1
|
Rathnayake IU, Graham RMA, Bayliss J, Staples M, Micalizzi G, Ariotti L, Cover L, Heron B, Graham T, Stafford R, Rubenach S, D'Addona A, Jennison AV. Implementation of routine genomic surveillance provided insights into a locally acquired outbreak caused by a rare clade of Salmonella enterica serovar Enteritidis in Queensland, Australia. Microb Genom 2023; 9:mgen001059. [PMID: 37459172 PMCID: PMC10438802 DOI: 10.1099/mgen.0.001059] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/17/2023] [Accepted: 06/08/2023] [Indexed: 07/20/2023] Open
Abstract
Salmonellosis is a significant public health problem globally. In Australia, Salmonella enterica serovar Enteritidis is one of the main causes of salmonellosis. This study reports how the implementation of routine genetic surveillance of isolates from human S. Enteritidis cases enabled identification of the likely source of an outbreak that occurred in a remote town in Far North Queensland, Australia. This study included patient, food and water samples collected during an outbreak investigation. S. Enteritidis of the novel sequence type 5438 was isolated from all seven patient samples and one bore water sample but not any of the food samples. Both whole-genome single nucleotide polymorphism (SNP) and core-genome multilocus sequence typing analysis revealed that S. Enteritidis isolated from outbreak-related patient samples and the bore water isolates clustered together with fewer than five SNP differences and ten allelic differences. This genetic relatedness informed the outbreak response team around public health interventions and no further cases were identified post-treatment of the bore water. This disease cluster was identified through the routine sequencing of S. Enteritidis performed by the state public health laboratory in an actionable time frame. Additionally, genomic surveillance captured a case with unknown epidemiological links to the affected community, ruled out a simultaneous outbreak in an adjacent state as the source and provided evidence for the likely source preventing further transmission. Therefore, this report provides compelling support for the implementation of whole-genome sequencing based genotyping methods in public health microbiology laboratories for better outbreak detection and management.
Collapse
Affiliation(s)
- Irani U. Rathnayake
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Rikki M. A. Graham
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Jo Bayliss
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Megan Staples
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Gino Micalizzi
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Lawrence Ariotti
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Leonie Cover
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Brett Heron
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Trudy Graham
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| | - Russell Stafford
- OzFoodNet, Communicable Diseases Branch, Queensland Public Health and Scientific Services, Queensland Department of Health, Butterfield Street, Herston, Brisbane, Queensland, Australia
| | - Sally Rubenach
- Health Surveillance, Tropical Public Health Services Cairns, Cairns and Hinterland Hospital and Health Service, Queensland Department of Health, Cairns, Queensland, Australia
| | - Andrew D'Addona
- Environmental Health, Tropical Public Health Services Cairns, Cairns and Hinterland Hospital and Health Service, Queensland Department of Health, Cairns, Queensland, Australia
| | - Amy V. Jennison
- Public Health Microbiology, Forensic and Scientific Services, Queensland Department of Health, Coopers Plains, Queensland, Australia
| |
Collapse
|
2
|
Sielski Galvão Soares L, Casella T, Kawagoe EK, Benetti Filho V, Omori WP, Nogueira MCL, Wagner G, Rodrigues de Oliveira R, Stahlhofer SR, Antunes Ferreira F, Tondo EC, De Dea Lindner J. Phenotypic and genotypic characterization of antibiotic resistance of Salmonella Heidelberg in the south of Brazil. Int J Food Microbiol 2023; 391-393:110151. [PMID: 36871395 DOI: 10.1016/j.ijfoodmicro.2023.110151] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/13/2022] [Revised: 02/20/2023] [Accepted: 02/22/2023] [Indexed: 03/03/2023]
Abstract
Salmonella is the main human pathogen present in the poultry chain. Salmonella Heidelberg is one of the most important serovars for public health since it has been frequently isolated in broiler chickens from different countries and may present multidrug resistance (MDR). This study was carried out with 130 S. Heidelberg isolates collected from pre-slaughter broiler farms in 2019 and 2020 in 18 cities from three Brazilian states to study relevant aspects regarding their genotypic and phenotypic resistance. The isolates were tested and identified using somatic and flagellar antiserum (0:4, H:2, and H:r), and an antimicrobial susceptibility test (AST) was performed against 11 antibiotics for veterinary use. The strains were typed by Enterobacterial Repetitive Intergenic Consensus (ERIC)-PCR, and representatives of the main clusters of the identified profiles were sequenced by Whole Genome Sequencing (WGS). AST results showed that all isolates were resistant to sulfonamide, 54 % (70/130) were resistant to amoxicillin, and only one was sensitive to tetracycline. Twelve isolates (15.4 %) were MDR. The dendrogram obtained from the ERIC-PCR showed that the strains were grouped into 27 clusters with similarity above 90 %, with some isolates showing 100 % similarity but with different phenotypic profiles of antimicrobial resistance. Identical strains collected on the same farm on other dates were identified, indicating that they were residents. WGS identified 66 antibiotic-resistance genes. The sul2 (present in all sequenced samples) and tet(A) genes were highlighted and validated in the experimental analysis. The fosA7 gene was also identified in all sequenced samples, but resistance was not observed in the phenotypic test, possibly due to the heteroresistance of the S. Heidelberg strains evaluated. Considering that chicken meat is one of the most consumed meats in the world, the data obtained in the present study can corroborate the mapping of the origin and trends of antimicrobial resistance.
