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Besser J, Singer R, Jervis RH, Boxrud D, Smith K, Daly ER. Laboratory Criteria for Exclusion and Readmission of Potentially Infectious Persons in Sensitive Settings in the Age of Culture-Independent Diagnostic Tests: Report of a Multidisciplinary Workgroup. J Food Prot 2023; 86:100173. [PMID: 37797737 DOI: 10.1016/j.jfp.2023.100173] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 09/23/2023] [Accepted: 09/27/2023] [Indexed: 10/07/2023]
Abstract
Culture-independent diagnostic tests (CIDTs) are increasingly used for clinical diagnosis of gastrointestinal diseases such as salmonellosis, Shiga toxin-producing E. coli disease, and shigellosis because of their speed, convenience, and generally high-performance characteristics. These tests are also used to screen potentially infectious asymptomatic persons during outbreak investigations in sensitive settings such as childcare, food service, and healthcare. However, only limited performance data are available for CIDTs used on specimens from asymptomatic persons. The Association of Public Health Laboratories (APHL) and Council of State and Territorial Epidemiologists (CSTE) convened a workgroup to examine the available scientific data to inform interim decision-making related to exclusion and readmission criteria for potentially infectious persons in sensitive settings, the risks and benefits of different testing strategies, and to identify knowledge gaps for further research. This is the report on the Workgroup findings.
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Affiliation(s)
- John Besser
- Association of Public Health Laboratories, 284 Vickers DR NE, Atlanta, GA 30307, USA.
| | - Rachael Singer
- Council of State and Territorial Epidemiologists, 2635 Century Parkway NE, Suite 700, Atlanta, GA 30345, USA.
| | - Rachel H Jervis
- Colorado Department of Public Health and Environment, 4300 Cherry Creek Drive South, Denver, CO 80246, USA.
| | - David Boxrud
- Centers for Disease Control and Prevention, 1600 Clifton Road NE. Atlanta GA 30329, USA.
| | - Kirk Smith
- Minnesota Department of Health, 625 Robert St. N. P.O. Box 64975, St. Paul, MN 55164, USA.
| | - Elizabeth R Daly
- Council of State and Territorial Epidemiologists, 2635 Century Parkway NE, Suite 700, Atlanta, GA 30345, USA.
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Berumen A, Lennon R, Breen-Lyles M, Griffith J, Patel R, Boxrud D, Decuir M, Farrugia G, Smith K, Grover M. Characteristics and Risk Factors of Post-Infection Irritable Bowel Syndrome After Campylobacter Enteritis. Clin Gastroenterol Hepatol 2021; 19:1855-1863.e1. [PMID: 32711045 PMCID: PMC8994162 DOI: 10.1016/j.cgh.2020.07.033] [Citation(s) in RCA: 9] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/22/2020] [Revised: 06/25/2020] [Accepted: 07/16/2020] [Indexed: 12/18/2022]
Abstract
BACKGROUND & AIMS Campylobacter is the leading cause of bacterial gastroenteritis in the United States. We investigated the prevalence of postinfection irritable bowel syndrome (PI-IBS) in a cohort with culture-confirmed Campylobacter cases; risk factors for PI-IBS based on clinical factors; and shifts in IBS patterns postinfection in patients with pre-existing IBS. METHODS The Minnesota Department of Health collects data on symptoms and exposures upon notification of Campylobacter cases. From 2011 through 2019, we sent surveys (the Rome III and IBS symptom severity surveys) to 3586 patients 6 to 9 months after Campylobacter infection. The prevalence of PI-IBS was estimated and risk factors were assessed using multivariable logistic regression. RESULTS There were 1667 responders to the survey, 249 of whom had pre-existing IBS. Of the 1418 responders without pre-existing IBS, 301 (21%) subsequently developed IBS. Most of these individuals had IBS-mixed (54%), followed by IBS-diarrhea (38%), and IBS-constipation (6%). The mean IBS symptom severity score was 218 (indicating moderate severity). Female sex, younger age, bloody stools, abdominal cramps, and hospitalization during acute enteritis were associated with increased risk, whereas fever was protective for the development of PI-IBS. Antibiotic use and exposure patterns were similar between PI-IBS and control groups. Among patients with IBS-mixed or IBS-diarrhea before infection, 78% retained their subtypes after infection. In contrast, only 50% of patients with IBS-constipation retained that subtype after infection, whereas 40% transitioned to IBS-mixed. Of patients with pre-existing IBS, 38% had increased frequency of abdominal pain after Campylobacter infection. CONCLUSIONS In a cohort of patients with Campylobacter infection in Minnesota, 21% developed PI-IBS; most cases reported mixed IBS or diarrhea of moderate severity. Demographic and clinical factors during acute enterocolitis are associated with PI-IBS development. Campylobacter infection also can result in a switch of a pre-existing IBS phenotype.
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Affiliation(s)
- Antonio Berumen
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Ryan Lennon
- Biomedical Statistics and Informatics, Mayo Clinic, Rochester, Minnesota
| | | | | | - Robin Patel
- Division of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota
| | - David Boxrud
- Minnesota Department of Health, St. Paul, Minnesota
| | | | - Gianrico Farrugia
- Division of Gastroenterology and Hepatology, Mayo Clinic, Rochester, Minnesota
| | - Kirk Smith
- Minnesota Department of Health, St. Paul, Minnesota
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Peters S, Pascoe B, Wu Z, Bayliss SC, Zeng X, Edwinson A, Veerabadhran-Gurunathan S, Jawahir S, Calland JK, Mourkas E, Patel R, Wiens T, Decuir M, Boxrud D, Smith K, Parker CT, Farrugia G, Zhang Q, Sheppard SK, Grover M. Campylobacter jejuni genotypes are associated with post-infection irritable bowel syndrome in humans. Commun Biol 2021; 4:1015. [PMID: 34462533 PMCID: PMC8405632 DOI: 10.1038/s42003-021-02554-8] [Citation(s) in RCA: 21] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/18/2020] [Accepted: 08/13/2021] [Indexed: 02/08/2023] Open
Abstract
Campylobacter enterocolitis may lead to post-infection irritable bowel syndrome (PI-IBS) and while some C. jejuni strains are more likely than others to cause human disease, genomic and virulence characteristics promoting PI-IBS development remain uncharacterized. We combined pangenome-wide association studies and phenotypic assays to compare C. jejuni isolates from patients who developed PI-IBS with those who did not. We show that variation in bacterial stress response (Cj0145_phoX), adhesion protein (Cj0628_CapA), and core biosynthetic pathway genes (biotin: Cj0308_bioD; purine: Cj0514_purQ; isoprenoid: Cj0894c_ispH) were associated with PI-IBS development. In vitro assays demonstrated greater adhesion, invasion, IL-8 and TNFα secretion on colonocytes with PI-IBS compared to PI-no-IBS strains. A risk-score for PI-IBS development was generated using 22 genomic markers, four of which were from Cj1631c, a putative heme oxidase gene linked to virulence. Our finding that specific Campylobacter genotypes confer greater in vitro virulence and increased risk of PI-IBS has potential to improve understanding of the complex host-pathogen interactions underlying this condition. Stephanie Peters, Ben Pascoe, et al. use whole-genome sequencing and phenotypic analysis of clinical strains from patients to identify potential genetic factors involved in irritable bowel syndrome resulting from Campylobacter jejuni infection. Their data suggest that genes involved in the bacterial stress response and biosynthetic pathways may contribute toward irritable bowel syndrome, providing further insight into links between Campylobacter genotypes and risk of disease.
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Affiliation(s)
- Stephanie Peters
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Ben Pascoe
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - Zuowei Wu
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
| | - Sion C Bayliss
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - Ximin Zeng
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Adam Edwinson
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | | | | | - Jessica K Calland
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - Evangelos Mourkas
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK
| | - Robin Patel
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Terra Wiens
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Marijke Decuir
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - David Boxrud
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Kirk Smith
- Division of Clinical Microbiology, Department of Laboratory Medicine and Pathology, Mayo Clinic, Rochester, MN, USA
| | - Craig T Parker
- United States Department of Agriculture, Albany, CA, USA
| | - Gianrico Farrugia
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA
| | - Qijing Zhang
- Department of Veterinary Microbiology and Preventive Medicine, Iowa State University, Ames, IA, USA
| | - Samuel K Sheppard
- The Milner Centre for Evolution, Department of Biology and Biochemistry, University of Bath, Claverton Down, Bath, UK.
| | - Madhusudan Grover
- Department of Gastroenterology and Hepatology, Mayo Clinic, Rochester, MN, USA.
