Human migration is important in the international spread of exotic Salmonella serovars in animal and human populations

Salmonella bovismorbificans abscess masking a primary testicular tumour in the retroperitoneum - A case report

INTRODUCTION AND IMPORTANCE

Testicular tumours can present outside the testis in about 5 % of cases, including as a primary lesion within the retroperitoneal space. These arise insidiously and can be hard to detect. Salmonella is an uncommon cause of abscess formation and the subtype of bovismorbificans, arising from geckos, only scarcely reported to cause an abscess. We describe a case in line with SCARE Criteria where a retroperitoneal non-seminomatous germ cell tumour presented with a salmonella bovismorbificans abscess and subsequent bacteraemia.

CASE PRESENTATION

A 37 year old male presented unwell with fevers and right flank pain suggestive of pyelonephritis. He had a salmonella bacteraemia on initial blood cultures, subsequently isolated to be salmonella bovismorbificans, and a CT scan demonstrate a large 7.7 cm retroperitoneal mass with surrounding lymphadenopathy.

CLINICAL DISCUSSION

An initial attempt at tissue sampling failed as the lesion was filled with purulent material requiring a pig tail drain to remain in place. He progressed slowly with resolution of fevers and bacteraemia however the lesion did not reduce in size despite adequate antibiotic treatment for two weeks. A repeat core biopsy and aspiration after 19 days revealed ongoing salmonella infection with a yolk sac tumour and seminoma. His AFP markers at this time were elevated at 3330kIU/L.

CONCLUSION

A underlying malignancy should be consider when a retroperitoneal abscess fails to resolve with adequate treatment especially when a organism unknown to cause abscess is isolated.

Genomic investigation of Salmonella enterica Serovar Welikade from a pediatric diarrhea case first time in Shanghai, China

BACKGROUND

Salmonella, an important foodborne pathogen, was estimated to be responsible for 95.1 million cases and 50,771 deaths worldwide. Sixteen serovars were responsible for approximately 80% of Salmonella infections in humans in China, and infections caused by a few uncommon serovars have been reported in recent years, though not with S. Welikade. This study reports the first clinical case caused by S. Welikade in China and places Chinese S. Welikade isolates in the context of global isolates via genomic analysis. For comparison, S. Welikade isolates were also screened in the Chinese Local Surveillance System for Salmonella (CLSSS). The minimum inhibitory concentrations (MICs) of 28 antimicrobial agents were determined using the broth microdilution method. The isolates were sequenced on an Illumina platform to identify antimicrobial resistance genes, virulence genes, and phylogenetic relationships.

RESULTS

The S. Welikade isolate (Sal097) was isolated from a two-year-old boy with acute gastroenteritis in 2021. Along with the other two isolates found in CLSSS, the three Chinese isolates were susceptible to all the examined antimicrobial agents, and their sequence types (STs) were ST5123 (n = 2) and ST3774 (n = 1). Single nucleotide polymorphism (SNP)-based phylogenetic analysis revealed that global S. Welikade strains can be divided into four groups, and these three Chinese isolates were assigned to B (n = 2; Sal097 and XXB1016) and C (n = 1; XXB700). In Group B, the two Chinese ST5123 isolates were closely clustered with three UK ST5123 isolates. In Group C, the Chinese isolate was closely related to the other 12 ST3774 isolates. The number of virulence genes in the S. Welikade isolates ranged from 59 to 152. The galF gene was only present in Group A, the pipB2 gene was only absent from Group A, the avrA gene was only absent from Group B, and the allB, sseK1, sspH2, STM0287, and tlde1 were found only within Group C and D isolates. There were 15 loci unique to the Sal097 isolate.

CONCLUSION

This study is the first to characterize and investigate clinical S. Welikade isolates in China. Responsible for a pediatric case of gastroenteritis in 2021, the clinical isolate harbored no antimicrobial resistance and belonged to phylogenetic Group B of global S. Welikade genomes.

