Epidemiologic typing of Salmonella enterica serotype enteritidis in a Canada-wide outbreak of gastroenteritis due to contaminated cheese

Identification of risk profiles for Salmonella prevalence in pig supply chains in South Korea using meta-analysis and a quantitative microbial risk assessment model

International travel and the globalization of food supplies have increased the risk of epidemic foodborne infections. Salmonella strains, particularly non-typhoidal Salmonella (NTS), are major zoonotic pathogens responsible for gastrointestinal diseases worldwide. In this study, the prevalence and Salmonella contamination in pigs/carcasses throughout the South Korean pig supply chain and the associated risk factors were evaluated using Systematic reviews and meta-analyses (SRMA), and quantitative microbial risk assessment (QMRA). The prevalence of Salmonella in finishing pigs, which is one of the major starting inputs of the QMRA model was calculated through SRMA of studies conducted in south Korea in order to complement and enhance the robustness of the model. Our findings revealed that the pooled Salmonella prevalence in pigs was 4.15% with a 95% confidence interval (CI) of 2.56 to 6.66%. Considering the pig supply chain, the highest prevalence was detected in slaughterhouses (6.27% [95% CI: 3.36; 11.37]), followed by farms (4.16% [95% CI: 2.32; 7.35]) and meat stores (1.21% [95% CI: 0.42; 3.46]). The QMRA model predicted a 3.9% likelihood of Salmonella-free carcasses and a 96.1% probability of Salmonella-positive carcasses at the end of slaughter, with an average Salmonella concentration of 6.38 log CFU/carcass (95% CI: 5.17; 7.28). This corresponds to an average contamination of 1.23 log CFU/g (95% CI: 0.37; 2.48) of pork meat. Across the pig supply chain, the highest Salmonella contamination was predicted after transport and lairage, with an average concentration of 8 log CFU/pig (95% CI: 7.15; 8.42). Sensitivity analysis indicated that Salmonella fecal shedding (r = 0.68) and Salmonella prevalence in finishing pigs (r = 0.39) at pre-harvest were the most significant factors associated with Salmonella contamination in pork carcasses. Although disinfection and sanitation interventions along the slaughter line can reduce contamination levels to some extent, effective measures should be taken to reduce Salmonella prevalence at the farm level to improve the safety of pork consumption.

Antimicrobial activity of ClO2 gas against Salmonella Enteritidis on almonds

Nuts, including almonds, are occasionally contaminated with Salmonella spp. In this study, we used chlorine dioxide (ClO₂) gas to inactivate S. enterica subsp. Enterica serovar Enteritidis on almonds. Almonds inoculated with a single strain of S. Enteritidis (8.95 log cfu/mL) were exposed to ClO₂ gas generated from 1.0 or 1.5 mL ClO₂ solution in a sealed container at 50 or 60 °C (43% relative humidity) for up to 10 h. The concentration of ClO₂ gas peaked at 354-510 and 750-786 ppm within 0.5 h upon deposition of 1.0 and 1.5 mL of aqueous ClO₂, respectively, and gradually decreased thereafter. Population of S. Enteritidis on almonds treated at 50 °C decreased to 1.70-2.32 log cfu/sample within 1 h of exposure to ClO₂ gas and decreased to below the detection limit (1.7 log cfu/sample) at all ClO₂ concentrations after 8 h. At 60 °C, the microbial population fell below the detection limit within 1 h, regardless of the volume of ClO₂ solution supplied. Microbial survival on almonds treated with ClO₂ gas and stored at 12 or 25 °C was observed for up to 8 weeks and the organism was not recovered from the almonds treated for 10 h and stored at 12 °C for 2-8 weeks. The lightness (L value) and redness (a value) of almonds treated for 10 h were not changed by ClO₂ gas treatment, but yellowness (b value) increased. Results showed that Salmonella on almonds was successfully inactivated by ClO₂ gas treatment and the microbial survival did not occur during storage.

Validation of a Simulated Commercial Frying Process to Control Salmonella in Donuts

This study validated a typical commercial donut frying process as an effective kill-step against a 7-serovar Salmonella cocktail (Newport, Typhimurium, Senftenberg, Tennessee, and three dry food isolates) when contamination was introduced through inoculated flour. The bread and pastry flour mix (3:1) was inoculated with the Salmonella cocktail, and subsequently dried back to original preinoculation moisture content, achieving a Salmonella population of 7.6 log CFU/g. Inoculated flour was used to prepare a typical commercial donut batter, which was fried using 375°F (190.6°C) oil temperature. No viable Salmonella was detected using an enrichment plating protocol in the donuts after 2 min of frying, resulting in >7-log reduction in Salmonella population. The internal donut temperature increased from ∼30°C to ∼119°C at the end of 2 min of frying. The water activities of the donut crumb and crust after 2 min of frying, followed by 30 min of ambient air cooling, were 0.944 and 0.852, respectively. The donut pH after ambient-air cooling was 5.51. The D- and z-values of the Salmonella cocktail in donut dough were determined using thermal-death-time disks and temperature-controlled water baths. The D-values of the cocktail were 8.6, 2.9, and 2.1 min at 55°C, 58°C, and 61°C, respectively, whereas the z-value was 10°C. This study validated that >7-log reduction could be achieved if donuts are fried for at least 2 min in the oil at 190.6°C, and calculated D- and z-values present the heat resistance of Salmonella in donut dough at the start of the frying processes. However, results from this study should not be extrapolated when donut composition and frying parameters are changed significantly.

Investigation of Salmonella Enteritidis outbreaks in South Africa using multi-locus variable-number tandem-repeats analysis, 2013-2015

BACKGROUND

Salmonella enterica serovar Enteritidis (Salmonella Enteritidis) has become a significant pathogen in South Africa, and the need for improved molecular surveillance of this pathogen has become important. Over the years, multi-locus variable-number tandem-repeats analysis (MLVA) has become a valuable molecular subtyping technique for Salmonella, particularly for highly homogenic serotypes such as Salmonella Enteritidis. This study describes the use of MLVA in the molecular epidemiological investigation of outbreak isolates in South Africa.