Collapse
Affiliation(s)
- Luana Sielski Galvão Soares
- Food Technology and Bioprocess Research Group, Department of Food Science and Technology, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil
| | - Tiago Casella
- Center for Microorganisms Investigation, São José Do Rio Preto Medical School (FAMERP), São José Do Rio Preto, SP, Brazil
| | - Eric Kazuo Kawagoe
- Laboratory of Bioinformatics, Department of Microbiology, Immunology and Parasitology, UFSC, Florianópolis, SC, Brazil
| | - Vilmar Benetti Filho
- Laboratory of Bioinformatics, Department of Microbiology, Immunology and Parasitology, UFSC, Florianópolis, SC, Brazil
| | | | - Mara Corrêa Lelles Nogueira
- Center for Microorganisms Investigation, São José Do Rio Preto Medical School (FAMERP), São José Do Rio Preto, SP, Brazil
| | - Glauber Wagner
- Laboratory of Bioinformatics, Department of Microbiology, Immunology and Parasitology, UFSC, Florianópolis, SC, Brazil
| | | | | | | | - Eduardo Cesar Tondo
- Laboratory of Food Microbiology and Food Control, Institute of Food Science and Food Technology of Federal University of Rio Grande do Sul (ICTA/UFRGS), Porto Alegre, RS, Brazil
| | - Juliano De Dea Lindner
- Food Technology and Bioprocess Research Group, Department of Food Science and Technology, Federal University of Santa Catarina (UFSC), Florianópolis, SC, Brazil.
| |
Collapse
|
3
|
İnce SS, Müştak HK. Genotyping and antimicrobial resistance profiles of chicken originated Salmonella Enteritidis isolates. Braz J Microbiol 2023; 54:499-507. [PMID: 36752945 PMCID: PMC9944479 DOI: 10.1007/s42770-023-00914-6] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/21/2022] [Accepted: 01/26/2023] [Indexed: 02/09/2023] Open
Abstract
Salmonellosis is a common foodborne zoonosis worldwide. The most common Salmonella serovar in humans is Salmonella enterica subsp. enterica serovar Enteritidis (50.3%) in the world. The main transmission route for S. Enteritidis is consumption of contaminated poultry products. Therefore, it is important to determine the diversity and spread of chicken-originated S. Enteritidis isolates in order to monitor and control salmonellosis. Pulsed-field gel electrophoresis (PFGE) and multiple locus variable number of tandem repeats analysis (MLVA) are frequently used for typing of S. Enteritidis isolates. This study aimed to determine the antimicrobial resistance (AMR) profiles and MLVA and PFGE genotypes of chicken-originated S. Enteritidis isolates. A total of 200 S. Enteritidis isolated from chicken broiler, layer, and breeder flocks from different locations in Turkey were investigated by Kirby-Bauer disk diffusion method, PFGE, and MLVA. The AMR test indicated that 57% of the S. Enteritidis isolates were susceptible to all antimicrobials, while 39% were resistant to at least one antimicrobial. The highest resistance (25%) was against ampicillin. Multi-drug resistance rate was low (21%) and mostly from broiler flocks (93%). All isolates were genotyped into 32 different PFGE genotypes (PT) and 34 different MLVA genotypes (MT). The dominant genotypes were PT6 (12.5%) and MT22 (50%). In specific sample groups, there was a correlation between genotypes, breeding type, geographic location, and isolation years of the isolates. There was no significant difference in the discrimination power of PFGE and MLVA. However, MLVA was more suitable for large sample groups and routine genotyping because it was easier, quicker, and less labor-intensive to use.
