METHODS

This is a retrospective study analyzing data from the national database for microbiological safety of food products for the period from 2003 to 2005 as well as a prospective study for 2006 and 2007. Isolation and identification of Salmonella spp. were performed in the Laboratory for Sanitary Microbiology of the Republic Institute for Health Protection in Skopje, Macedonia. All samples were tested using the horizontal method for detection of Salmonella spp., according to ISO 6579:2002. Two immunological methods were used: Singlepath and VIDAS Salmonella spp. in food.

RESULTS

Presence of Salmonella spp. was 0.04-0.06% during 2003-2005, 0.63% in 2006, and 0.39% in 2007. During the period 2003 to 2005, Salmonella spp. were most frequently isolated from meat and meat products (75%), followed by milk and dairy products. In 2006 and 2007, the most frequently contaminated food products were mechanically separated chicken meat (71% in 2006 and 75% in 2007). The most frequent serogroups of Salmonella spp. in 2006 were C(1) (47%), followed by B and D (17.6%), and F (11.7%). In 2007, the most frequent serogroups of Salmonella spp. were C(1) (50%), followed by D (20%), E(3) (15%), and B (10%).

CONCLUSIONS

We found an increasing trend in the contamination level of food products with Salmonella spp., especially in 2006 and 2007, in which the most frequently contaminated food products were mechanically separated chicken meat, milk, dairy products, and sweets, and the most frequently isolated serogroup was C(1).