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4
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Decuir M, Fowler RC, Cebelinski E, Smith K, Boxrud D, Medus C. Evidence of False Positivity for Vibrio Species Tested by Gastrointestinal Multiplex PCR Panels, Minnesota, 2016-2018. Open Forum Infect Dis 2021; 8:ofab247. [PMID: 34141820 DOI: 10.1093/ofid/ofab247] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/08/2021] [Accepted: 05/12/2021] [Indexed: 02/04/2023] Open
Abstract
Background Syndromic gastrointestinal multiplex polymerase chain reaction (PCR) panels (GMPPs) are used by an increasing number of clinical laboratories to identify enteric pathogens. Vibrio species are included on GMPPs, but because of the low prevalence of vibriosis, performance characteristics for these panels have been difficult to measure. Methods All Vibrio spp. cases identified by GMPPs in Minnesota during 2016-2018 (n = 100) were assessed to identify differences between culture-confirmed cases and those that were PCR-positive only. Results Overall, 47% of cases had Vibrio species recovered by culture. Two GMPPs were used in Minnesota, Verigene EPT and FilmArray GIP, and the recovery rate of Vibrio spp. was significantly different between these platforms (Verigene EPT 63%, compared with FilmArray GIP 28%). No distinct seasonality was identified among GMPP-positive, culture-negative cases, whereas culture-confirmed case incidence peaked during July and August. Among cases with no other pathogen detected by the GMPP, confirmed cases reported a lower rate of bloody diarrhea (odds ratio [OR], 0.7; P = .004) and were less likely to have a symptom duration >14 days (OR, 0.3; P = .04). Confirmed cases were also more likely to include reports of consuming food items typically associated with Vibrio spp. infection or to have another likely source of infection (eg, international travel or contact with an untreated body of fresh or salt water or marine life; OR, 9.6; P = .001). Conclusions The combined findings indicate that cases identified by GMPP that did not have culture confirmation were less likely to include symptoms or exposures consistent with vibriosis. These findings emphasize the need for improvements to testing platform specificity and the importance of combining clinical and exposure information when diagnosing an infection. This study underscores the importance of maintaining the ability to culture Vibrio species to aid in accurate diagnoses.
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Affiliation(s)
- Marijke Decuir
- Foodborne, Waterborne, Vectorborne, and Zoonotic Diseases Section, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - Randal C Fowler
- Laboratory Leadership Service, Division of Scientific Education and Professional Development, Centers for Disease Control and Prevention, Atlanta, Georgia, USA
| | - Elizabeth Cebelinski
- Public Health Laboratory, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - Kirk Smith
- Foodborne, Waterborne, Vectorborne, and Zoonotic Diseases Section, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - David Boxrud
- Public Health Laboratory, Minnesota Department of Health, Saint Paul, Minnesota, USA
| | - Carlota Medus
- Foodborne, Waterborne, Vectorborne, and Zoonotic Diseases Section, Minnesota Department of Health, Saint Paul, Minnesota, USA
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McNall RJ, Wharton AK, Anderson R, Clemmons N, Lopareva EN, Gonzalez C, Espinosa A, Probert WS, Hacker JK, Liu G, Garfin J, Strain AK, Boxrud D, Bryant PW, George KS, Davis T, Griesser RH, Shult P, Bankamp B, Hickman CJ, Wroblewski K, Rota PA. Genetic characterization of mumps viruses associated with the resurgence of mumps in the United States: 2015-2017. Virus Res 2020; 281:197935. [PMID: 32194138 DOI: 10.1016/j.virusres.2020.197935] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/15/2019] [Revised: 02/07/2020] [Accepted: 03/13/2020] [Indexed: 10/24/2022]
Abstract
Despite high coverage with measles, mumps, and rubella vaccine in the United States, outbreaks of mumps occur in close contact settings such as schools, colleges, and camps. Starting in late 2015, outbreaks were reported from several universities, and by the end of 2017, greater than 13,800 cases had been reported nation-wide. In 2013, the CDC and the Association of Public Health Laboratories contracted four Vaccine Preventable Diseases Reference Centers (VPD-RCs) to perform real-time reverse transcription PCR (RT-qPCR) to detect mumps RNA in clinical samples and to determine the genotype. Twelve genotypes of mumps virus are currently recognized by the World Health Organization, and the standard protocol for genotyping requires sequencing the entire gene coding for the small hydrophobic (SH) protein. Phylogenetic analysis of the 1862 mumps samples genotyped from 2015 through 2017 showed that the overall diversity of genotypes detected was low. Only 0.8 % of the sequences were identified as genotypes C, H, J, or K, and 0.5 % were identified as vaccine strains in genotypes A or N, while most sequences (98.7 %) were genotype G. The majority of the genotype G sequences could be included into one of two large groups with identical SH sequences. Within genotype G, a small number of phylogenetically significant outlier sequences were associated with epidemiologically distinct chains of transmission. These results demonstrate that molecular and epidemiologic data can be used to track transmission pathways of mumps virus; however, the limited diversity of the SH sequences may be insufficient for resolving transmission in all outbreaks.
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Affiliation(s)
- Rebecca J McNall
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Adam K Wharton
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Raydel Anderson
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Nakia Clemmons
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Elena N Lopareva
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | | | - Alex Espinosa
- California Department of Public Health, Richmond, CA, USA
| | | | - Jill K Hacker
- California Department of Public Health, Richmond, CA, USA
| | - Gongping Liu
- Minnesota Department of Health, St Paul, MN, USA
| | - Jacob Garfin
- Minnesota Department of Health, St Paul, MN, USA
| | | | - David Boxrud
- Minnesota Department of Health, St Paul, MN, USA
| | - Patrick W Bryant
- Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Kirsten St George
- Wadsworth Center, New York State Department of Health, Albany, NY, USA
| | - Timothy Davis
- Wisconsin State Laboratory of Hygiene, Madison, University of Wisconsin, WI, USA
| | - Richard H Griesser
- Wisconsin State Laboratory of Hygiene, Madison, University of Wisconsin, WI, USA
| | - Peter Shult
- Wisconsin State Laboratory of Hygiene, Madison, University of Wisconsin, WI, USA
| | - Bettina Bankamp
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Carole J Hickman
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Kelly Wroblewski
- Association of Public Health Laboratories, Silver Spring, MD, USA
| | - Paul A Rota
- Division of Viral Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
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Kubota KA, Wolfgang WJ, Baker DJ, Boxrud D, Turner L, Trees E, Carleton HA, Gerner-Smidt P. PulseNet and the Changing Paradigm of Laboratory-Based Surveillance for Foodborne Diseases. Public Health Rep 2020; 134:22S-28S. [PMID: 31682558 PMCID: PMC6832030 DOI: 10.1177/0033354919881650] [Citation(s) in RCA: 19] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/20/2022] Open
Abstract
PulseNet, the National Molecular Subtyping Network for Foodborne Disease Surveillance, was established in 1996 through a collaboration with the Centers for Disease Control and Prevention; the US Department of Agriculture, Food Safety and Inspection Service; the US Food and Drug Administration; 4 state public health laboratories; and the Association of Public Health Laboratories. The network has since expanded to include 83 state, local, and food regulatory public health laboratories. In 2016, PulseNet was estimated to be helping prevent an estimated 270 000 foodborne illnesses annually. PulseNet is undergoing a transformation toward whole-genome sequencing (WGS), which provides better discriminatory power and precision than pulsed-field gel electrophoresis (PFGE). WGS improves the detection of outbreak clusters and could replace many traditional reference identification and characterization methods. This article highlights the contributions made by public health laboratories in transforming PulseNet's surveillance and describes how the transformation is changing local and national surveillance practices. Our data show that WGS is better at identifying clusters than PFGE, especially for clonal organisms such as Salmonella Enteritidis. The need to develop prioritization schemes for cluster follow-up and additional resources for both public health laboratory and epidemiology departments will be critical as PulseNet implements WGS for foodborne disease surveillance in the United States.