Collapse
Affiliation(s)
- Seyyide Sarıçam İnce
- Department of Microbiology, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey.
| | - Hamit Kaan Müştak
- Department of Microbiology, Faculty of Veterinary Medicine, Ankara University, Ankara, Turkey
| |
Collapse
|
4
|
Papić B, Kušar D, Mićunović J, Pirš M, Ocepek M, Avberšek J. Clonal Spread of pESI-Positive Multidrug-Resistant ST32 Salmonella enterica Serovar Infantis Isolates among Broilers and Humans in Slovenia. Microbiol Spectr 2022; 10:e0248122. [PMID: 36250854 PMCID: PMC9769575 DOI: 10.1128/spectrum.02481-22] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/01/2022] [Accepted: 09/28/2022] [Indexed: 01/06/2023] Open
Abstract
Salmonella enterica subsp. enterica serovar Infantis is the most prevalent serovar found in broilers and broiler meat and is among the top five serovars responsible for human infections in Europe. In 2008, a multidrug-resistant S. Infantis isolate emerged in Israel with a mosaic megaplasmid named pESI, associated with increased virulence, biofilm formation, and multidrug resistance. Since then, S. Infantis clones with pESI-like plasmids have been reported worldwide, replacing pESI-free clones. Here, we typed 161 S. Infantis isolates of poultry (n = 133) and human clinical (n = 28) origin using whole-genome sequencing. The isolates were collected between 2007 and 2021. In addition, we performed PacBio/Illumina sequencing for two representative pESI-like plasmids and compared them with publicly available sequences. All isolates belonged to sequence type 32 (ST32), except for one isolate that represented a novel single-locus variant of ST32. Core genome MLST (cgMLST) analysis revealed 14 clusters of genetically closely related isolates, of which four suggested broiler-to-human transmission of S. Infantis. pESI-like plasmids were present in 148/161 (91.9%) isolates; all were highly similar to the publicly available pESI-like sequences but lacked extended-spectrum beta-lactamase (ESBL) genes. PacBio/Illumina hybrid assembly allowed the reconstruction of two novel complete pESI variants. The present study revealed that the multidrug-resistant, pESI-positive S. Infantis clone became the predominant S. Infantis clone in Slovenian broilers and humans during the last decade. Continued surveillance of resistant S. Infantis clones along the food chain is needed to guide public health efforts. IMPORTANCE Salmonella Infantis clones with pESI-like plasmids harboring several virulence and resistance genes have been reported worldwide. In the present study, we compared the population structure of 161 Salmonella Infantis isolates obtained from humans and broilers in Slovenia from 2007 to 2021. Whole-genome sequencing showed that most human isolates clustered apart from broiler isolates, suggesting an alternative source of infection. Most isolates were multidrug resistant due to the presence of pESI-like plasmids, of which two variants (pS89 and pS19) were fully reconstructed using long-read sequencing. Both exhibited high similarity with the original Israeli pESI plasmid and German p2747 plasmid. The prototype plasmid pS89 harbored the typical pESI-associated resistance genes aadA1, qacEΔ1, sul1, and tet(A), which were absent in the truncated plasmid pS19.