METHODS

Between the years 2013 and 2015, the Centre for Enteric Diseases (CED) received 39 Salmonella Enteritidis isolates from seven foodborne illness outbreaks, which occurred in six provinces. MLVA was performed on all isolates.

RESULTS

Three MLVA profiles (MLVA profiles 21, 22 and 28) were identified among the 39 isolates. MLVA profile 28 accounted for 77% (30/39) of the isolates. Isolates from a single outbreak were grouped into a single MLVA profile. A minimum spanning tree (MST) created from the MLVA data showed a close relationship between MLVA profiles 21, 22 and 28, with a single VNTR locus difference between them.

CONCLUSIONS

MLVA has proven to be a reliable method for the molecular epidemiological investigation of Salmonella Enteritidis outbreaks in South Africa. These foodborne outbreaks emphasize the importance of the One Health approach as an essential component for combating the spread of zoonotic pathogens such as Salmonella Enteritidis.

Validation of Baking To Control Salmonella Serovars in Hamburger Bun Manufacturing, and Evaluation of Enterococcus faecium ATCC 8459 and Saccharomyces cerevisiae as Nonpathogenic Surrogate Indicators

This study was conducted to validate a simulated commercial baking process for hamburger buns to destroy Salmonella serovars and to determine the appropriateness of using nonpathogenic surrogates (Enterococcus faecium ATCC 8459 or Saccharomyces cerevisiae) for in-plant process validation studies. Wheat flour was inoculated (∼6 log CFU/g) with three Salmonella serovars (Typhimurium, Newport, or Senftenberg 775W) or with E. faecium. Dough was formed, proofed, and baked to mimic commercial manufacturing conditions. Buns were baked for up to 13 min in a conventional oven (218.3°C), with internal crumb temperature increasing to ∼100°C during the first 8 min of baking and remaining at this temperature until removal from the oven. Salmonella and E. faecium populations were undetectable by enrichment (>6-log CFU/g reductions) after 9.0 and 11.5 min of baking, respectively, and ≥5-log-cycle reductions were achieved by 6.0 and 7.75 min, respectively. D-values of Salmonella (three-serovar cocktail) and E. faecium 8459 in dough were 28.64 and 133.33, 7.61 and 55.67, and 3.14 and 14.72 min at 55, 58, and 61°C, respectively, whereas D-values of S. cerevisiae were 18.73, 5.67, and 1.03 min at 52, 55, and 58°C, respectivly. The z-values of Salmonella, E. faecium, and S. cerevisiae were 6.58, 6.25, and 4.74°C, respectively. A high level of thermal lethality was observed for baking of typical hamburger bun dough, resulting in rapid elimination of high levels of the three-strain Salmonella cocktail; however, the lethality and microbial destruction kinetics should not be extrapolated to other bakery products without further research. E. faecium demonstrated greater thermal resistance compared with Salmonella during bun baking and could serve as a conservative surrogate to validate thermal process lethality in commercial bun baking operations. Low thermal tolerance of S. cerevisiae relative to Salmonella serovars limits its usefulness as a surrogate for process validations.

Identification of the risk factors associated with cheese production to implement the hazard analysis and critical control points (HACCP) system on cheese farms

The purpose of this paper was to evaluate, by statistical analyses, risk factors on cheese farms that can influence the microbial contamination of their products. Various assessment tools, such as cheese production questionnaires, food handlers' knowledge testing, and hygiene assessment system surveys, were used on 39 cheese farms on the island of Gran Canaria, Spain. The microbiological status of 773 raw milk and cheese samples from the cheese farms was assessed by enumerating total viable counts and 4 pathogens: Escherichia coli, Staphylococcus aureus, Listeria monocytogenes, and Salmonella spp. The results revealed that the highest contamination by Staph. aureus (4.39%, >10(5)cfu/mL) was found in milk, and the highest contamination by E. coli (5.18%, >10(3) cfu/mL) was found in cheese. Very few samples (0.52%) were contaminated by L. monocytogenes or Salmonella spp. The factors associated with any tested microorganism were "handling," "knowledge," and "type of milk." Subsequently, multidimensional logistic analysis for contamination by E. coli showed an independent association for factors "cleaning and disinfection test" and "type of milk." The probability of total aerobic contamination of milk increased with lower hygiene assessment system survey scores. These results emphasize the need to apply and maintain good hygiene practices, and to study risk factors to prevent contamination and bacterial growth. Further research is required in other areas with different cheese farm types to reinforce the validity of these results.

Characterization of the Invasive, Multidrug Resistant Non-typhoidal Salmonella Strain D23580 in a Murine Model of Infection

A distinct pathovar of Salmonella enterica serovar Typhimurium, ST313, has emerged in sub-Saharan Africa as a major cause of fatal bacteremia in young children and HIV-infected adults. D23580, a multidrug resistant clinical isolate of ST313, was previously shown to have undergone genome reduction in a manner that resembles that of the more human-restricted pathogen, Salmonella enterica serovar Typhi. It has since been shown through tissue distribution studies that D23580 is able to establish an invasive infection in chickens. However, it remains unclear whether ST313 can cause lethal disease in a non-human host following a natural course of infection. Herein we report that D23580 causes lethal and invasive disease in a murine model of infection following peroral challenge. The LD₅₀ of D23580 in female BALB/c mice was 4.7 x 10⁵ CFU. Tissue distribution studies performed 3 and 5 days post-infection confirmed that D23580 was able to more rapidly colonize the spleen, mesenteric lymph nodes and gall bladder in mice when compared to the well-characterized S. Typhimurium strain SL1344. D23580 exhibited enhanced resistance to acid stress relative to SL1344, which may lend towards increased capability to survive passage through the gastrointestinal tract as well as during its intracellular lifecycle. Interestingly, D23580 also displayed higher swimming motility relative to SL1344, S. Typhi strain Ty2, and the ST313 strain A130. Biochemical tests revealed that D23580 shares many similar metabolic features with SL1344, with several notable differences in the Voges-Proskauer and catalase tests, as well alterations in melibiose, and inositol utilization. These results represent the first full duration infection study using an ST313 strain following the entire natural course of disease progression, and serve as a benchmark for ongoing and future studies into the pathogenesis of D23580.