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Affiliation(s)
- Kristy A Kubota
- Association of Public Health Laboratories, Food Safety Program, Silver Spring, MD, USA
| | - William J Wolfgang
- New York State Department of Health, Bacteriology Laboratory, Albany, NY, USA
- Department of Biomedical Sciences, University of Albany, Rensselaer, NY, USA
| | - Deborah J Baker
- New York State Department of Health, Bacteriology Laboratory, Albany, NY, USA
| | - David Boxrud
- Public Health Laboratory Division, Minnesota Department of Health, St. Paul, MN, USA
| | - Lauren Turner
- Virginia Department of General Services, Division of Consolidated Laboratory Services, Richmond, VA, USA
| | - Eija Trees
- Association of Public Health Laboratories, Food Safety Program, Silver Spring, MD, USA
| | - Heather A Carleton
- Enteric Diseases Laboratory Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
| | - Peter Gerner-Smidt
- Enteric Diseases Laboratory Branch, Division of Foodborne, Waterborne and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA
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Kingry LC, Anacker M, Pritt B, Bjork J, Respicio-Kingry L, Liu G, Sheldon S, Boxrud D, Strain A, Oatman S, Berry J, Sloan L, Mead P, Neitzel D, Kugeler KJ, Petersen JM. Surveillance for and Discovery of Borrelia Species in US Patients Suspected of Tickborne Illness. Clin Infect Dis 2019; 66:1864-1871. [PMID: 29272385 DOI: 10.1093/cid/cix1107] [Citation(s) in RCA: 50] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/11/2017] [Accepted: 12/16/2017] [Indexed: 12/24/2022] Open
Abstract
Background Tick-transmitted Borrelia fall into 2 heterogeneous bacterial complexes comprised of multiple species, the relapsing fever (RF) group and the Borrelia burgdorferi sensu lato group, which are the causative agents of Lyme borreliosis (LB), the most common tickborne disease in the Northern Hemisphere. Geographic expansion of LB in the United States and discovery of emerging Borrelia pathogens underscores the importance of surveillance for disease-causing Borrelia. Methods De-identified clinical specimens, submitted by providers throughout the United States, for patients suspected of LB, anaplasmosis, ehrlichiosis, or babesiosis were screened using a Borrelia genus-level TaqMan polymerase chain reaction (PCR). Borrelia species and sequence types (STs) were characterized by multilocus sequence typing (MLST) utilizing next-generation sequencing. Results Among 7292 specimens tested, 5 Borrelia species were identified: 2 causing LB, B. burgdorferi (n = 25) and B. mayonii (n = 9), and 3 RF borreliae, B. hermsii (n = 1), B. miyamotoi (n = 8), and Candidatus B. johnsonii (n = 1), a species previously detected only in the bat tick, Carios kelleyi. ST diversity was greatest for B. burgdorferi-positive specimens, with new STs identified primarily among synovial fluids. Conclusions These results demonstrate that broad PCR screening followed by MLST is a powerful surveillance tool for uncovering the spectrum of disease-causing Borrelia species, understanding their geographic distribution, and investigating the correlation between B. burgdorferi STs and joint involvement. Detection of Candidatus B. johnsonii in a patient with suspected tickborne disease suggests this species may be a previously undetected cause of illness in humans exposed to bat ticks.
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Affiliation(s)
- Luke C Kingry
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | | | | | - Laurel Respicio-Kingry
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Sarah Sheldon
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | | | - Stephanie Oatman
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | | | - Paul Mead
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | | | - Kiersten J Kugeler
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
| | - Jeannine M Petersen
- Division of Vector-Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, Colorado
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Elnekave E, Hong S, Taylor A, Boxrud D, Rovira A, Alvarez J. A66 Tracing the evolutionary history of an emerging Salmonella 4,[5],12:i:- clone in the United States. Virus Evol 2019. [PMCID: PMC6735749 DOI: 10.1093/ve/vez002.065] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022] Open
Abstract
Salmonellosis is one of the leading causes of foodborne disease worldwide, with an estimated one million cases a year in the United States. Salmonella 4,[5],12: i:-, a monophasic variant of Salmonella typhimurium, is an emerging serovar that has been associated with multiple foodborne outbreaks throughout the world, mostly attributed to pig and pig products. Recently, we have demonstrated that two distinct groups of Salmonella 4,[5],12:i:- circulate in the USA and Europe, with the majority of isolates recovered during recent years belonging to an emerging multidrug-resistant clade (Elnekave et al. 2018). We applied Bayesian phylodynamic reconstruction to uncover the evolutionary history of this clade. We used a dataset of whole-genome sequences of 1446 4,[5],12:i:- isolates from different sources (livestock, human, food products, and others) from the USA (n = 752) and Europe (n = 694), collected between 2008 and 2017 and belonging to the Multilocus Subtype 34, which was predominant in the emerging clade (Elnekave et al. 2018). A subset (n = 110) of Salmonella 4,[5],12:i: isolates was then randomly selected after stratifying by location and year of isolation in order to achieve balanced sampling. Evidence of temporal signal was confirmed by looking at root-to-tip divergences using TempEst. Evolutionary hypotheses using strict and relaxed-clock models were tested using BEAST for a variety of demographic models and assuming a general time reversible substitution model. Model selection was performed by estimating Bayes Factors using path sampling and stepping-stone sampling. The selected model was then used for applying discrete trait models comparing different scenarios of transmission between locations (i.e. bidirectional symmetric/asymmetric or unidirectional). Our preliminary phylodynamic inference results indicate that the origin of this subtype was in Europe and dates back to 1990 (HPD 95%: 1984–2001). We report an exponential growth rate of 0.362 per year, which corresponds to a doubling time of 1.43 years. Our results suggest that this subtype was introduced to the US in the year 2000 (HPD 95%: 1994–2006). Phylodynamic analysis suggests that the recent increase in isolation of Salmonella 4,[5],12:i:- from different sources in the USA may be due to the exponential expansion of an emerging clone which originated in Europe and then expanded to the USA. The emergence and expansion of this serovar is of great public health importance due to the high prevalence of multidrug resistance traits found in USA isolates from this group and especially due to the presence of plasmid-mediated resistance genes for quinolones and extended spectrum cephalosporins, key antimicrobials used for the treatment of invasive Salmonella infections.
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Affiliation(s)
- E Elnekave
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - S Hong
- Department of Veterinary Population Medicine, College of Veterinary Medicine, University of Minnesota, Saint Paul, MN, USA
| | - A Taylor
- Minnesota Department of Health, St Paul, MN, USA
| | - D Boxrud
- Minnesota Department of Health, St Paul, MN, USA
| | - A Rovira
- Veterinary Diagnostic Laboratory, College of Veterinary Medicine, University of Minnesota, St Paul, MN, USA
| | - J Alvarez
- Centro de Vigilancia Sanitaria Veterinaria (VISAVET), Universidad Complutense de Madrid, Madrid, Spain
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9
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Shaughnessy MK, Snider T, Sepulveda R, Boxrud D, Cebelinski E, Jawahir S, Holzbauer S, Johnston BD, Smith K, Bender JB, Thuras P, Diez-Gonzalez F, Johnson JR. Prevalence and Molecular Characteristics of Clostridium difficile in Retail Meats, Food-Producing and Companion Animals, and Humans in Minnesota. J Food Prot 2018; 81:1635-1642. [PMID: 30198756 DOI: 10.4315/0362-028x.jfp-18-104] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.2] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/26/2023]
Abstract
Community-associated Clostridium difficile infection (CA-CDI) now accounts for approximately 50% of CDI cases in central Minnesota; animals and meat products are potential sources. From November 2011 to July 2013, we cultured retail meat products and fecal samples from food-producing and companion animals in central Minnesota for C. difficile by using standard methods. The resulting 51 C. difficile isolates, plus 30 archived local veterinary C. difficile isolates and 208 human CA-CDI case isolates from central Minnesota (from 2012) from the Minnesota Department of Health, were characterized molecularly, and source groups were compared using discriminant analysis. C. difficile was recovered from 0 (0%) of 342 retail meat samples and 51 (9%) of 559 animal fecal samples. Overall, the 81 animal source isolates and 208 human source isolates were highly diverse genetically. Molecular traits segregated extensively in relation to animal versus human origin. Discriminant analysis classified 95% of isolates correctly by source group; only five (2.5%) human source isolates were classified as animal source. These data do not support meat products or food-producing and companion animals as important sources of CA-CDI in the central Minnesota study region.
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Affiliation(s)
- Megan K Shaughnessy
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | - Tim Snider
- 2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | | | - David Boxrud
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Elizabeth Cebelinski
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Selina Jawahir
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Stacy Holzbauer
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975.,5 Centers for Disease Control and Prevention, 1600 Clifton Road, Atlanta, Georgia 30329-4027, USA
| | - Brian D Johnston
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | - Kirk Smith
- 4 Minnesota Department of Health, 625 Robert Street North, St. Paul, Minnesota 55164-0975
| | - Jeff B Bender
- 3 University of Minnesota, St. Paul, Minnesota 55108
| | - Paul Thuras
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
| | | | - James R Johnson
- 1 University of Minnesota, Minneapolis, Minnesota 55455.,2 Minneapolis Veterans Affairs Health Care System, 1 Veterans Drive, Minneapolis, Minnesota 55417 (ORCID: http://orcid.org/0000-0002-9588-5045 [J.R.J.])
