Salmonella enterica serovar Agbeni, British Columbia, Canada, 2011

Vertebral Discitis in a Young Patient With No Comorbidities Caused by Salmonella enterica Serovar Agbeni Infection: A Case Report

Vertebral discitis is an infection of the vertebrae most commonly caused by Staphylococcus aureus (S. aureus) and usually presents in patients with preexisting medical conditions such as diabetes mellitus. This disease process involves the invasion of bacteria into the vertebral disc through one of three basic routes: hematogenous spread from a distant site, direct trauma due to iatrogenic causes, or due to a contiguous spread from adjacent soft tissue infection. Here, we present a 24-year-old Asian male with no past medical history or history of trauma who presented with nonspecific symptoms of fever and nasopharyngitis. The patient subsequently developed persistent thoracic back pain that failed multiple lines of treatment. Magnetic resonance imaging (MRI) of the spine showed vertebral discitis, and cultures confirmed Salmonella being the etiologic agent for his symptoms. Salmonella discitis is extremely rare, with only about 0.45% of these cases being reported in the literature. Even more uncommon is the isolation of Salmonella enterica serovar Agbeni in a young patient without comorbidities. This case report highlights the importance of including Salmonella as a possible causative agent in patients who present with signs and symptoms of vertebral discitis.

Exotic dried fruits caused Salmonella Agbeni outbreak with severe clinical presentation, Norway, December 2018 to March 2019

We describe an outbreak of Salmonella Agbeni sequence type (ST)2009 infections in Norway. Between 31 December 2018 and 16 March 2019, 56 cases (33 female and 23 male; median age: 50 years, range: 2-91) were reported, of which 21 were hospitalised. Cases were defined as people living in Norway, with laboratory-confirmed infection with S. Agbeni ST2009 and cluster type (CT)2489, reported between 31 December 2018 and 30 March 2019. We conducted a case-control study, with three controls per case (matched by age, sex and municipality), using the Norwegian National Registry. Cases were more likely to have consumed a commercial mix of dried exotic fruits than controls (cases = 8, controls = 31; odds ratio: 50; 95% confidence interval: 3-2,437). The outbreak strain was confirmed by whole genome sequencing (WGS) and was isolated from the fruit mix consumed by cases, resulting in withdrawal from the market on 6 March 2019.The fruit mix consisted of fruits from different countries and continents. It was packed in Italy and distributed to several European countries, including Norway. However, no other countries reported cases. This outbreak highlights that dried fruits could represent a risk in terms of food-borne infections, which is of particular concern in ready-to-eat products.