A deadly form of non-typhoidal Salmonella has emerged as a major cause of invasive disease in sub-Saharan Africa. Initial genomic profiling of this novel Salmonella sequence type, ST313, indicated that although it is technically classified as S. Typhimurium (a serovar characterized by a broad host range), it may be evolving towards becoming a more human-specific, ‘typhoid-like’ pathogen. However, it was recently demonstrated that ST313 strains were indeed able to establish an invasive and damaging infection in chickens. Despite these important findings, it remains unclear whether ST313 is able to cause lethal disease in a non-human host, since no study has yet followed the entire natural course of disease progression. As such, there are no data available concerning the median lethal dose (LD₅₀) of any ST313 strain. This is an important metric, as the LD₅₀ value will serve as a benchmark for mechanistic studies focused on understanding the relationship between virulence and the phenotypic and molecular genetic attributes associated with ST313 infections. Here we report that D23580 causes lethal disease in BALB/c mice and determined the LD₅₀ following peroral challenge. Phenotypic characterization revealed distinct differences in tissue distribution, acid stress resistance, and biochemical utilization between D23580 and the ‘classic’ Typhimurium strain SL1344.

A systematic review characterizing on-farm sources of Campylobacter spp. for broiler chickens

Campylobacter and antimicrobial-resistant Campylobacter are frequently isolated from broiler chickens worldwide. In Canada, campylobacteriosis is the third leading cause of enteric disease and the regional emergence of ciprofloxacin-resistant Campylobacter in broiler chickens has raised a public health concern. This study aimed to identify, critically appraise, and synthesize literature on sources of Campylobacter in broilers at the farm level using systematic review methodology. Literature searches were conducted in January 2012 and included electronic searches in four bibliographic databases. Relevant studies in French or English (n = 95) conducted worldwide in any year and all study designs were included. Risk of Bias and GRADE criteria endorsed by the Cochrane collaboration was used to assess the internal validity of the study and overall confidence in the meta-analysis. The categories for on-farm sources were: broiler breeders/vertical transfer (number of studies = 32), animals (n = 57), humans (n = 26), environment (n = 54), and water (n = 63). Only three studies examined the antimicrobial resistance profiles of Campylobacter from these on-farm sources. Subgroups of data by source and outcome were analyzed using random effect meta-analysis. The highest risk for contaminating a new flock appears to be a contaminated barn environment due to insufficient cleaning and disinfection, insufficient downtime, and the presence of an adjacent broiler flock. Effective biosecurity enhancements from physical barriers to restricting human movement on the farm are recommended for consideration to enhance local on-farm food safety programs. Improved sampling procedures and standardized laboratory testing are needed for comparability across studies. Knowledge gaps that should be addressed include farm-level drug use and antimicrobial resistance information, further evaluation of the potential for vertical transfer, and improved genotyping methods to strengthen our understanding of Campylobacter epidemiology in broilers at the farm-level. This systematic review emphasizes the importance of improved industry-level and on-farm risk management strategies to reduce pre-harvest Campylobacter in broilers.

Comparing the behavior of multidrug-resistant and pansusceptible Salmonella during the production and aging of a Gouda cheese manufactured from raw milk

Outbreaks of salmonellosis have been linked to the consumption of cheese, and emerging multidrug-resistant (MDR) strains of Salmonella may be more virulent and more tolerant than less resistant strains to stresses encountered in food production, which may enhance the survival of these resistant strains in cheese. This study was conducted to compare the behavior of MDR and pansusceptible Salmonella strains during the manufacture and aging of Gouda cheese and compare pathogen recovery via several rapid and traditional methods. Cheeses were manufactured from raw milk inoculated with a six-strain cocktail of either MDR or susceptible Salmonella Newport and Salmonella Typhimurium at initial levels of <20 CFU/ml. Samples of milk, whey, curd, and finished cheese were analyzed using eight enrichment and detection protocols. Overall, changes in pathogen levels observed throughout manufacture and aging did not differ significantly between MDR and susceptible Salmonella strains. Salmonella counts increased significantly during manufacture to a mean of 734 CFU/g on day 1 followed by a significant decrease over 60 days of aging to <1 CFU/g. Although levels fell and stayed below the direct plating detection limit of $ 5 CFU/g after 54 days on average, viable cells remained detectable after enrichment for an average of 210 ± 40 days. The International Organization for Standardization methods with and without PCR detection provided the most accurate results, and the remaining methods, notably those with selective primary incubation, produced results that disagreed significantly with the true result. Overall, our findings suggest that MDR Salmonella strains may not pose a greater threat to cheese safety than do non-MDR Salmonella strains.

Genetic diversity and evolution of Salmonella enterica serovar Enteritidis strains with different phage types

Phage typing has been used for the epidemiological surveillance of Salmonella enterica serovar Enteritidis for over 2 decades. However, knowledge of the genetic and evolutionary relationships between phage types is very limited, making differences difficult to interpret. Here, single nucleotide polymorphisms (SNPs) identified from whole-genome comparisons were used to determine the relationships between some S. Enteritidis phage types (PTs) commonly associated with food-borne outbreaks in the United States. Emphasis was placed on the predominant phage types PT8, PT13a, and PT13 in North America. With >89,400 bp surveyed across 98 S. Enteritidis isolates representing 14 distinct phage types, 55 informative SNPs were discovered within 23 chromosomally anchored loci. To maximize the discriminatory and evolutionary partitioning of these highly homogeneous strains, sequences comprising informative SNPs were concatenated into a single combined data matrix and subjected to phylogenetic analysis. The resultant phylogeny allocated most S. Enteritidis isolates into two distinct clades (clades I and II) and four subclades. Synapomorphic (shared and derived) sets of SNPs capable of distinguishing individual clades/subclades were identified. However, individual phage types appeared to be evolutionarily disjunct when mapped to this phylogeny, suggesting that phage typing may not be valid for making phylogenetic inferences. Furthermore, the set of SNPs identified here represents useful genetic markers for strain differentiation of more clonal S. Enteritidis strains and provides core genotypic markers for future development of a SNP typing scheme with S. Enteritidis.