Salmonella enterica subsp. enterica Welikade: guideline for phylogenetic analysis of serovars rarely involved in foodborne outbreaks

BACKGROUND

Salmonella spp. is a major foodborne pathogen with a wide variety of serovars associated with human cases and food sources. Nevertheless, in Europe a panel of ten serovars is responsible for up to 80% of confirmed human cases. Clustering studies by single nucleotide polymorphism (SNP) core-genome phylogenetic analysis of outbreaks due to these major serovars are simplified by the availability of many complete genomes in the free access databases. This is not the case for outbreaks due to less common serovars, such as Welikade, for which no reference genomes are available. In this study, we propose a method to solve this problem. We propose to perform a core genome MLST (cgMLST) analysis based on hierarchical clustering using the free-access EnteroBase to select the most suitable genome to use as a reference for SNP phylogenetic analysis. In this study, we applied this protocol to a retrospective analysis of a Salmonella enterica serovar Welikade (S. Welikade) foodborne outbreak that occurred in France in 2016. Finally, we compared the cgMLST and SNP analyses. SNP phylogenetic reconstruction was carried out considering the effect of recombination events identified by the ClonalFrameML tool. The accessory genome was also explored by phage content and virulome analyses.

RESULTS

Our findings revealed high clustering concordance using cgMLST and SNP analyses. Nevertheless, SNP analysis allowed for better assessment of the genetic distance among strains. The results revealed epidemic clones of S. Welikade circulating within the poultry and dairy sectors in France, responsible for sporadic and non-sporadic human cases between 2012 and 2019.

CONCLUSIONS

This study increases knowledge on this poorly described serovar and enriches public genome databases with 42 genomes from human and non-human S. Welikade strains, including the isolate collected in 1956 in Sri Lanka, which gave the name to this serovar. This is the first genomic analysis of an outbreak due to S. Welikade described to date.

Zoonoses and the Aboriginal and Torres Strait Islander population: A One Health scoping review

With limited access to animal health services, and high disease burdens among domesticated animals, Aboriginal and Torres Strait Islander communities in Australia face higher risk of disease including zoonoses. However, we lack understanding of the contribution of often preventable zoonoses to the health of these communities, which would enable us to enhance public health strategies and improve health outcomes. We conducted a scoping review to identify the current state of evidence on zoonoses in the Aboriginal and Torres Strait Islander population. We examined the size, scope and characteristics of the evidence base and analysed the zoonoses detected in the studies within a One Health framework. We identified 18 studies that detected 22 zoonotic pathogens in animals, people, and the environment, with most studies detecting pathogens in a single One Health sector and no studies investigating pathogens in all three sectors. Findings indicate that despite the strong conceptual foundations of One Health throughout the evidence base, evidence is lacking in application of this concept. There is a need to undertake further research that prioritises Aboriginal and Torres Strait Islander leadership, considers the contribution of human, animal and environmental health factors, and investigates the prevalence and impact of zoonoses in communities through a One Health approach.

Diversity of Salmonella serotypes from humans, food, domestic animals and wildlife in New South Wales, Australia

BACKGROUND

Salmonella is an important human pathogen in Australia and annual case rates continue to increase. In addition to foodborne exposures, cases have been associated with animal and contaminated environment contact. However, routine surveillance in Australia has tended to focus on humans and food, with no reported attempts to collate and compare Salmonella data from a wider range of potential sources of exposure.

METHODS

Salmonella data from humans, food, animals and environments were collated from a range of surveillance and diagnostic sources in New South Wales (NSW). Data were categorised to reflect one of 29 sample origins. Serotype diversity was described for each category, and the distribution of serotypes commonly isolated from humans was examined for each sample origin. The distribution of serotypes along the livestock-food-human continuum and at the companion animal-wildlife interface was also examined.