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10
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Thielen BK, Friedlander H, Bistodeau S, Shu B, Lynch B, Martin K, Bye E, Como-Sabetti K, Boxrud D, Strain AK, Chaves SS, Steffens A, Fowlkes AL, Lindstrom S, Lynfield R. Detection of Influenza C Viruses Among Outpatients and Patients Hospitalized for Severe Acute Respiratory Infection, Minnesota, 2013-2016. Clin Infect Dis 2018; 66:1092-1098. [PMID: 29069373 PMCID: PMC5862734 DOI: 10.1093/cid/cix931] [Citation(s) in RCA: 14] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/14/2017] [Accepted: 10/19/2017] [Indexed: 11/23/2022] Open
Abstract
Background Existing literature suggests that influenza C typically causes mild respiratory tract disease. However, clinical and epidemiological data are limited. Methods Four outpatient clinics and 3 hospitals submitted clinical data and respiratory specimens through a surveillance network for acute respiratory infection (ARI) from May 2013 through December 2016. Specimens were tested using multitarget nucleic acid amplification for 19-22 respiratory pathogens, including influenza C. Results Influenza C virus was detected among 59 of 10 202 (0.58%) hospitalized severe ARI cases and 11 of 2282 (0.48%) outpatients. Most detections occurred from December to March, 73% during the 2014-2015 season. Influenza C detections occurred among patients of all ages, with rates being similar between inpatients and outpatients. The highest rate of detection occurred among children aged 6-24 months (1.2%). Among hospitalized cases, 7 required intensive care. Medical comorbidities were reported in 58% of hospitalized cases and all who required intensive care. At least 1 other respiratory pathogen was detected in 40 (66%) cases, most commonly rhinovirus/enterovirus (25%) and respiratory syncytial virus (20%). The hemagglutinin-esterase-fusion gene was sequenced in 37 specimens, and both C/Kanagawa and C/Sao Paulo lineages were detected in inpatients and outpatients. Conclusions We found seasonal circulation of influenza C with year-to-year variability. Detection was most frequent among young children but occurred in all ages. Some cases that were positive for influenza C, particularly those with comorbid conditions, had severe disease, suggesting a need for further study of the role of influenza C virus in the pathogenesis of respiratory disease.
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Affiliation(s)
- Beth K Thielen
- Division of Infectious Diseases and International Medicine, University of Minnesota, Minneapolis
- Division of Pediatric Infectious Diseases and Immunology, University of Minnesota, Minneapolis
| | | | | | - Bo Shu
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Brian Lynch
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Erica Bye
- Minnesota Department of Health, St. Paul
| | | | | | | | - Sandra S Chaves
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Andrea Steffens
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Ashley L Fowlkes
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Stephen Lindstrom
- National Center for Immunization and Respiratory Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia
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11
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Alshalchi S, Hayer SS, An R, Munoz-Aguayo J, Flores-Figueroa C, Nguyen R, Lauer D, Olsen K, Alvarez J, Boxrud D, Cardona C, Vidovic S. The Possible Influence of Non-synonymous Point Mutations within the FimA Adhesin of Non-typhoidal Salmonella (NTS) Isolates in the Process of Host Adaptation. Front Microbiol 2017; 8:2030. [PMID: 29089942 PMCID: PMC5651078 DOI: 10.3389/fmicb.2017.02030] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/30/2017] [Accepted: 10/04/2017] [Indexed: 12/18/2022] Open
Abstract
Non-typhoidal Salmonella (NTS) remains a global pathogen that affects a wide range of animal species. We analyzed a large number of NTS isolates of different host origins, including Salmonella Heidelberg (n = 80, avian), S. Dublin (50, bovine), S. Typhimurium var 5- (n = 40, porcine), S. 4,5,12,:i:- (n = 40, porcine), S. Cerro (n = 16, bovine), and S. Montevideo (n = 14, bovine), using virulence profiling of the bcfC, mgtC, ssaC, invE, pefA, stn, sopB, and siiE virulence-associated genes, a biofilm production assay, pulsed field gel electrophoresis, and the full-length sequencing of the fimA (adhesin) and iroN (receptor) genes. We determined a key amino acid substitution, A169 (i.e., threonine changed to alanine at position 169), in the FimA protein that changed ligand affinity of FimA toward N-acetyl-D-glucosamine. This finding clearly indicates the important role of non-synonymous single nucleotide polymorphism (nsSNPs) in adhesin functionality that may impact the host tropism of NTS. This nsSNP was found in S. Heidelberg and S. Cerro isolates. Although this was not the case for the IroN receptor, the phylogeny of this receptor and different host origins of NTS isolates were positively correlated, suggesting existence of specific host immune selective pressures on this unique receptor in S. enterica. We found that pefA, a gene encoding major fimbrial subunit, was the most-segregative virulence factor. It was associated with S. Heidelberg, S. Typhimurium var 5- and S. 4,5,12,:i:- but not with the rest of NTS strains. Further, we observed a significantly higher frequency of non-biofilm producers among NTS strains that do not carry pefA (42.5%) compared to S. Heidelberg (2.5%) and S. Typhimurium var 5- (7.5%) and S. 4,5,12,:i:- (0%). This study provides new insights into the host adaptation of avian and mammalian NTS isolates that are based on the bacterial antigens FimA and IroN as well as the interrelationships between host adaptation, overall genetic relatedness, and virulence potential in these NTS isolates.
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Affiliation(s)
- Sahar Alshalchi
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Minnesota, MN, United States
| | - Shivdeep S Hayer
- Department of Population Medicine, University of Minnesota, Minnesota, MN, United States
| | - Ran An
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Minnesota, MN, United States
| | - Jeannette Munoz-Aguayo
- Mid-Central Research and Outreach Center, University of Minnesota, Minnesota, MN, United States
| | | | - Ryan Nguyen
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Minnesota, MN, United States
| | - Dale Lauer
- Minnesota Poultry Testing Laboratory, University of Minnesota, Minnesota, MN, United States
| | - Karen Olsen
- Veterinary Diagnostic Laboratory, University of Minnesota, Minnesota, MN, United States
| | - Julio Alvarez
- Department of Population Medicine, University of Minnesota, Minnesota, MN, United States
| | - David Boxrud
- Public Health Laboratory, Minnesota Department of Health, Minnesota, MN, United States
| | - Carol Cardona
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Minnesota, MN, United States
| | - Sinisa Vidovic
- Department of Veterinary and Biomedical Sciences, University of Minnesota, Minnesota, MN, United States
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12
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Dong HJ, Cho S, Boxrud D, Rankin S, Downe F, Lovchik J, Gibson J, Erdman M, Saeed AM. Single-nucleotide polymorphism typing analysis for molecular subtyping of Salmonella Tennessee isolates associated with the 2007 nationwide peanut butter outbreak in the United States. Gut Pathog 2017; 9:25. [PMID: 28469710 PMCID: PMC5412032 DOI: 10.1186/s13099-017-0176-y] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 02/02/2017] [Accepted: 04/21/2017] [Indexed: 11/18/2022] Open
Abstract
Background In 2007, a nationwide Salmonella Tennessee outbreak occurred via contaminated peanut butter. Here, we developed a single-nucleotide polymorphism (SNP)-typing method for S. Tennessee to determine the clonal subtypes of S. Tennessee that were associated with the peanut butter outbreak. Methods and results One seventy-six S. Tennessee isolates from various sources, including humans, animals, food, and the environment, were analyzed by using the SNP technique. Eighty-four representative SNP markers were selected by comparing the sequences of three representative S. Tennessee strains with different multi-locus sequence typing and variable number tandem repeats from our collection. The set of eighty-four SNP markers showed 100% typeability for the 176 strains, with the nucleotide diversity ranging from 0.011 to 0.107 (mean = 0.049 ± 0.018, median = 0.044) for each marker. Among the four clades and nine subtypes generated by the SNP typing, subtype 1, which comprised 142 S. Tennessee strains, was the most predominant. The dominance of single-strain clones in subtype 1 revealed that S. Tennessee is highly clonal regardless of outbreak-association, source, or period of isolation, suggesting the presence of an S. Tennessee strain prototype. Notably, a minimum 18 SNP set was able to determine clonal S. Tennessee strains with similar discrimination power, potentially allowing more rapid and economic strain genotyping for both outbreaks and sporadic cases. Conclusions The SNP-typing method described here might aid the investigation of the epidemiology and microevolution of pathogenic bacteria by discriminating between outbreak-related and sporadic clinical cases. In addition, this approach enables us to understand the population structure of the bacterial subtypes involved in the outbreak. Electronic supplementary material The online version of this article (doi:10.1186/s13099-017-0176-y) contains supplementary material, which is available to authorized users.
