Association between wetland presence and incidence of Salmonella enterica serotype Javiana infections in selected US sites, 2005–2011

Geographical distribution and space-time clustering of human illnesses with major Salmonella serotypes in Florida, USA, 2017-2018

Nontyphoidal salmonellosis is the leading reported foodborne illness in Florida. Although the diversity of Salmonella serotypes circulating in Florida has been identified, the geographical characteristics of the major serotypes are poorly described. Here we examined the geospatial patterns of 803 whole-genome sequenced Salmonella isolates within seven major serotypes (Enteritidis, Newport, Javiana, Sandiego, Braenderup, Typhimurium and I 4,[5],12:i:-) with the metadata obtained from Florida Department of Health during 2017-2018. Geographically, the distribution of incidence rates varied distinctively between serotypes. Illnesses with Enteritidis and Newport serotypes were widespread in Florida. The incidence rate for Javiana was relatively higher in the north compared to the south. Typhimurium was concentrated in the northwest, while I 4,[5],12:i:-, the monophasic variant of Typhimurium was limited to the south. We also evaluated space-time clustering of isolates at the zip code level using scan statistic models. Space-time clusters were detected for each major serotype during 2017-2018. The multinomial scan statistic found the risk of illness with Javiana was higher in the north and southwest in the fall of 2017 compared to other major serotypes. This serotype-specific clustering analysis will assist in further unpacking the associations between distinct reservoirs and illnesses with major serotypes in Florida.

Climate change, extreme events, and increased risk of salmonellosis: foodborne diseases active surveillance network (FoodNet), 2004-2014

BACKGROUND

Infections with nontyphoidal Salmonella cause an estimated 19,336 hospitalizations each year in the United States. Sources of infection can vary by state and include animal and plant-based foods, as well as environmental reservoirs. Several studies have recognized the importance of increased ambient temperature and precipitation in the spread and persistence of Salmonella in soil and food. However, the impact of extreme weather events on Salmonella infection rates among the most prevalent serovars, has not been fully evaluated across distinct U.S. regions.

METHODS

To address this knowledge gap, we obtained Salmonella case data for S. Enteriditis, S. Typhimurium, S. Newport, and S. Javiana (2004-2014; n = 32,951) from the Foodborne Diseases Active Surveillance Network (FoodNet), and weather data from the National Climatic Data Center (1960-2014). Extreme heat and precipitation events for the study period (2004-2014) were identified using location and calendar day specific 95^th percentile thresholds derived using a 30-year baseline (1960-1989). Negative binomial generalized estimating equations were used to evaluate the association between exposure to extreme events and salmonellosis rates.

RESULTS

We observed that extreme heat exposure was associated with increased rates of infection with S. Newport in Maryland (Incidence Rate Ratio (IRR): 1.07, 95% Confidence Interval (CI): 1.01, 1.14), and Tennessee (IRR: 1.06, 95% CI: 1.04, 1.09), both FoodNet sites with high densities of animal feeding operations (e.g., broiler chickens and cattle). Extreme precipitation events were also associated with increased rates of S. Javiana infections, by 22% in Connecticut (IRR: 1.22, 95% CI: 1.10, 1.35) and by 5% in Georgia (IRR: 1.05, 95% CI: 1.01, 1.08), respectively. In addition, there was an 11% (IRR: 1.11, 95% CI: 1.04-1.18) increased rate of S. Newport infections in Maryland associated with extreme precipitation events.

CONCLUSIONS

Overall, our study suggests a stronger association between extreme precipitation events, compared to extreme heat, and salmonellosis across multiple U.S. regions. In addition, the rates of infection with Salmonella serovars that persist in environmental or plant-based reservoirs, such as S. Javiana and S. Newport, appear to be of particular significance regarding increased heat and rainfall events.

