A retrospective epidemiological study on the incidence of salmonellosis in the State of Qatar during 2004-2012

Current State of Salmonella, Campylobacter and Listeria in the Food Chain across the Arab Countries: A Descriptive Review

Foodborne infections caused by bacterial pathogens are a common cause of human illness in the Middle East, with a substantial burden of economic loss and public health consequences. This review aims at elucidating recent literature on the prevalence of Non-Typhoidal Salmonella (NTS), Campylobacter and Listeria monocytogens in the food chain in the Arab countries, and to consolidate available evidence on the public health burden and the status of antimicrobial resistance (AMR) among the concerned three pathogens. The reviewed evidence points to a scarcity of understanding of the magnitude of NTS in the food chain in the Arab countries. Additionally, not much work has been done at the molecular characterization level to address the source-attribution of NTS in the Arab World. Very few surveys have been done on Campylobacter in the food chain in the Gulf Cooperation Council (GCC) countries. There is a gap in quantitative (counts/numbers) surveillance efforts for Campylobacter in the chicken meat supply across all Arab countries, despite the availability of some qualitative (presence/absence) surveillance data. While there are several reports on L. monocytogenes in animal-sourced foods, notably in North African Arab countries, fewer are published on L. monocytogenes in plant-sourced foods. Information on the L. monocytogenes serotypes and strain diversity circulating in the Arab region is widely lacking. Antibiotic resistance in the three pathogens is not fully understood across the Arab region, despite some reports indicating varying trends at the human-food interface. The literature evidence presented in this review stresses that Salmonella, Campylobacter and L. monocytogenes continue to challenge food safety and public health in the Arab countries.

Rodent-Related Zoonotic Pathogens at the Human-Animal-Environment Interface in Qatar: A Systematic Review and Meta-Analysis

Rodents are one of the most diversified terrestrial mammals, and they perform several beneficial activities in nature. These animals are also important as carriers of many pathogens with public health importance. The current systematic review was conducted to formulate a true depiction of rodent-related zoonoses in Qatar. Following systematic searches on PubMed, Scopus, Science Direct, and Web of Science and a screening process, a total of 94 published articles were selected and studied. The studied articles reported 23 rodent-related zoonotic pathogens that include nine bacterial, eleven parasitic, and three viral pathogens, from which the frequently reported pathogens were Mycobacterium tuberculosis (32 reports), Escherichia coli (23), and Salmonella spp. (16). The possible pathway of entry of the rodent-borne pathogens can be the land port, seaports, and airport of Qatar through carrier humans and animals, contaminated food, and agricultural products. The pathogens can be conserved internally by rodents, pets, and livestock; by agricultural production systems; and by food marketing chains. The overall estimated pooled prevalence of the pathogens among the human population was 4.27% (95%CI: 4.03–4.51%; p < 0.001) with significant heterogeneity (I² = 99.50%). The top three highest prevalent pathogens were M.tuberculosis (30.90%; 22.75–39.04%; p < 0.001; I² = 99.70%) followed by Toxoplasma gondii (21.93%; 6.23–37.61%; p < 0.001; I² = 99.30%) and hepatitis E virus (18.29%; 11.72–24.86%; p < 0.001; I² = 96.70%). However, there is a knowledge gap about the listed pathogens regarding the occurrence, transmission pathways, and rodent role in transmission dynamics at the human–animal–environment interface in Qatar. Further studies are required to explore the role of rodents in spreading zoonotic pathogens through the One Health framework, consisting of zoologists, ecologists, microbiologists, entomologists, veterinarians, and public health experts in this country.

Serogroups, and drug resistance of nontyphoidal Salmonella in symptomatic patients with community-acquired diarrhea and chicken meat samples in Tehran

BACKGROUND

Salmonella is considered as a main cause of community-acquired diarrhea in humans, however, sources of the multi-drug resistant (MDR) strains and their link with the disease are not well known.

AIMS

This study aimed to investigate the frequency, serogroup diversity, and antimicrobial susceptibility patterns of Salmonella strains in poultry meat and stool samples of patients with community acquired diarrhea in Tehran.

METHODS

We compared the frequency of non-typhoidal Salmonella serogroups, the similarities of their resistance patterns to 10 antimicrobial compounds, the prevalence of extended spectrum β-lactamase (ESBL) and ampicillinase C (AmpC) genetic determinants, and class 1 and 2 integrons in 100 chicken meat and 400 stool samples of symptomatic patients in Tehran during June 2018 to March 2019.