Use of bacteriophage for biological control of Salmonella Enteritidis infection in chicken

Bacteriophage ΦCJ07 with broad host ranges for Salmonella strains isolated from sewage effluent were used to reduce Salmonella Enteritidis (SE) infection in chickens. One-day-old chicks challenged with 5×10(7) colony-forming units/bird of SE were cohabitated with contact chicks and treated with three concentrations (10(5), 10(7) and 10(9) plaque forming units (PFU)/g) of bacteriophage prepared as a feed additive for 21days after challenge. Salmonella in the intestine was quantified and environmental contamination level was examined at 1, 2 and 3weeks after challenge. All treatments reduced intestinal SE colonization in challenged and contact chickens and reduced the environmental contamination level, but the reductions produced by 10(7) and 10(9)PFU/g of bacteriophage were significant (P<0.05) as compared with untreated controls. In addition, seven out of 10 (70%) contact chickens treated with 10(9)PFU/g of bacteriophage had no detectable intestinal Salmonella at 3weeks after treatment, suggesting that bacteriophage therapy significantly prevented the horizontal transmission of SE. These results provide important insights into preventive and control strategies against SE infection in poultry and indicate that the use of bacteriophage could reduce the incidence of Salmonella food poisoning.

Large outbreak ofSalmonellaEnteritidis PT8 in Portsmouth, UK, associated with a restaurant

Seventy-five individuals withSalmonellainfection were identified in the Portsmouth area during August and September 2009, predominantlySalmonellaEnteritidis phage type 8. Five patients were admitted to hospital. A case-case comparison study showed that a local restaurant was the most likely source of the infection with a risk of illness among its customers 25-fold higher than that of those who did not attend the restaurant. A case-control study conducted to investigate specific risk factors for infection at the restaurant showed that eating salad was associated with a threefold increase in probability of illness. Changing from using ready washed lettuces to lettuces requiring washing and not adhering strictly to the 48 hours exclusion policy for food handlers with diarrhoea were likely to have contributed to the initiation and propagation of this outbreak. Possibilities for cross-contamination and environmental contamination were identified in the restaurant.

Comparison of molecular typing methods for the differentiation of Salmonella foodborne pathogens

Bacteria belonging to the genus Salmonella are among the leading causes of foodborne disease of bacterial etiology. These bacteria are also widely disseminated throughout the animal kingdom. The ability to identify the food source from which a human pathogen originated would be of great value in reducing the incidence of foodborne disease and the extent of disease outbreaks due to Salmonella. To date, efforts to identify the origin of these pathogens have centered on phenotypic and genotypic characterization of Salmonella isolates. This review focuses molecular or genotypic techniques that are currently being used for typing, and examines their strengths and weaknesses for determining the source of Salmonella foodborne infections.

Characteristics of non-typhoidal Salmonella isolates from human and broiler-chickens in southwestern Seoul, Korea

Non-typhoidal Salmonella (NTS) is an important commensal microorganism. The purpose of this study was to determine the epidemiological relation between NTS isolates from livestock and NTS isolates from human by analyzing antimicrobial susceptibilities and performing molecular typing. We determined the serotypes of 36 human clinical isolates and 64 livestock isolates, performed antimicrobial susceptibility testing against 8 antibiotics, and determined the molecular types of isolated NTS spp. by pulsed field gel electrophoresis (PFGE). In human isolates, S. enteritidis was the most common serotype (17 isolates; 47.2%) and S. typhimurium the second most (8 isolates; 22.2%). In livestock isolates, S. typhimurium was the most common serotype (15 isolates; 23.44%), and S. enteritidis was the second most (14 isolates; 21.88%). Ampicillin and tetracycline resistance were 50% (32/64 isolates) each among broiler-chicken NTS isolates. No human or livestock NTS isolates showed resistance to ciprofloxacin, TMP-SMX, or ceftriaxone. However, 19.4% (7/36) and 46.8% (30/64) of the human and livestock NTS isolates were resistant to nalidixic acid (MIC > or = 16 mg/mL), respectively. The presence of the three identical PFGE molecular types from human and broiler-chicken NTS isolates suggests the possibility of transmission from livestock to humans.

Limited genetic diversity in Salmonella enterica serovar Enteritidis PT13

Background

Salmonella enterica serovar Enteritidis has emerged as a significant foodborne pathogen throughout the world and is commonly characterized by phage typing. In Canada phage types (PT) 4, 8 and 13 predominate and in 2005 a large foodborne PT13 outbreak occurred in the province of Ontario. The ability to link strains during this outbreak was difficult due to the apparent clonality of PT13 isolates in Canada, as there was a single dominant pulsed-field gel electrophoresis (PFGE) profile amongst epidemiologically linked human and food isolates as well as concurrent sporadic strains. The aim of this study was to perform comparative genomic hybridization (CGH), DNA sequence-based typing (SBT) genomic analyses, plasmid analyses, and automated repetitive sequence-based PCR (rep-PCR) to identify epidemiologically significant traits capable of subtyping S. Enteritidis PT13.