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Affiliation(s)
- Hee-Jin Dong
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, 08826 South Korea
| | - Seongbeom Cho
- BK21 PLUS Program for Creative Veterinary Science Research, Research Institute for Veterinary Science and College of Veterinary Medicine, Seoul National University, Seoul, 08826 South Korea
| | - David Boxrud
- Minnesota Department of Health, St Paul, MN 55164 USA
| | - Shelly Rankin
- Department of Microbiology, School of Veterinary Medicine, University of Pennsylvania, Kennett Square, PA 19348 USA
| | - Francis Downe
- Michigan Department of Health, Lansing, MI 48909 USA
| | - Judith Lovchik
- Indiana State Department of Health, Indianapolis, IN 46204 USA
| | - Jim Gibson
- Tennessee Department of Health, Nashville, TN 37247 USA
| | - Matt Erdman
- NVSL USDA, National Veterinary, Services Laboratories, a unit within the U.S. Department of Agriculture, Riverdale, MD 20737 USA
| | - A Mahdi Saeed
- Departments of Large Animal Clinical Sciences and Epidemiology and Biostatistics, Michigan State University, East Lansing, MI 48824 USA
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13
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Pritt BS, Respicio-Kingry LB, Sloan LM, Schriefer ME, Replogle AJ, Bjork J, Liu G, Kingry LC, Mead PS, Neitzel DF, Schiffman E, Hoang Johnson DK, Davis JP, Paskewitz SM, Boxrud D, Deedon A, Lee X, Miller TK, Feist MA, Steward CR, Theel ES, Patel R, Irish CL, Petersen JM. Borrelia mayonii sp. nov., a member of the Borrelia burgdorferi sensu lato complex, detected in patients and ticks in the upper midwestern United States. Int J Syst Evol Microbiol 2016; 66:4878-4880. [PMID: 27558626 DOI: 10.1099/ijsem.0.001445] [Citation(s) in RCA: 109] [Impact Index Per Article: 13.6] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/18/2022] Open
Abstract
Lyme borreliosis (LB) is a multisystem disease caused by spirochetes in the Borrelia burgdorferisensu lato (Bbsl) genospecies complex. We previously described a novel Bbsl genospecies (type strain MN14-1420T) that causes LB among patients with exposures to ticks in the upper midwestern USA. Patients infected with the novel Bbsl genospecies demonstrated higher levels of spirochetemia and somewhat differing clinical symptoms as compared with those infected with other Bbsl genospecies. The organism was detected from human specimens using PCR, microscopy, serology and culture. The taxonomic status was determined using an eight-housekeeping-gene (uvrA, rplB, recG, pyrG, pepX, clpX, clpA and nifS) multi-locus sequence analysis (MLSA) and comparison of 16S rRNA gene, flaB, rrf-rrl, ospC and oppA2 nucleotide sequences. Using a system threshold of 98.3 % similarity for delineation of Bbsl genospecies by MLSA, we demonstrated that the novel species is a member of the Bbsl genospecies complex, most closely related to B. burgdorferisensu stricto (94.7-94.9 % similarity). This same species was identified in Ixodes scapularis ticks collected in Minnesota and Wisconsin. This novel species, Borrelia mayonii sp. nov, is formally described here. The type strain, MN14-1420, is available through the Deutsche Sammlung von Mikroorganismen und Zelkulturen GmbH (DSM 102811) and the American Type Culture Collection (ATCC BAA-2743).
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Affiliation(s)
- Bobbi S Pritt
- Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Laurel B Respicio-Kingry
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Lynne M Sloan
- Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Martin E Schriefer
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Adam J Replogle
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Jenna Bjork
- Minnesota Department of Health, St. Paul, MN, USA
| | - Gongping Liu
- Minnesota Department of Health, St. Paul, MN, USA
| | - Luke C Kingry
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | - Paul S Mead
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
| | | | | | | | | | | | - David Boxrud
- Minnesota Department of Health, St. Paul, MN, USA
| | - Alecia Deedon
- Wisconsin Department of Health Services, Madison, WI, USA
| | - Xia Lee
- University of Wisconsin-Madison, Madison, WI, USA
| | | | | | | | - Elitza S Theel
- Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Robin Patel
- Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Cole L Irish
- Department of Clinical Microbiology, Mayo Clinic, Rochester, Minnesota, USA
| | - Jeannine M Petersen
- Division of Vector Borne Diseases, Centers for Disease Control and Prevention, Fort Collins, CO, USA
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14
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Friedlander H, Como-Sabetti K, Bistodeau S, Strain A, Boxrud D, Fowlkes A, Steffens A, Chaves SS, Lindstrom S, Lynfield R. Influenza C Detection Among Patients Hospitalized with Severe Acute Respiratory Illness, Minnesota 2014–2015. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.411] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/13/2022] Open
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15
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Steffens A, Fowlkes A, Friedlander H, Como-Sabetti K, Boxrud D, Lu X, Lynfield R, Chaves SS, Bistodeau S, Strain A. Rhinovirus-Associated Pediatric Hospitalizations in the Minnesota Severe Acute Respiratory Illness Surveillance System, 2013-2015. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.393] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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16
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Fowlkes A, Steffens A, Temte J, Reisdorf E, Rubino H, Martin K, Boxrud D, Wotton J, Brannan L, Ledbetter J, Selzer C, Green N, Diaz-Decaro J, Lonardo SD, Fu J, Lindstrom S, Heberlein-Larson L. Epidemiologic Comparison of Laboratory-Confirmed Influenza Virus B Yamagata and Victoria Lineage Infections During the 2014–2015 Influenza Season. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1459] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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17
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Koeck M, Como-Sabetti K, Glennen A, Boxrud D, Dobbins G, See I, Lynfield R. Invasive Staphylococcus aureus Infections: A Large Role for MSSA. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.832] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
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18
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Beaudoin A, Lesher L, Koeck M, Jawahir S, Boxrud D, Como-Sabetti K, Glennen A, Vagnone PS, Lynfield R. Critical and Fatal Infections Due to Community-Associated Staphylococcus aureus, 9 Years of Surveillance in Minnesota. Open Forum Infect Dis 2015. [DOI: 10.1093/ofid/ofv133.1147] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
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19
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Choi MJ, Torremorell M, Bender JB, Smith K, Boxrud D, Ertl JR, Yang M, Suwannakarn K, Her D, Nguyen J, Uyeki TM, Levine M, Lindstrom S, Katz JM, Jhung M, Vetter S, Wong KK, Sreevatsan S, Lynfield R. Live Animal Markets in Minnesota: A Potential Source for Emergence of Novel Influenza A Viruses and Interspecies Transmission. Clin Infect Dis 2015. [PMID: 26223994 DOI: 10.1093/cid/civ618] [Citation(s) in RCA: 37] [Impact Index Per Article: 4.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/01/2023] Open
Abstract
BACKGROUND Live animal markets have been implicated in transmission of influenza A viruses (IAVs) from animals to people. We sought to characterize IAVs at 2 live animal markets in Minnesota to assess potential routes of occupational exposure and risk for interspecies transmission. METHODS We implemented surveillance for IAVs among employees, swine, and environment (air and surfaces) during a 12-week period (October 2012-January 2013) at 2 markets epidemiologically associated with persons with swine-origin IAV (variant) infections. Real-time reverse transcription polymerase chain reaction (rRT-PCR), viral culture, and whole-genome sequencing were performed on respiratory and environmental specimens, and serology on sera from employees at beginning and end of surveillance. RESULTS Nasal swabs from 11 of 17 (65%) employees tested positive for IAVs by rRT-PCR; 7 employees tested positive on multiple occasions and 1 employee reported influenza-like illness. Eleven of 15 (73%) employees had baseline hemagglutination inhibition antibody titers ≥40 to swine-origin IAVs, but only 1 demonstrated a 4-fold titer increase to both swine-origin and pandemic A/Mexico/4108/2009 IAVs. IAVs were isolated from swine (72/84), air (30/45), and pen railings (5/21). Whole-genome sequencing of 122 IAVs isolated from swine and environmental specimens revealed multiple strains and subtype codetections. Multiple gene segment exchanges among and within subtypes were observed, resulting in new genetic constellations and reassortant viruses. Genetic sequence similarities of 99%-100% among IAVs of 1 market customer and swine indicated interspecies transmission. CONCLUSIONS At markets where swine and persons are in close contact, swine-origin IAVs are prevalent and potentially provide conditions for novel IAV emergence.