RESULTS

Salmonella was isolated from 75% and 5.5% of the chicken meats and human stool samples, respectively. The chicken meat isolates mainly belonged to serogroup C (88%, 66/75), while the human stool isolates were mainly related to serogroup D (59.1%, 13/22). The MDR phenotype and the most common rates of resistance to antibiotics, including tetracycline, trimethoprim/sulfamethoxazole (TS) and azithromycin, were detected in 4.5% and 45.3%, 59% and 13.6%, 43% and 9.1%, 42% and 9.1% of the human stool and chicken meat samples, respectively. Carriage of bla _CTX, bla _SHV, and bla _PER genes in the meat isolate with ESBL resistance phenotype and bla _ACC, bla _FOX, and bla _CMY-2 among the 7 meat strains with AmpC resistance phenotype was not confirmed using polymerase chain reaction (PCR). High prevalence of class 1 and 2 integrons was characterized and showed a correlation with resistance to TS and chloramphenicol.

CONCLUSION

These findings showed a lack of association between chicken meats and human isolates due to discrepancy between the characterized serogroups and resistance phenotypes.

Epidemiological characteristics of a salmonella outbreak among infants in Qatar, 2017

Purpose: This study was conducted to investigate the epidemiology behind the increased incidence of infant salmonella cases in Qatar during 2017 and identify the possible risk factors. Methods: This was a cross-sectional study using the notification reports of laboratory-confirmed infant salmonella cases received by the Ministry of Public Health during the year 2017. Furthermore, complementary phone interviews with the infants' mothers using a validated questionnaire were conducted. Results: The infant salmonella attack rate was calculated at approximately 3.23 cases per 1000 infants. Among the 89 confirmed infant salmonella cases, there were more girls (53%) than boys (47%) with a median age of 8 months. The most common type of salmonella species isolated was group B (50.5%). Among the 59 infant cases whose mothers were interviewed, the majority (94.9%) were symptomatic and diarrhea was the main reported symptom (90%), particularly bloody diarrhoea (62%). Regarding their dietary consumption, the majority (69.5%) of the infected infants were formula-fed. Moreover, the majority reported having no pets at home (91.6%) and were not enrolled in a day care center (93.3%). Conclusion: This study revealed a high incidence of salmonella infection among infants in the State of Qatar, which poses a public health concern. Therefore, targeted interventions and health awareness programs are required for outbreak prevention, detection and control.

Childhood Diarrhoea in the Eastern Mediterranean Region with Special Emphasis on Non-Typhoidal Salmonella at the Human⁻Food Interface

Diarrhoeal disease is still one of the most challenging issues for health in many countries across the Eastern Mediterranean region (EMR), with infectious diarrhoea being an important cause of morbidity and mortality, especially in children under five years of age. However, the understanding of the aetiological spectrum and the burden of enteric pathogens involved in diarrhoeal disease in the EMR is incomplete. Non-typhoidal Salmonella (NTS), the focus of this review, is one of the most frequently reported bacterial aetiologies in diarrhoeal disease in the EMR. Strains of NTS with resistance to antimicrobial drugs are increasingly reported in both developed and developing countries. In the EMR, it is now widely accepted that many such resistant strains are zoonotic in origin and acquire their resistance in the food-animal host before onward transmission to humans through the food chain. Here, we review epidemiological and microbiological aspects of diarrhoeal diseases among children in the EMR, with emphasis on the implication and burden of NTS. We collate evidence from studies across the EMR on the zoonotic exposure and antimicrobial resistance in NTS at the interface between human and foods of animal origin. This review adds to our understanding of the global epidemiology of Salmonella with emphasis on the current situation in the EMR.

A Retrospective Epidemiological Study of the Incidence and Risk Factors of Salmonellosis in Bahrain in Children During 2012⁻2016

Salmonellosis is one of the major public health concerns in Bahrain as it has increased rapidly during the past few years. This study aims to determine the prevalence of salmonellosis in children and the possible risk factors such as age, geographical area, nationality, gender, unsafe drinking water, infant born weight and gastrointestinal disease. The cases of salmonellosis in children reported by the Ministry of Health of Bahrain ranged from 21 to 26 per 100,000 population during the period 2012-2016. Salmonellosis cases were geographically concentrated in the capital and northern regions. Statistical analysis showed a significant difference in the number of salmonellosis cases between Bahrainis and non-Bahrainis based on region, and gender (p < 0.001). In the Bahraini cohort, there was an association between the increase of cases and the number of gastrointestinal disease-related deaths (p < 0.05). In addition, unsafe water (over the level of 2.14%) and low-birth weight (<3.100 g) were associated, but not statistically significant (p = 0.086 and p = 0.126, respectively) with the increase of salmonellosis cases. Despite the decline in the number of cases, the results of this study contribute to the understanding of the epidemiology of Salmonella in humans and this, in turn, will help develop and implement preventative measures.