Results

CGH using an oligonucleotide array based upon chromosomal coding sequences of S. enterica serovar Typhimurium strain LT2 and the Salmonella genomic island 1 successfully determined major genetic differences between S. Typhimurium and S. Enteritidis PT13, but no significant strain-to-strain differences were observed between S. Enteritidis PT13 isolates. Individual loci (safA and fliC) that were identified as potentially divergent in the CGH data set were sequenced in a panel of S. Enteritidis strains, and no differences were detected between the PT13 strains. Additional sequence-based typing was performed at the fimA, mdh, manB, cyaA, citT, caiC, dmsA, ratA and STM0660 loci. Similarly, no diversity was observed amongst PT13 strains. Variation in plasmid content between PT13 strains was observed, but macrorestriction with BglII did not identify further differences. Automated rep-PCR patterns were variable between serovars, but S. Enteritidis PT13 strains could not be differentiated.

Conclusion

None of the methods identified any significant variation between PT13 strains. Greater than 11,300 base pairs of sequence for each of seven S. Enteritidis PT13 strains were analyzed without detecting a single polymorphic site, although diversity between different phage types of S. Enteritidis was observed. These data suggest that Canadian S. Enteritidis PT13 strains are highly related genetically.

Microbiological characterization of randomly selected Portuguese raw milk cheeses with reference to food safety

Seventy raw milk cheeses made in different regions of Portugal, both hard and soft varieties, made with cow's, ewe's, or goat's milk or combinations of these, were sampled within their quoted shelf lives for microbiological safety. On the basis of the presence or numbers of Escherichia coli, E. coli O157, Staphylococcus aureus, Salmonella, and Listeria monocytogenes, cheeses were categorized as satisfactory, acceptable, unsatisfactory, or unacceptable and potentially hazardous. Twenty-two of the 70 cheeses were classified as satisfactory or acceptable. Thirty-seven of the cheeses were considered unsatisfactory because of the presence of E. coli, S. aureus, or both, while 11 of the cheeses were graded as unacceptable and potentially hazardous because of the presence of excessive numbers of S. aureus, E. coli, or L. monocytogenes and the presence of Salmonella in three of these. All cheeses graded as unacceptable and potentially hazardous were soft or semisoft cheeses made with ewe's and goat's milk, with the exception of two hard cheeses made with cow's milk. E. coli O157 was not detected in any of the cheeses. According to the present results, it seems that the presence or counts of pathogenic or indicator organisms in raw milk cheeses cannot be related to the processing conditions, milk type, or region of production.

Response of Two Salmonella enterica Strains Inoculated in Model Cheese Treated with High Hydrostatic Pressure

The aim of this work was to determine the response to high hydrostatic pressure and the ability for survival, recovery, and growth of 2 strains of Salmonella enterica (Salmonella enteritidis and Salmonella typhimurium) inoculated in a washed-curd model cheese produced with and without starter culture. Inoculated samples were treated at 300 and 400 MPa for 10 min at room temperature and analyzed after treatment and after 1, 7, and 15 d of storage at 12 degrees C to study the behavior of the Salmonella population. Cheese samples produced with starter culture and treated at 300 and 400 MPa showed maximum lethality; no significant differences in the baroresistant behavior of both strains were detected. Nevertheless, when starter culture was not present, the maximum lethality was only observed in cheese samples treated at 400 MPa, in the case of S. enteritidis. Ability to repair and grow was not observed in model cheese produced with starter culture and cell counts of treated samples decreased after 15 d of storage at 12 degrees C. In cheese produced without starter culture, Salmonella cells showed the ability to repair and grow during the storage period, reaching counts over 3 log(10) (cfu/mL) in both applied treatments and serotypes. These results suggest that high hydrostatic pressure treatments are effective to reduce Salmonella population in this type of cheese, but the presence of the starter culture affects the ability of this microorganism to repair and grow during the storage period.

Comparison of DNA fingerprinting methods for use in investigation of type E botulism outbreaks in the Canadian Arctic

Pulsed-field gel electrophoresis (PFGE), randomly amplified polymorphic DNA (RAPD) analysis, and automated ribotyping were compared for epidemiological typing of Clostridium botulinum type E using clinical and food isolates associated with four botulism outbreaks occurring in the Canadian Arctic. All type E strains previously untypeable by PFGE, even with the use of a formaldehyde fixation step, could be typed by the addition of 50 microM thiourea to the electrophoresis running buffer. Digestion with SmaI or XhoI followed by PFGE was used to link food and clinical isolates from four different type E botulism outbreaks and differentiate them from among 39 group II strains. Strain differentiation was unsuccessful with the automated ribotyping system, producing a single characteristic EcoRI fingerprint common to all group II strains. RAPD analysis of C. botulinum group II strains was not consistently reproducible with primer OPJ-6 or OPJ-13, apparently discriminating between epidemiologically related strains. A modified PFGE protocol was judged to be the most useful method for typing epidemiologically related C. botulinum type E strains, based on its ability to type all strains reproducibly and with an adequate level of discrimination.

Molecular analysis of Salmonella enteritidis and Typhimurium clinical and food isolates by pulsed-field gel electrophoresis in Bogotá, Colombia

In 1997, the Microbiology Group of the Colombian Instituto Nacional de Salud set up a surveillance program with the National Public Health Laboratories to monitor the principal etiological agents responsible for acute diarrheal disease. The main goal of this study was to determine the XbaI DNA digestion patterns of clinical and food Salmonella spp. isolates recovered in Bogotá from 1997 to 2002, and related them to the susceptibility patterns to antimicrobial agents. Two hundred and twenty-four Salmonella spp. isolates were studied, 153 (63%) S. Enteritidis and 71 (37%) S. Typhimurium. Pulsed-field gel electrophoresis (PFGE) was done using the XbaI restriction enzyme and Salmonella Braenderup H9812 as the molecular weight marker. For S. Enteritidis, pattern S. En0001 was found to be prevalent in 127 (83%) isolates, 78 (61%) susceptible to the antimicrobial agents tested. For S. Typhimurium, pattern S. Typ0001 was predominant in 18 (25%) isolates with different antimicrobial resistance profiles. Patterns S. En0001 and S. Typ0001 prevailed monthly during the 6 years of the study. Data collected demonstrate that there was a dominant pattern of S. Enteritidis and S. Typhimurium circulating in clinical and food isolates in Bogotá, Colombia.