Increased Incidence of Antimicrobial-Resistant Nontyphoidal Salmonella Infections, United States, 2004-2016

Salmonella is a major cause of foodborne illness in the United States, and antimicrobial-resistant strains pose a serious threat to public health. We used Bayesian hierarchical models of culture-confirmed infections during 2004-2016 from 2 Centers for Disease Control and Prevention surveillance systems to estimate changes in the national incidence of resistant nontyphoidal Salmonella infections. Extrapolating to the United States population and accounting for unreported infections, we estimated a 40% increase in the annual incidence of infections with clinically important resistance (resistance to ampicillin or ceftriaxone or nonsusceptibility to ciprofloxacin) during 2015-2016 (≈222,000 infections) compared with 2004-2008 (≈159,000 infections). Changes in the incidence of resistance varied by serotype. Serotypes I 4,[5],12:i:- and Enteritidis were responsible for two thirds of the increased incidence of clinically important resistance during 2015-2016. Ciprofloxacin-nonsusceptible infections accounted for more than half of the increase. These estimates can help in setting targets and priorities for prevention.

Factors influencing the persistence of enteropathogenic bacteria in wetland habitats and implications for water quality

AIMS

To better understand the persistence dynamics of enteropathogenic bacteria in freshwater wetland habitats, we constructed lab-scale mesocosms planted with two different wetland plant species using a subsurface flow wetland design. Mesocosms were treated with either a high-quality or a poor-quality water source to examine the effects of water quality exposure and plant species on Escherichia coli, Salmonella spp. and Enterococcus spp. in the rhizoplane, rhizosphere and water of wetland habitats.

METHODS AND RESULTS

Quantities of study micro-organisms were detected using real-time PCR in wetland mesocosms. A combination of molecular and culture-based methods was also used to enumerate these organisms from surface water and plant material at high, medium and poor water quality sites in the field. We found that all three enteropathogenic micro-organisms were influenced by microhabitat type and plant species. Organisms differed with respect to their predominant microhabitat and the extent of persistence associated with wetland plant species in the mesocosm study. Of the monitored pathogens, only E. coli was influenced by both water quality treatment and plant species. Salmonella spp. quantities in the rhizoplane consistently increased in all treatments over the course of the mesocosm experiment.

CONCLUSIONS

Plant species selection appears to be an overlooked aspect of constructed wetland design with respect to the removal of enteropathogenic micro-organisms. Escherichia coli and Enterococcus concentrations in wetland outflow were significantly different between the two plant species tested, with Enterococcus concentrations being significantly higher in mesocosms planted with Phalaris arundinaceae and E. coli concentrations being higher in mesocosms planted with Veronica anagallis-aquatica. Furthermore, there is evidence that the rhizoplane is a significant reservoir for Salmonella spp. within wetland habitats.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first time that Salmonella spp. has been shown to proliferate under natural conditions within the rhizoplane. This will contribute to our understanding of wetland removal mechanisms for enteropathogenic bacteria. This study identifies the rhizoplane as a potentially important reservoir for human pathogenic micro-organisms and warrants additional study to establish whether this finding is applicable in non-wetland habitats.

Genomic characterization and phylogenetic analysis of Salmonella enterica serovar Javiana