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Affiliation(s)
- Mary J Choi
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Montserrat Torremorell
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
| | - Jeff B Bender
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
| | | | | | - Jon R Ertl
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
| | - My Yang
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
| | - Kamol Suwannakarn
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
| | | | | | - Timothy M Uyeki
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Min Levine
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | - Michael Jhung
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | - Karen K Wong
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | - Srinand Sreevatsan
- University of Minnesota College of Veterinary Medicine, Minnesota Center of Excellence for Influenza Research and Surveillance
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20
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Whitten T, Jawahir S, Boxrud D, Holzbauer SM. 1659Relapse vs Reinfection. Evaluation of Clostridium difficile Isolates from Incident and Recurrent Infections, Minnesota 2009-2011. Open Forum Infect Dis 2014. [PMCID: PMC5781611 DOI: 10.1093/ofid/ofu052.1205] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Affiliation(s)
| | - Selina Jawahir
- Public Health Laboratory, Minnesota Department of Health, St. Paul, MN
| | - David Boxrud
- Public Health Laboratory, Minnesota Department of Health, St. Paul, MN
| | - Stacy M. Holzbauer
- Minnesota Department of Health, Saint Paul, MN
- Field Services Branch, Office of Public Health Preparedness and Response, Centers for Disease Control and Prevention, Atlanta, GA
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21
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Rajasingham R, Klammer K, Nabeta H, Musubire A, Akampurira A, Williams D, Boxrud D, Rolfes M, Tengsupakul S, Andama A, Rhein J, Meya D, Boulware D. 1472Epidemiology of Meningitis in an HIV-infected Ugandan Cohort. Open Forum Infect Dis 2014. [PMCID: PMC5781860 DOI: 10.1093/ofid/ofu052.1018] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/14/2022] Open
Affiliation(s)
| | | | - Henry Nabeta
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | - Abdu Musubire
- Infectious Diseases Institute, Makerere University, Kampala, Uganda
| | | | - Darlisha Williams
- Center for Infectious Diseases and Microbiology Translational Research, University of Minnesota, Minneapolis, MN
| | - David Boxrud
- Public Health Laboratory, Minnesota Department of Health, St. Paul, MN
| | | | | | - Alfred Andama
- Medicine, Makerere University College of Health Sciences, Kampala, Uganda
| | - Joshua Rhein
- Infectious Disease and International Medicine, University of Minnesota, Minneapolis, MN
| | - David Meya
- Public Health Laboratory, Minnesota Department of Health, St. Paul, MN
| | - David Boulware
- Public Health Laboratory, Minnesota Department of Health, St. Paul, MN
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22
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Gahr P, DeVries AS, Wallace G, Miller C, Kenyon C, Sweet K, Martin K, White K, Bagstad E, Hooker C, Krawczynski G, Boxrud D, Liu G, Stinchfield P, LeBlanc J, Hickman C, Bahta L, Barskey A, Lynfield R. An outbreak of measles in an undervaccinated community. Pediatrics 2014; 134:e220-8. [PMID: 24913790 PMCID: PMC8167837 DOI: 10.1542/peds.2013-4260] [Citation(s) in RCA: 67] [Impact Index Per Article: 6.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
Abstract
Measles is readily spread to susceptible individuals, but is no longer endemic in the United States. In March 2011, measles was confirmed in a Minnesota child without travel abroad. This was the first identified case-patient of an outbreak. An investigation was initiated to determine the source, prevent transmission, and examine measles-mumps-rubella (MMR) vaccine coverage in the affected community. Investigation and response included case-patient follow-up, post-exposure prophylaxis, voluntary isolation and quarantine, and early MMR vaccine for non-immune shelter residents >6 months and <12 months of age. Vaccine coverage was assessed by using immunization information system records. Outreach to the affected community included education and support from public health, health care, and community and spiritual leaders. Twenty-one measles cases were identified. The median age was 12 months (range, 4 months to 51 years) and 14 (67%) were hospitalized (range of stay, 2-7 days). The source was a 30-month-old US-born child of Somali descent infected while visiting Kenya. Measles spread in several settings, and over 3000 individuals were exposed. Sixteen case-patients were unvaccinated; 9 of the 16 were age-eligible: 7 of the 9 had safety concerns and 6 were of Somali descent. MMR vaccine coverage among Somali children declined significantly from 2004 through 2010 starting at 91.1% in 2004 and reaching 54.0% in 2010 (χ(2) for linear trend 553.79; P < .001). This was the largest measles outbreak in Minnesota in 20 years, and aggressive response likely prevented additional transmission. Measles outbreaks can occur if undervaccinated subpopulations exist. Misunderstandings about vaccine safety must be effectively addressed.
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Affiliation(s)
- Pamala Gahr
- Minnesota Department of Health, St Paul, Minnesota;
| | | | - Gregory Wallace
- Centers for Disease Control and Prevention, Atlanta, Georgia
| | | | | | | | - Karen Martin
- Minnesota Department of Health, St Paul, Minnesota
| | - Karen White
- Minnesota Department of Health, St Paul, Minnesota
| | - Erica Bagstad
- Hennepin County Human Services and Public Health, Hopkins, Minnesota
| | - Carol Hooker
- Hennepin County Human Services and Public Health, Hopkins, Minnesota
| | | | - David Boxrud
- Minnesota Department of Health, St Paul, Minnesota
| | - Gongping Liu
- Minnesota Department of Health, St Paul, Minnesota
| | | | - Julie LeBlanc
- Children’s Hospital and Clinics of Minnesota, St Paul, Minnesota
| | | | - Lynn Bahta
- Minnesota Department of Health, St Paul, Minnesota
| | - Albert Barskey
- Centers for Disease Control and Prevention, Atlanta, Georgia
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23
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DeVries A, Wotton J, Lees C, Boxrud D, Uyeki T, Lynfield R. Neuraminidase H275Y and hemagglutinin D222G mutations in a fatal case of 2009 pandemic influenza A (H1N1) virus infection. Influenza Other Respir Viruses 2012; 6:e85-8. [PMID: 22243670 DOI: 10.1111/j.1750-2659.2011.00329.x] [Citation(s) in RCA: 10] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023] Open
Abstract
Oseltamivir-resistant 2009 H1N1 influenza virus infections associated with neuraminidase (NA) H275Y have been identified sporadically. Strains possessing the hemagglutinin (HA) D222G mutation have been detected in small numbers of fatal 2009 H1N1 cases. We report the first clinical description of 2009 H1N1 virus infection with both NA-H275Y and HA-D222G mutations detected by pyrosequencing of bronchioalveolar lavage fluid obtained on symptom day 19. The 59-year-old immunosuppressed patient had multiple conditions conferring higher risk of prolonged viral replication and severe illness and died on symptom day 34. Further investigations are needed to determine the significance of infection with strains possessing NA-H275Y and HA-D222G.
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Affiliation(s)
- Aaron DeVries
- Infectious Disease Epidemiology, Prevention and Control Division, Minnesota Department of Health, Saint Paul, MN 55164, USA.
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Boxrud D, Monson T, Stiles T, Besser J. The role, challenges, and support of pulsenet laboratories in detecting foodborne disease outbreaks. Public Health Rep 2010; 125 Suppl 2:57-62. [PMID: 20518445 DOI: 10.1177/00333549101250s207] [Citation(s) in RCA: 42] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022] Open
Abstract
In recent years, there have been several high-profile nationwide foodborne outbreaks due to enteric organisms in food products, including Salmonella Typhimurium in peanut products, Salmonella Saintpaul in peppers, and Escherichia coli O157:H7 in spinach. PulseNet, the national molecular subtyping network for foodborne disease surveillance, played a key role in detecting each of these outbreaks. PulseNet laboratories use bacterial subtyping methods to rapidly detect clusters of foodborne disease, which are often the first indication that an outbreak is occurring. Rapid outbreak detection reduces ongoing transmission through product recalls, restaurant closures, and other mechanisms. By greatly increasing the sensitivity of outbreak detection, PulseNet allows us to identify and correct problems with our food production and distribution systems that would not otherwise have come to our attention. Annually, millions of potentially preventable cases of foodborne illness result in billions of dollars in lost productivity and health-care expenses. We describe the critical role PulseNet laboratories play in the detection of foodborne outbreaks and discuss current challenges and potential improvements for PulseNet laboratories to more rapidly identify future foodborne outbreaks.