Detection of virulence determinants in clinical strains of Salmonella enterica serovar Enteritidis and mapping on macrorestriction profiles

A total of 80 strains of Salmonella enterica serovar Enteritidis, causing gastroenteritis (G) or bacteraemia (B), and three control strains (C), were subjected to: (i) detection of 14 chromosomally and 1 plasmid-located virulence genes by PCR, (ii) detection of DNA polymorphisms by XbaI and BlnI PFGE, and cluster analysis, (iii) mapping of the 15 screened sequences on macrorestriction profiles and (iv) comparison of the screening and mapping results with data available for other Salmonella strains. Identical virulence genotypes and very similar macrorestriction profiles were shown by most S. Enteritidis strains. However, a number of B strains belonged to genomic types with polymorphisms affecting fragments carrying (SPI2-slyA), (SPI2-slyA-phoP/Q-agfA), (SPI4 and/or stn) and spvC. The information obtained provides the basis for further studies on the genetic background of virulence and the molecular epidemiology of S. Enteritidis.

Reduction of Salmonella enterica serovar enteritidis on the surface of raw shelled almonds by exposure to steam

This study was conducted to investigate the effect of steam treatment on the reduction of Salmonella enterica serovar Enteritidis on the surface of raw almonds. Two cultivars, 'Nonpareil' and 'Mission', were studied. Salmonella Enteritidis was inoculated on the surface of raw almonds, which were then treated with steam (93 degrees C +/- 1 degrees C) for 5, 15, 25, 35, 45, 55, and 65 s. After steam treatment, samples were plated on xylose lysine desoxycholate (XLD) and overlay (OV) XLD as a selective and nonselective agar for Salmonella, respectively, to investigate the extent of sublethal injury in Salmonella. Steam treatment of raw almonds effectively reduced Salmonella Enteritidis, and the effect was pronounced with increasing treatment time. After 65 s of steam treatment, reductions in Salmonella Enteritidis populations were 5.7 log and 5.8 log for 'Nonpareil' and 4.0 log and 4.1 log for 'Mission' when enumerated on XLD and OV XLD, respectively. There was no significant difference in population estimates determined with XLD and OV XLD over time (P > 0.05). The effect of the steam treatment was significantly different between two almond cultivars. Salmonella inoculated onto 'Mission' was more resistant to the steam treatment than that on 'Nonpareil', indicating that varietal differences must be considered in the application of steam for the disinfection of raw almonds. The present investigation revealed the potential usefulness of steam treatments for the control of pathogens in raw almonds.

Temporal clusters of Salmonella serovars in humans in Alberta, 1990-2001

BACKGROUND

Temporal clusters of salmonellosis are believed to occur but have not been quantitatively explored, thus, our objectives were to describe trends, seasonal patterns, and clusters of salmonellosis in humans in Alberta by examining isolates reported through passive surveillance systems.

METHODS

Cases of salmonellosis reported through Notifiable Disease Records between January 1990 and December 2001 were obtained from Alberta Health and Wellness. Least squares regression was used to characterize the distribution (long-term trends and seasonal patterns) of isolates. A cluster detection test was used to determine if and when isolates of specific serovars aggregated in time, over and above the background distribution. Comparisons were made to temporal patterns in Alberta livestock and to known outbreaks in humans.

RESULTS

S. Typhimurium, Enteritidis, Hadar, Heidelberg, and Thompson were the five most common serovars of the 9,188 isolates reported. The annual number of isolates was relatively stable over time, with a distinct summertime seasonal pattern. Clusters were observed in 23 of 32 serovars examined. More clusters occurred in September and October than in other months, and in 1998 through 2001 than in the early to mid-1990s. Also, more clusters were of short duration than long.

INTERPRETATION

Short-duration clusters likely indicate a point source of infection, while long-duration clusters may indicate exposure to a persistent common source or the occurrence of secondary infections. A sharp increasing trend and a large cluster of S. Heidelberg may have public health implications. Surveillance activities focussed on similarities between common serovars, trends, and temporal clusters in humans and animals, and studies on factors associated with autumn clusters may be useful in preventing outbreaks in humans.

Temporal clusters of Salmonella serovars in humans in Alberta, 1990-2001

BACKGROUND

Temporal clusters of salmonellosis are believed to occur but have not been quantitatively explored, thus, our objectives were to describe trends, seasonal patterns, and clusters of salmonellosis in humans in Alberta by examining isolates reported through passive surveillance systems.

METHODS

Cases of salmonellosis reported through Notifiable Disease Records between January 1990 and December 2001 were obtained from Alberta Health and Wellness. Least squares regression was used to characterize the distribution (long-term trends and seasonal patterns) of isolates. A cluster detection test was used to determine if and when isolates of specific serovars aggregated in time, over and above the background distribution. Comparisons were made to temporal patterns in Alberta livestock and to known outbreaks in humans.

RESULTS

S. Typhimurium, Enteritidis, Hadar, Heidelberg, and Thompson were the five most common serovars of the 9,188 isolates reported. The annual number of isolates was relatively stable over time, with a distinct summertime seasonal pattern. Clusters were observed in 23 of 32 serovars examined. More clusters occurred in September and October than in other months, and in 1998 through 2001 than in the early to mid-1990s. Also, more clusters were of short duration than long.

INTERPRETATION

Short-duration clusters likely indicate a point source of infection, while long-duration clusters may indicate exposure to a persistent common source or the occurrence of secondary infections. A sharp increasing trend and a large cluster of S. Heidelberg may have public health implications. Surveillance activities focussed on similarities between common serovars, trends, and temporal clusters in humans and animals, and studies on factors associated with autumn clusters may be useful in preventing outbreaks in humans.