Salmonella enterica serovar Javiana is the fourth most reported serovar of laboratory-confirmed human Salmonella infections in the U.S. and in Tennessee (TN). Although Salmonella ser. Javiana is a common cause of human infection, the majority of cases are sporadic in nature rather than outbreak-associated. To better understand Salmonella ser. Javiana microbial population structure in TN, we completed a phylogenetic analysis of 111 Salmonella ser. Javiana clinical isolates from TN collected from Jan. 2017 to Oct. 2018. We identified mobile genetic elements and genes known to confer antibiotic resistance present in the isolates, and performed a pan-genome-wide association study (pan-GWAS) to compare gene content between clades identified in this study. The population structure of TN Salmonella ser. Javiana clinical isolates consisted of three genetic clades: TN clade I (n = 54), TN clade II (n = 4), and TN clade III (n = 48). Using a 5, 10, and 25 hqSNP distance threshold for cluster identification, nine, 12, and 10 potential epidemiologically-relevant clusters were identified, respectively. The majority of genes that were found to be over-represented in specific clades were located in mobile genetic element (MGE) regions, including genes encoding integrases and phage structures (91.5%). Additionally, a large portion of the over-represented genes from TN clade II (44.9%) were located on an 87.5 kb plasmid containing genes encoding a toxin/antitoxin system (ccdAB). Additionally, we completed phylogenetic analyses of global Salmonella ser. Javiana datasets to gain a broader insight into the population structure of this serovar. We found that the global phylogeny consisted of three major clades (one of which all of the TN isolates belonged to) and two cgMLST eBurstGroups (ceBGs) and that the branch length between the two Salmonella ser. Javiana ceBGs (1,423 allelic differences) was comparable to those from other serovars that have been reported as polyphyletic (929–2,850 allelic differences). This study demonstrates the population structure of TN and global Salmonella ser. Javiana isolates, a clinically important Salmonella serovar and can provide guidance for phylogenetic cluster analyses for public health surveillance and response.

Multidrug-Resistant Salmonella enterica Isolated in Paca (Cuniculus paca) Carcasses from the Belen Market, Iquitos, Perú

The consumption of wildlife meat is traditionally accepted in the Peruvian Amazon; however, little is known about the pathogens present in this type of food. One of the most frequently consumed species is a rodent, the paca (Cuniculus paca) or "majaz" in the Peruvian language. The objective of this study was to determine the presence of Salmonella enterica and its antimicrobial resistance profile in paca carcasses sold in the Belen Market of Iquitos-Peru. An observational, descriptive, cross-sectional study was carried out. Fresh and smoked paca carcasses (72 samples) were evaluated during the low-rain period (July 2019) in the traditional market of Iquitos, in the Amazonian Region. Meat samples were swabbed, and International Standards Organization (ISO) 6579-1: 2017 protocol was followed to Salmonella isolation. Antimicrobial susceptibility analysis was performed by the disk diffusion method. In addition, serotyping was performed by using the Kauffmann-White scheme. A total of 25 strains of S. enterica were isolated in the paca carcasses, mainly in fresh carcasses (48.6%). The serovars isolated were Agona (45.8%), Infantis (41.7%), Wangata (8.3%), and Javiana (4.2%). A considerable number of the isolated strains were multidrug resistant (40%). The highest prevalence of resistance corresponded to trimethoprim-sulfamethoxazole (64%) followed by nitrofurantoin (44%), chloramphenicol (40%), cefotaxime (40%), and nalidixic acid (40%). Ten strains isolated (40%) were identified as producers of extended spectrum beta lactamases, all in S. enterica serovar Infantis. This study describes the presence of Salmonella Infantis with multidrug resistance profiles in wildlife meat carcasses, making the consumption of this type of products a risk factor for the development of foodborne diseases in the Amazon region. Institutional Review Board: Approval Resolution of Thesis Project: N° 024-DACMVZ-DAFCVB-U.CIENTÍFICA-2019.

SALMONELLA SPP. INFECTION IN PSITTACIDAE AT A WILDLIFE REHABILITATION CENTER IN THE STATE OF MATO GROSSO DO SUL, BRAZIL

The growing interest in wild birds as pets and the increasingly complex interspecific relationships due to human activities in wild environments underscore the need for better knowledge about the health of these animals. Salmonella stands out among the infectious agents of considerable importance to both animal and human health. The importance of these enterobacteria to the health of humans and livestock animals has long been known. In wild birds in countries such as Brazil, however, little is known regarding the frequency of infection and the main serotypes of occurrence. In the present study, the frequency of infection and the main serotypes of Salmonella spp. were investigated in 258 birds at a wild animal rehabilitation center using conventional microbiological methods and molecular diagnostic techniques. Four birds infected with Salmonella enterica were identified using PCR. The birds were of the species Brotogeris chiriri, Ara ararauna, and Eupsittula aurea. Sequencing of DNA revealed identity with the Javiana, Newport, and Arizonae serotypes. These results are of considerable importance to the implementation of management and control measures directed at human and animal health.