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Affiliation(s)
- David Boxrud
- Minnesota Department of Health, St. Paul, MN 55164-0899, USA.
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Abstract
UNLABELLED Animals provide benefits to elderly and chronically ill people by decreasing loneliness, increasing social interactions, and improving mental health. As a result, many hospitals and long-term care facilities allow family pets to visit ill or convalescing patients or support animal-assisted therapy programs. These include programs that have resident animals in long-term care facilities. Despite the benefits, there are concerns about disease transmission between pets and patients. Antibiotic-resistant bacteria, such as methicillin-resistant Staphylococcus aureus (MRSA), are a recognized problem in healthcare settings leading to refractory infections and potentially life-threatening illnesses. MRSA has been isolated from numerous animal species, yet few studies are available on the carriage of this pathogen in animals residing in long-term care facilities. Our objective was to characterize MRSA carriage among resident animals in a long-term care facility. METHODS To document MRSA colonization, nasal swabs from 12 resident animals (one dogs and 11 cats) of a long-term care facility were collected weekly for 8 weeks. Staphylococcus isolates were characterized by antimicrobial susceptibility and MRSA isolates were further characterized by pulsed-field gel electrophoresis (PFGE). PFGE isolate patterns were compared with an existing database of MRSA isolate patterns at the Minnesota Department of Health. RESULTS Two of 11 cats were colonized with MRSA. MRSA was recovered from five of eight weekly samples in one cat and two of eight weekly samples in the other cat. All isolates were classified as USA100 (healthcare-associated strains). DISCUSSION Long-term care resident animals may acquire MRSA. Clonally related strains were identified over the 8-week sampling period. It is unclear if pets serve as an on-going source of infection to their human companions in long-term care facilities.
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Affiliation(s)
- K Coughlan
- Veterinary Public Health, University of Minnesota, St Paul, MN 55108, USA
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Garten RJ, Davis CT, Russell CA, Shu B, Lindstrom S, Balish A, Sessions WM, Xu X, Skepner E, Deyde V, Okomo-Adhiambo M, Gubareva L, Barnes J, Smith CB, Emery SL, Hillman MJ, Rivailler P, Smagala J, de Graaf M, Burke DF, Fouchier RAM, Pappas C, Alpuche-Aranda CM, López-Gatell H, Olivera H, López I, Myers CA, Faix D, Blair PJ, Yu C, Keene KM, Dotson PD, Boxrud D, Sambol AR, Abid SH, St George K, Bannerman T, Moore AL, Stringer DJ, Blevins P, Demmler-Harrison GJ, Ginsberg M, Kriner P, Waterman S, Smole S, Guevara HF, Belongia EA, Clark PA, Beatrice ST, Donis R, Katz J, Finelli L, Bridges CB, Shaw M, Jernigan DB, Uyeki TM, Smith DJ, Klimov AI, Cox NJ. Antigenic and genetic characteristics of swine-origin 2009 A(H1N1) influenza viruses circulating in humans. Science 2009; 325:197-201. [PMID: 19465683 PMCID: PMC3250984 DOI: 10.1126/science.1176225] [Citation(s) in RCA: 1771] [Impact Index Per Article: 118.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022]
Abstract
Since its identification in April 2009, an A(H1N1) virus containing a unique combination of gene segments from both North American and Eurasian swine lineages has continued to circulate in humans. The lack of similarity between the 2009 A(H1N1) virus and its nearest relatives indicates that its gene segments have been circulating undetected for an extended period. Its low genetic diversity suggests that the introduction into humans was a single event or multiple events of similar viruses. Molecular markers predictive of adaptation to humans are not currently present in 2009 A(H1N1) viruses, suggesting that previously unrecognized molecular determinants could be responsible for the transmission among humans. Antigenically the viruses are homogeneous and similar to North American swine A(H1N1) viruses but distinct from seasonal human A(H1N1).
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MESH Headings
- Animals
- Antibodies, Viral/immunology
- Antigens, Viral/genetics
- Antigens, Viral/immunology
- Disease Outbreaks
- Evolution, Molecular
- Genes, Viral
- Genetic Variation
- Genome, Viral
- Hemagglutination Inhibition Tests
- Hemagglutinin Glycoproteins, Influenza Virus/chemistry
- Hemagglutinin Glycoproteins, Influenza Virus/genetics
- Hemagglutinin Glycoproteins, Influenza Virus/immunology
- Humans
- Influenza A Virus, H1N1 Subtype/classification
- Influenza A Virus, H1N1 Subtype/genetics
- Influenza A Virus, H1N1 Subtype/immunology
- Influenza A Virus, H1N1 Subtype/isolation & purification
- Influenza A Virus, H3N2 Subtype/genetics
- Influenza A virus/genetics
- Influenza, Human/epidemiology
- Influenza, Human/immunology
- Influenza, Human/virology
- Mutation
- Neuraminidase/genetics
- Orthomyxoviridae Infections/veterinary
- Orthomyxoviridae Infections/virology
- Phylogeny
- Reassortant Viruses/genetics
- Swine
- Swine Diseases/virology
- Viral Matrix Proteins/genetics
- Viral Nonstructural Proteins/genetics
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Affiliation(s)
- Rebecca J Garten
- WHO Collaborating Center for Influenza, Centers for Disease Control and Prevention (CDC), Atlanta, GA 30333, USA
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Rainbow J, Jewell B, Danila RN, Boxrud D, Beall B, Van Beneden C, Lynfield R. Invasive group a streptococcal disease in nursing homes, Minnesota, 1995-2006. Emerg Infect Dis 2008. [PMID: 18439360 PMCID: PMC2600262 DOI: 10.3201/eid1405.0704072] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/03/2022] Open
Abstract
Nursing home residents are at high risk for invasive GAS disease; clusters are common. Nursing home residents are at high risk for invasive group A streptococcal (GAS) disease, and clusters of cases in nursing homes are common.To characterize the epidemiologic features of invasive GAS disease in nursing homes, we conducted active, statewide, population- and laboratory-based surveillance in Minnesota from April 1995 through 2006. Of 1,858 invasive GAS disease cases, 134 (7%) occurred in nursing home residents; 34 of these cases were identified as part of 13 clusters. Recognizing cases of GAS disease in nursing homes posed challenges. Measures to ensure identification of case-patients as residents of specific nursing homes need to be included in standard guidelines for the prevention and control of invasive GAS disease in this setting.
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Affiliation(s)
- Jean Rainbow
- Minnesota Department of Health, St. Paul, Minnesota 55164-0975, USA.
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Rainbow J, Jewell B, Danila RN, Boxrud D, Beall B, Van Beneden C, Lynfield R. Invasive group a streptococcal disease in nursing homes, Minnesota, 1995-2006. Emerg Infect Dis 2008; 14:772-7. [PMID: 18439360 DOI: 10.3201/eid1405.070407] [Citation(s) in RCA: 6] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022] Open
Abstract
Nursing home residents are at high risk for invasive group A streptococcal (GAS) disease, and clusters of cases in nursing homes are common.To characterize the epidemiologic features of invasive GAS disease in nursing homes, we conducted active, statewide, population- and laboratory-based surveillance in Minnesota from April 1995 through 2006. Of 1,858 invasive GAS disease cases, 134 (7%) occurred in nursing home residents; 34 of these cases were identified as part of 13 clusters. Recognizing cases of GAS disease in nursing homes posed challenges. Measures to ensure identification of case-patients as residents of specific nursing homes need to be included in standard guidelines for the prevention and control of invasive GAS disease in this setting.
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Affiliation(s)
- Jean Rainbow
- Minnesota Department of Health, St. Paul, Minnesota 55164-0975, USA.
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Abstract
We investigated a cluster of community-associated methicillin-resistant Staphylococcus aureus infections among persons at a wilderness canoe camp. Isolates from the investigation had identical profiles for susceptibility, pulsed-field gel electrophoresis, and toxins. Participants in activities that involve skin injury, person-to-person contact, and inadequate hygiene are at increased risk for methicillin-resistant S. aureus infections.