An international outbreak of salmonellosis associated with raw almonds contaminated with a rare phage type of Salmonella enteritidis

During the winter of 2000 to 2001, an outbreak due to Salmonella Enteritidis (SE) phage type 30 (PT30), a rare strain, was detected in Canada. The ensuing investigation involved Canadian and American public health and food regulatory agencies and an academic research laboratory. Enhanced laboratory surveillance, including phage typing and pulsed-field gel electrophoresis, was used to identify cases. Case questionnaires were administered to collect information about food and environmental exposures. A case-control study with 16 matched case-control pairs was conducted to test the hypothesis of an association between raw whole almond consumption and infection. Almond samples were collected from case homes, retail outlets, and the implicated processor, and environmental samples were collected from processing equipment and associated farms for microbiological testing. One hundred sixty-eight laboratory-confirmed cases of SE PT30 infection (157 in Canada, 11 in the United States) were identified between October 2000 and July 2001. The case-control study identified raw whole almonds as the source of infection (odds ration, 21.1; 95% confidence interval, 3.6 to infinity). SE PT30 was detected in raw whole natural almonds collected from home, retail, distribution, and warehouse sources and from environmental swabs of processing equipment and associated farmers' orchards. The frequent and prolonged recovery of this specific organism from a large agricultural area was an unexpected finding and may indicate significant diffuse contamination on these farms. Identification of almonds as the source of a foodborne outbreak is a previously undocumented finding, leading to a North American recall of this product and a review of current industry practices.

Evaluation of an automated immunomagnetic separation method for the rapid detection of Salmonella species in poultry environmental samples

Automated immunomagnetic separation (AIMS), using Dynabeads anti-Salmonella (Dynal, Oslo), was evaluated for its ability to detect Salmonella spp. in poultry environmental samples in comparison with standard, culture-based method (Health Canada, Health Protection Branch, MFHPB-20). AIMS was found to be more reliable in detecting Salmonella from artificially inoculated enrichment broths at low levels and exhibited a 15.5% higher sensitivity value than the culture method.

An insidious nosocomial outbreak due to Salmonella enteritidis

OBJECTIVES

To investigate an increase in the number of Salmonella enteritidis isolates detected in a large hospital to ascertain whether it was due to a nosocomial source, to identify the mechanisms of transmission, and to institute effective control measures to prevent future episodes.

DESIGN

Observational study, survey of all microbiological samples positive for S. enteritidis detected in the hospital, outbreak investigation, and review of the literature.

SETTING

A tertiary-care teaching hospital for adults in Barcelona, Spain.

RESULTS

During a 7-month period from May to November 1998, we identified 22 inpatients with S. enteritidis infection for whom nosocomial acquisition was strongly suspected. The attack rate was 0.138 per 1,000 patient-days. All affected patients were immunosuppressed and overall mortality was 41% (9 of 22). A sample of a meal cooked in the kitchen was culture positive for S. enteritidis. All isolates shared the same antibiotic susceptibility pattern and all except one shared the same pulsed-field gel electrophoresis (PFGE) pattern, but PFGE could not differentiate between outbreak-related and control strains. After compliance with kitchen hygiene procedures was emphasized and cleansing was intensified, no more cases were detected.

CONCLUSIONS

Apparently, sporadic cases of S. enteritidis may be part of an outbreak with a low attack rate. A small but persistent inoculum affecting only individuals with special predisposition for Salmonella infection might account for this. Suspicion should be raised in hospitals and institutions with a highly susceptible population.

Shelf Life and Safety Concerns of Bakery Products—A Review

Bakery products are an important part of a balanced diet and, today, a wide variety of such products can be found on supermarket shelves. This includes unsweetened goods (bread, rolls, buns, crumpets, muffins and bagels), sweet goods (pancakes, doughnuts, waffles and cookies) and filled goods (fruit and meat pies, sausage rolls, pastries, sandwiches, cream cakes, pizza and quiche). However, bakery products, like many processed foods, are subject to physical, chemical and microbiological spoilage. While physical and chemical spoilage limits the shelf life of low and intermediate moisture bakery products, microbiological spoilage by bacteria, yeast and molds is the concern in high moisture products i.e., products with a water activity (a(w)) > 0.85. Furthermore, several bakery products also have been implicated infoodborne illnesses involving Salmonella spp., Listeria monoctyogenes and Bacillus cereus, while Clostridium botulinum is a concern in high moisture bakery products packaged under modified atmospheres. This extensive review is divided into two parts. Part I focuses on the spoilage concerns of low, intermediate and high moisture bakery products while Part II focuses on the safety concerns of high moisture bakery products only. In both parts, traditional and novel methods of food preservation that can be used by the bakery industry to extend the shelf life and enhance the safety of products are discussed in detail.

Genetic diversity of human isolates of Salmonella enterica serovar Enteritidis in Malaysia

AIMS

The study was undertaken to determine clonal relationship and genetic diversity of the human strains of Salmonella enterica serovar Enteritidis isolated from 1995 to 2002 from different parts of Malaysia.

METHODS AND RESULTS

Antimicrobial susceptibility test, plasmid profiling and pulsed-field gel electrophoresis were applied to analyse 65 human isolates of S. Enteritidis obtained over an eight year period from different parts of Malaysia. Four nonhuman isolates were included for comparison. A total of 14 distinct XbaI-pulsed-field profiles (PFPs) were observed, although a single PFP X1 was predominant and this particular clone was found to be endemic in Malaysia. The incidence of drug resistant S. Enteritidis remained relatively low with only 37% of the strains analysed being resistant to one or more antimicrobial agents. All except one resistant strain carried at least one plasmid ranging in size from 3.7 to 62 MDa giving nine plasmid profiles. The three isolates from raw milk and one from well-water had similar PFPs to that of the human isolates.

CONCLUSIONS

Salmonella Enteritidis strains were more diverse than was previously thought. Fourteen subtypes were noted although one predominant clone persisted in Malaysia. The combination of pulsed-field gel electrophoresis, plasmid profiling and antibiograms provided additional discrimination to the highly clonal strains of S. Enteritidis.