Precipitation and Salmonellosis Incidence in Georgia, USA: Interactions between Extreme Rainfall Events and Antecedent Rainfall Conditions

BACKGROUND

The southeastern United States consistently has high salmonellosis incidence, but disease drivers remain unknown. Salmonella is regularly detected in this region's natural environment, leading to numerous exposure opportunities. Rainfall patterns may impact the survival/transport of environmental Salmonella in ways that can affect disease transmission.

OBJECTIVES

This study investigated associations between short-term precipitation (extreme rainfall events) and longer-term precipitation (rainfall conditions antecedent to these extreme events) on salmonellosis counts in the state of Georgia in the United States.

METHODS

For the period 1997-2016, negative binomial models estimated associations between weekly county-level extreme rainfall events (≥90th percentile of daily rainfall) and antecedent conditions (8-week precipitation sums, categorized into tertiles) and weekly county-level salmonellosis counts.

RESULTS

In Georgia's Coastal Plain counties, extreme and antecedent rainfall were associated with significant differences in salmonellosis counts. In these counties, extreme rainfall was associated with a 5% increase in salmonellosis risk (95% CI: 1%, 10%) compared with weeks with no extreme rainfall. Antecedent dry periods were associated with a 9% risk decrease (95% CI: 5%, 12%), whereas wet periods were associated with a 5% increase (95% CI: 1%, 9%), compared with periods of moderate rainfall. In models considering the interaction between extreme and antecedent rainfall conditions, wet periods were associated with a 13% risk increase (95% CI: 6%, 19%), whereas wet periods followed by extreme events were associated with an 11% increase (95% CI: 5%, 18%). Associations were substantially magnified when analyses were restricted to cases attributed to serovars commonly isolated from wildlife/environment (e.g., Javiana). For example, wet periods followed by extreme rainfall were associated with a 34% risk increase (95% CI: 20%, 49%) in environmental serovar infection.

CONCLUSIONS

Given the associations of short-term extreme rainfall events and longer-term rainfall conditions on salmonellosis incidence, our findings suggest that avoiding contact with environmental reservoirs of Salmonella following heavy rainfall events, especially during the rainy season, may reduce the risk of salmonellosis. https://doi.org/10.1289/EHP4621.

Divergent geography of Salmonella Wangata and Salmonella Typhimurium epidemiology in New South Wales, Australia

Salmonella enterica serovar Wangata is an important cause of salmonellosis in the state of New South Wales, Australia. Standard surveillance has not identified a common food source and cases have been attributed to an unknown environmental or wildlife reservoir. Investigation of the spatial distribution of cases may provide valuable insights into local risk factors for infection and the potential role of the environment and wildlife.

Using conditional autoregressive analysis, we explored the association between laboratory-confirmed cases of S. Wangata reported to the New South Wales Department of Health and human socio-demographic, climate, land cover and wildlife features. For comparison, a model was also fitted to investigate the association of cases of Salmonella enterica serovar Typhimurium, an established foodborne serotype, with the same features. To determine if cases of S. Wangata were associated with potential wildlife reservoir species, additional variables were included in the S. Wangata model that indicated areas of high suitability for each species.

We found that cases of S. Wangata were associated with warmer temperatures, proximity to wetlands and amphibian species richness. In contrast, cases of S. Typhimurium were associated with human demographic features (proportion of the population comprising children <5 years old), climate (mean annual precipitation and mean annual temperature) and land cover (proportion comprising urban and evergreen broadleaf forest). These findings support the hypothesis that S. Wangata is likely to be associated with an environmental source. Whilst we expected S. Typhimurium to be associated with the human socio-demographic feature, the significance of the land cover features was surprising and might suggest the epidemiology of S. Typhimurium in Australia is more complex than currently understood.