Collapse
Affiliation(s)
- Bojan Papić
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Darja Kušar
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Jasna Mićunović
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Mateja Pirš
- Institute of Microbiology and Immunology, Faculty of Medicine, University of Ljubljana, Ljubljana, Slovenia
| | - Matjaž Ocepek
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| | - Jana Avberšek
- Institute of Microbiology and Parasitology, Veterinary Faculty, University of Ljubljana, Ljubljana, Slovenia
| |
Collapse
|
5
|
Di Marcantonio L, Romantini R, Marotta F, Chiaverini A, Zilli K, Abass A, Di Giannatale E, Garofolo G, Janowicz A. The Current Landscape of Antibiotic Resistance of Salmonella Infantis in Italy: The Expansion of Extended-Spectrum Beta-Lactamase Producers on a Local Scale. Front Microbiol 2022; 13:812481. [PMID: 35418960 PMCID: PMC8996230 DOI: 10.3389/fmicb.2022.812481] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/10/2021] [Accepted: 02/14/2022] [Indexed: 11/13/2022] Open
Abstract
Salmonella enterica serovar Infantis is one of the five main causes of human salmonellosis in the European Union (EU) and in recent years, has been increasingly reported to carry multiple antimicrobial resistance determinants, including extended-spectrum beta-lactamase (ESBL) genes. In our study, we used WGS-based tools to characterize S. Infantis strains circulating in the Abruzzo and Molise regions of Italy between 2017 and 2020 and compared this local dataset to the S. Infantis population present in Italy over the last two decades. Phylogenetic analyses demonstrated that the majority of strains isolated from poultry and turkeys from Abruzzo and Molise were closely related and belonged to one of the two main genetic clusters present in Italy, which were grouped predominantly as ESBL-producing strains that harbored pESI-like plasmid. We showed that 60% of the local strains carried multiple antibiotic resistance genes, including ESBL gene blaCTX–M–1 as well as aadA1, dfrA1, dfrA14, sul1, and tet(A) genes present on the pESI-like megaplasmid. The analysis of strains from Abruzzo and Molise and the publicly available Italian S. Infantis sequences revealed a dramatic increase in the number of identified AMR genes in the strains isolated after 2011. Moreover, the number of strains resistant to five or more antibiotic classes increased from 20–80% in the last decade likely due to the acquisition of the megaplasmid. The persistence of the ESBL-producing and the multidrug-resistant (MDR) clone of S. Infantis in poultry populations in Italy and in Europe requires rapid and efficient intervention strategies to prevent further expansion of the clone.
Collapse
Affiliation(s)
- Lisa Di Marcantonio
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Romina Romantini
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Francesca Marotta
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Alexandra Chiaverini
- Hygiene in Food Technology and Animal Feeds, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Katiuscia Zilli
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Anna Abass
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Elisabetta Di Giannatale
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Giuliano Garofolo
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| | - Anna Janowicz
- Bacteriology and Diary Production Hygiene Department, Istituto Zooprofilattico Sperimentale dell'Abruzzo e del Molise "G. Caporale," Teramo, Italy
| |
Collapse
|
6
|
Wang Z, Zhang Y, Xu H, Chu C, Wang J, Jiao X, Li Q. Whole-genome sequencing analysis reveals pig as the main reservoir for persistent evolution of Salmonella enterica serovar Rissen causing human salmonellosis. Food Res Int 2022; 154:111007. [DOI: 10.1016/j.foodres.2022.111007] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/15/2021] [Revised: 01/15/2022] [Accepted: 02/10/2022] [Indexed: 11/30/2022]
|
7
|
Papić B, Kušar D, Mićunović J, Vidrih Š, Pirš M, Ocepek M, Avberšek J. Genomic insights into Salmonella Choleraesuis var. Kunzendorf outbreak reveal possible interspecies transmission. Vet Microbiol 2021; 263:109282. [PMID: 34785475 DOI: 10.1016/j.vetmic.2021.109282] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/10/2021] [Revised: 11/08/2021] [Accepted: 11/10/2021] [Indexed: 10/19/2022]
Abstract
Salmonella enterica serovar Choleraesuis is a host-adapted serovar that causes serious infections in domestic pigs and wild boars. Here, we investigated an outbreak of salmonellosis in domestic pigs in Slovenia, 2018-2019. To assess the outbreak, 18 isolates from domestic pigs, wild boars, wild boar meat and a human patient underwent whole-genome sequencing (WGS). All isolates were of sequence type (ST) 145 and harbored no antimicrobial resistance genes or AMR-associated mutations. A single transmission cluster (≤ 6 alleles) of spatially (< 100 km) and temporally linked isolates was observed, comprising isolates of pig (n = 9), wild boar (n = 2) and human (n = 1) origin, and suggesting possible interspecies transmission. In all outbreak-related animal cases, septicemic salmonellosis was observed, accompanied in some cases by enteric symptoms. All pig isolates were linked to a single intensive breeding farm that distributed growers to small family farms. The same transport vehicles were used to distribute growers to family farms and also to transport livestock between neighboring countries. Both isolates that originated from the imported wild boar meat were genetically distant (≥ 122 alleles) from the outbreak cluster. The present results indicate the importance of screening domestic pigs and proper disinfection of transport vehicles to control the spread of S. Choleraesuis.