SIGNIFICANCE AND IMPACT OF THE STUDY

This is the first report to assess the genotypes of the predominant clinical S. Enteritidis in different parts of the country. As S. Enteritidis is highly endemic in Malaysia, the data generated would be useful for tracing the source during outbreaks of gastroenteritis in the study area.

Molecular epidemiology in the public health and hospital environments

The increasing speed and ease of genomic sequencing coupled with available funding to sequence multiple, unrelated strains of the same species will lead inevitably to the identification of candidate genes that can be used as molecular typing tools (MLST, SLST, microarray approach). However, it is important to note that even the most sophisticated typing tool should never replace a full epidemiologic investigation in which all available information is taken into account. Nevertheless, the typing methods discussed in this article and those yet to be developed have significantly improved the quality of health care worldwide.

Phage-based typing scheme for Salmonella enterica serovar Heidelberg, a causative agent of food poisonings in Canada

Salmonella enterica serovar Heidelberg is perhaps the second most frequent Salmonella serovar isolated from humans and the most common isolated from animals in Canada. This pathogen has shown increasing resistance to antimicrobial agents and mimics the multidrug resistance observed in S. enterica serovar Typhimurium strain DT 104. However, unlike for serovar Typhimurium, a rapid and inexpensive subtyping method has not been available for large-scale surveillance efforts. We developed a phage typing scheme and subtyped 2,523 strains of serovar Heidelberg from outbreaks, sporadic infections, and environmental sources in Canada between January 1991 and December 2000. All strains were sensitive to one or more phages and could be subdivided into 49 phage types. A total of 196 isolates from 13 major outbreaks could be subtyped into six phage types, while 86 strains from family outbreaks were assigned to seven phage types. All strains were typeable, and epidemiologically related strains isolated from patients and implicated foods had identical phage types, antibiograms, and pulsed-field gel electrophoresis (PFGE) patterns. Combining PFGE with phage typing increased the discriminatory power of the analysis beyond that of either method alone. We concluded that this phage typing scheme, in conjunction with PFGE, enhances subtyping of serovar Heidelberg strains. Furthermore, this phage typing scheme is a rapid, economical, stable, and reliable epidemiologic tool for tracing the origin of food-borne disease and for the surveillance of sporadic infections.

Regional dissemination of Salmonella enterica serovar Enteritidis is season dependent

OBJECTIVE

To carry out epidemiological typing of clinical isolates of Salmonella enterica serovar Enteritidis by pulsed-field gel electrophoresis (PFGE), random amplified polymorphic DNA (RAPD) and analysis of their antibiotic resistance.

METHODS

Over a 12-month period, 44 Salmonella Enteritidis isolates, recovered from 40 patients admitted to the University Hospital Center of Amiens, France and from three outpatients, were characterized by the analysis of phenotypic and genotypic traits and clinical data from medical reports.

RESULTS

Forty nontyphoidal salmonellosis episodes were diagnosed in hospitalized patients (34 episodes of gastroenteritis, two episodes of bacteremia not affecting other organs, one episodes of bacteremia plus urinary infection, one episodes of bacteremia plus gastroenteritis, one episodes of chronic colitis plus gastroenteritis and one episode of peritonitis), and three carriers were observed in outpatients. By means of PFGE, RAPD and antibiotic susceptibility patterns 44 isolates were subdivided into 16 clonally related groups. Two of them were predominantly implicated in the course of these infections, being responsible for two successive waves of infection, while the others were encountered sporadically.

Subtyping of Salmonella enterica serotype enteritidis strains by manual and automated PstI-SphI ribotyping

Salmonella enterica subsp. enterica serotype Enteritidis is not readily subtyped beyond the level of phage type (PT). A recently developed method for ribotyping of this organism, which uses a mixture of PstI and SphI (PS) for restriction of DNA (PS ribotyping), has proved useful for further subtyping of a number of PTs of this organism, including PT 4. However, it has not been extensively tested with PT 8. In the present study the PS ribotyping method was used to investigate outbreaks of both S. enterica serotype Enteritidis PT 4 and PT 8 and provided subtyping data that were consistent with information obtained from epidemiologic investigations. The method proved to be more discriminatory than phage typing and pulsed-field gel electrophoresis (PFGE) combined and was useful for investigating a pseudo-outbreak involving isolates that had identical PTs and PFGE types but that could not be linked epidemiologically. Several PS ribotypes were found within the cluster of isolates indistinguishable by other subtyping methods, confirming the epidemiologic findings. Although the PS ribotyping method proved to have a superior discriminatory ability in resolving clusters, it did not have high enough throughput for use in outbreak investigations. This method has therefore been adapted for use in automated ribotyping with a RiboPrinter, and the results were compared with those obtained by manual ribotyping. Both methods produce equivalent results and are useful for obtaining epidemiologically relevant subtyping data for S. enterica serotype Enteritidis, including PT 8 strains not extensively tested previously.

Lack of clonal relationship between non-typhi Salmonella strain types from humans and those isolated from animals living in close contact

Antibiogram patterns and chromosomal DNA typing were used to compare 151 non-typhoidal Salmonella spp. (NTS) isolated from patients and 78 from animals, environmental or food specimens obtained within or near the homes of patients with invasive salmonellosis. The majority of NTS from humans (137; 90.7%) were Salmonella enterica serotype Typhimurium (S. Typhimurium) and S. Enteritidis. Chicken specimens and feeds produced (24; 52.2%) S. Enteritidis, while S. Agona was the predominant (20; 77%) serovar among pigs and dairy cows. The majority (97; 64.2%) of NTS from humans were multidrug resistant, while NTS from cows, pigs, beef carcass swabs and sewers were fully susceptible to all antibiotics tested. Pulsed-field gel electrophoresis patterns of XbaI-digested genomic DNA of NTS from the humans and the chickens were different. However, S. Enteritidis from chickens, and S. Braenderup and S. Agona from cows and pigs were clustered together in one group. There was no significant relatedness between NTS isolates from humans and those from animals, food or the environment in close contact to humans.