RESULTS

In total, 49,872 Salmonella isolates were included in this analysis, comprising 325 serotypes. The vast majority of these isolates were from humans (n = 38,106). Overall S. Typhimurium was the most frequently isolated serotype and was isolated from all sample categories except natural environment and game meat. S. Enteriditis was not isolated from any livestock animal, however sporadic cases were documented in food, companion animals and a reptile. Many serotypes that were frequently isolated from livestock animals and associated food products were only rarely isolated from humans. In addition, a number of key human serotypes were only sporadically isolated from livestock and food products, suggesting alternative sources of infection. In particular, S. Paratyphi B Java and S. Wangata were more often isolated from wild animals. Finally, there was some overlap between serotypes in companion animals and wildlife, with cats in particular having a large number of serotypes in common with wild birds.

CONCLUSIONS

This is the most comprehensive description of Salmonella data from humans, food, livestock, wildlife, companion animals and various environments in Australia reported to date. Results confirm that livestock and food are important sources of salmonellosis in humans but that alternative sources - such as contact with wildlife and environments - warrant further investigation. Surveillance in NSW is largely human-focussed: major knowledge gaps exist regarding the diversity and frequency of serotypes in animals. More systematic surveillance of domestic animals and wildlife is needed to inform targeted control strategies and quantitative source attribution modelling in this state.

Nontyphoidal Salmonella Gastroenteritis in Baoshan, Shanghai, China, 2010 to 2014: An Etiological Surveillance and Case-Control Study

Nontyphoidal Salmonella (NTS) gastroenteritis is a widespread global foodborne disease. To identify the epidemiologic characteristics, sources of food contamination, and risk factors of NTS gastroenteritis, epidemiologic data and stool specimens of diarrheal patients were collected from sentinel hospitals in Baoshan, Shanghai, People's Republic of China, between 2010 and 2014. Food products from nearby farmers' markets and animal feces from live poultry markets and livestock farms were sampled to identify the pathogen; a case-control study was conducted to characterize risk factors of NTS gastroenteritis. Of 3,906 diarrheal patients examined, 266 (6.8%) were positive for Salmonella. The positive rates were higher in summer than in the other seasons. Salmonella Typhimurium (36.1%) and Salmonella Enteritidis (30.8%) were the dominant serovars in the patients. Salmonella was detected in 26.2% pork samples, 7.1 to 7.8% poultry meats, and 3.3 to 8.9% poultry feces. Salmonella Typhimurium was the major serovar in contaminated food and animal feces. Multivariate conditional logistic regression analysis indicated that consumption of pork and quickly cooked eggs increased, whereas separating kitchen knives for cooked and raw food decreased the risk of NTS gastroenteritis, independently. We believe that NTS in poultry feces contaminated the meat products in the same markets and then infected humans if these foods were not sufficiently cooked. To prevent NTS gastroenteritis, it is necessary to survey Salmonella in meats and poultry feces, to cook eggs and pork sufficiently, to separate kitchen knives for cooked and raw food, and to prohibit live poultry trade in fresh meat markets.

The movement of humans and the spread of Salmonella into existing and pristine ecosystems

The spread of infectious diseases by the international and national movement of people, animals, insects and products has a documented history dating back several centuries1. The role of human movements has been fundamental to this, and has increased as global travel has risen in amount and speed. This has been exemplified by international epidemics of influenza, antimicrobial resistant bacteria, SARS coronavirus, dengue, chikungunya virus, Zika viruses and many others. Foodborne pathogens have also regularly come to our attention for their ability to move internationally, and outbreaks of salmonellosis due to importation of contaminated foods are well described2,3. An extensive collection of non-typhoidal Salmonella and related species isolated from human, food, animal and environmental sources has been accumulated within Western Australia (WA) since the mid-20th century, and has proven an important historical source of information about the role of humans in the dissemination of microorganisms across and within diverse ecosystems4–6. It is clear that the movement of microorganisms into and out of Australia is by no means a new phenomenon, and that humans have been important contributors to that spread. These are important markers of our impact on established and pristine ecosystems.