Collapse
Affiliation(s)
- Bojan Papić
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia.
| | - Darja Kušar
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Jasna Mićunović
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Špela Vidrih
- University of Ljubljana, Veterinary Faculty, National Veterinary Institute, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Mateja Pirš
- University of Ljubljana, Faculty of Medicine, Institute of Microbiology and Immunology, Zaloška 4, SI-1000 Ljubljana, Slovenia
| | - Matjaž Ocepek
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| | - Jana Avberšek
- University of Ljubljana, Veterinary Faculty, Institute of Microbiology and Parasitology, Gerbičeva 60, SI-1000 Ljubljana, Slovenia
| |
Collapse
|
8
|
Usein CR, Oprea M, Ciontea AS, Dinu S, Cristea D, Zota LC, Kotila S. A Snapshot of the Genetic Diversity of Salmonella Enteritidis Population Involved in Human Infections in Romania Taken in the European Epidemiological Context. Pathogens 2021; 10:pathogens10111490. [PMID: 34832645 PMCID: PMC8621327 DOI: 10.3390/pathogens10111490] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/28/2021] [Revised: 11/12/2021] [Accepted: 11/12/2021] [Indexed: 11/16/2022] Open
Abstract
In the absence of consistent national molecular typing data to enhance the surveillance of Salmonella Enteritidis, it was considered useful to collect baseline information on the genetic diversity and antibiotic susceptibility of strains isolated in Romania between January 2016 and April 2020 and compare them to strains described in major international outbreaks of the same period. A collection of 245 clinical isolates were genotyped by a standardised multiple-locus variable-number of tandem repeats analysis (MLVA) 5-loci protocol and screened for antimicrobial resistance against 15 compounds. Twenty strains were further subjected to whole genome sequencing (WGS) and compared to epidemiologically relevant high-throughput sequencing data available in European databases. Twenty-seven MLVA genotypes were identified, of which three, commonly reported in Europe between 2016–2020, covered 72% of the collection. Antibiotic resistance was detected in 30% of the strains, with resistance to nalidixic acid and ciprofloxacin as the most common phenotype, and also associated with two prevalent MLVA clones. WGS-derived multilocus sequence typing (MLST) revealed a single sequence type (ST11) further resolved into 10 core-genome MLST complex types. The minimum spanning tree constructed from the cgMLST data clustered Romanian and international strains, which shared more than 95% of the core genes, revealing links with a contemporaneous multi-country outbreak. This study could be regarded as a forerunner to the advent of using this integrative approach in the public health practice at a national level and thus contribute to the concerted actions at a European level to stop outbreaks.
Collapse
Affiliation(s)
- Codruta-Romanita Usein
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (A.S.C.); (S.D.); (D.C.)
- Correspondence: (C.-R.U.); (M.O.)
| | - Mihaela Oprea
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (A.S.C.); (S.D.); (D.C.)
- Correspondence: (C.-R.U.); (M.O.)
| | - Adriana Simona Ciontea
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (A.S.C.); (S.D.); (D.C.)
| | - Sorin Dinu
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (A.S.C.); (S.D.); (D.C.)
| | - Daniela Cristea
- “Cantacuzino” National Military Medical Institute for Research and Development, 050096 Bucharest, Romania; (A.S.C.); (S.D.); (D.C.)
| | - Lavinia Cipriana Zota
- National Center for Surveillance and Control of Communicable Diseases, National Institute of Public Health, 050463 Bucharest, Romania;
| | - Saara Kotila
- European Centre for Disease Prevention and Control, 16973 Solna, Sweden;
| |
Collapse
|
9
|
Molecular characterisation of antimicrobial resistance determinants and class 1 integrons of Salmonella enterica subsp. enterica serotype Enteritidis strains from retail food in China. Food Control 2021. [DOI: 10.1016/j.foodcont.2021.108191] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|