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Affiliation(s)
- Kathryn Como-Sabetti
- Infectious Disease Epidemiology, Prevention and Control Section, Minnesota Department of Health, Saint Paul, Minnesota 55164-0975, USA.
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Swanson SJ, Snider C, Braden CR, Boxrud D, Wünschmann A, Rudroff JA, Lockett J, Smith KE. Multidrug-resistant Salmonella enterica serotype Typhimurium associated with pet rodents. N Engl J Med 2007; 356:21-8. [PMID: 17202452 DOI: 10.1056/nejmoa060465] [Citation(s) in RCA: 82] [Impact Index Per Article: 4.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
BACKGROUND An estimated 1.4 million salmonella infections occur annually in the United States. The majority of these infections are foodborne, but many are acquired by contact with animals. In August 2004, isolates of Salmonella enterica serotype Typhimurium, which were indistinguishable from one another by pulsed-field gel electrophoresis (PFGE), were obtained from eight hamsters from a Minnesota pet distributor. We conducted an investigation to determine whether human cases of salmonella could be linked to this rodent-borne strain. METHODS To identify cases of human infection with S. enterica serotype Typhimurium potentially related to pet rodents, we reviewed salmonella PFGE patterns submitted to the National Molecular Subtyping Network for Foodborne Disease Surveillance. Patients with isolates matching the hamster strain were interviewed about exposure to pet rodents. Implicated rodents were traced to pet stores, distributors, and breeders. RESULTS We identified matching S. enterica serotype Typhimurium isolates from 28 patients in whom the onset of illness occurred between December 2003 and September 2004. Of 22 patients (or in the case of children, their parents) interviewed, 13 patients (59%) in 10 states reported exposure to pet hamsters, mice, or rats, and 2 (9%) had secondary infections. The median age of the 15 patients with primary or secondary rodent exposure was 16 years, and 6 patients (40%) were hospitalized. Thirteen associated pet stores supplied by seven distributors were identified in 10 states. No single source of the rodents was identified. The outbreak strain of S. enterica serotype Typhimurium was cultured from a patient's pet mouse and from seven hamsters from pet stores. Closely related S. enterica serotype Typhimurium isolates were cultured from rodent cages and reusable transport containers at a pet distributor. Human, rodent, and environmental isolates were resistant to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline. CONCLUSIONS Pet rodents probably are an underrecognized source of human salmonella infection.
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Affiliation(s)
- Stephen J Swanson
- Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, USA.
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Boxrud D, Pederson-Gulrud K, Wotton J, Medus C, Lyszkowicz E, Besser J, Bartkus JM. Comparison of multiple-locus variable-number tandem repeat analysis, pulsed-field gel electrophoresis, and phage typing for subtype analysis of Salmonella enterica serotype Enteritidis. J Clin Microbiol 2006; 45:536-43. [PMID: 17151203 PMCID: PMC1829081 DOI: 10.1128/jcm.01595-06] [Citation(s) in RCA: 141] [Impact Index Per Article: 7.8] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/20/2022] Open
Abstract
Strain subtyping is an important tool for detection of outbreaks caused by Salmonella enterica serotype Enteritidis. Current subtyping methods, however, yield less than optimal subtype discrimination. In this study, we describe the development and evaluation of a multiple-locus variable-number tandem repeat analysis (MLVA) method for subtyping Salmonella serotype Enteritidis. The discrimination ability and epidemiological concordance of MLVA were compared with those of pulsed-field gel electrophoresis (PFGE) and phage typing. MLVA provided greater discrimination among non-epidemiologically linked isolates than did PFGE or phage typing. Epidemiologic concordance was evaluated by typing 40 isolates from four food-borne disease outbreaks. MLVA, PFGE, and, to a lesser extent, phage typing exhibited consistent subtypes within an outbreak. MLVA was better able to differentiate isolates between the individual outbreaks than either PFGE or phage typing. The reproducibility of MLVA was evaluated by subtyping sequential isolates from an infected individual and by testing isolates following multiple passages and freeze-thaw cycles. PFGE and MLVA patterns were reproducible for isolates that were frozen and passaged multiple times. However, 2 of 12 sequential isolates obtained from an individual over the course of 36 days had an MLVA type that differed at one locus and one isolate had a different phage type. Overall, MLVA typing of Salmonella serotype Enteritidis had enhanced resolution, good reproducibility, and good epidemiological concordance. These results indicate that MLVA may be a useful tool for detection and investigation of outbreaks caused by Salmonella serotype Enteritidis.
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Affiliation(s)
- D Boxrud
- Minnesota Department of Health, 601 Robert Street N., P.O. Box 64899, Saint Paul, MN 55164-0899, USA.
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Hardwick TH, Plikaytis B, Cassiday PK, Cage G, Peppler MS, Shea D, Boxrud D, Sanden GN. Reproducibility of Bordetella pertussis genomic DNA fragments generated by XbaI restriction and resolved by pulsed-field gel electrophoresis. J Clin Microbiol 2002; 40:811-6. [PMID: 11880398 PMCID: PMC120225 DOI: 10.1128/jcm.40.3.811-816.2002] [Citation(s) in RCA: 16] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/02/2001] [Revised: 06/19/2001] [Accepted: 12/10/2001] [Indexed: 11/20/2022] Open
Abstract
The intra- and interlaboratory variabilities of the molecular size measurements of each DNA fragment contributing to three pulsed-field gel electrophoresis (PFGE) profiles were assessed, as were the reproducibilities of the entire PFGE profiles for three Bordetella pertussis strains. The major source of variability within a laboratory occurred between subcultures rather than within gels or between gels. Each PFGE profile was generated reproducibly and was objectively defined by the molecular sizes of its composite fragments. A strain or profile most suitable for use as an internal reference standard was identified.
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Affiliation(s)
- Terri H Hardwick
- Meningitis and Special Pathogens Branch, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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Groom AV, Wolsey DH, Naimi TS, Smith K, Johnson S, Boxrud D, Moore KA, Cheek JE. Community-acquired methicillin-resistant Staphylococcus aureus in a rural American Indian community. JAMA 2001; 286:1201-5. [PMID: 11559265 DOI: 10.1001/jama.286.10.1201] [Citation(s) in RCA: 261] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 11/14/2022]
Abstract
CONTEXT Until recently, methicillin-resistant Staphylococcus aureus (MRSA) infections have been acquired primarily in nosocomial settings. Four recent deaths due to MRSA infection in previously healthy children in the Midwest suggest that serious MRSA infections can be acquired in the community in rural as well as urban locations. OBJECTIVES To document the occurrence of community-acquired MRSA infections and evaluate risk factors for community-acquired MRSA infection compared with methicillin-susceptible S aureus (MSSA) infection. DESIGN Retrospective cohort study with medical record review. SETTING Indian Health Service facility in a rural midwestern American Indian community. PATIENTS Patients whose medical records indicated laboratory-confirmed S aureus infection diagnosed during 1997. MAIN OUTCOME MEASURES Proportion of MRSA infections classified as community acquired based on standardized criteria; risk factors for community-acquired MRSA infection compared with those for community-acquired MSSA infection; and relatedness of MRSA strains, determined by pulsed-field gel electrophoresis (PFGE). RESULTS Of 112 S aureus isolates, 62 (55%) were MRSA and 50 (45%) were MSSA. Forty-six (74%) of the 62 MRSA infections were classified as community acquired. Risk factors for community-acquired MRSA infections were not significantly different from those for community-acquired MSSA. Pulsed-field gel electrophoresis subtyping indicated that 34 (89%) of 38 community-acquired MRSA isolates were clonally related and distinct from nosocomial MRSA isolates found in the region. CONCLUSIONS Community-acquired MRSA may have replaced community-acquired MSSA as the dominant strain in this community. Antimicrobial susceptibility patterns and PFGE subtyping support the finding that MRSA is circulating beyond nosocomial settings in this and possibly other rural US communities.
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Affiliation(s)
- A V Groom
- Indian Health Service National Epidemiology Program, 5300 Homestead Rd NE, Albuquerque, NM 87110, USA
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Popovic T, Schmink S, Rosenstein NA, Ajello GW, Reeves MW, Plikaytis B, Hunter SB, Ribot EM, Boxrud D, Tondella ML, Kim C, Noble C, Mothershed E, Besser J, Perkins BA. Evaluation of pulsed-field gel electrophoresis in epidemiological investigations of meningococcal disease outbreaks caused by Neisseria meningitidis serogroup C. J Clin Microbiol 2001; 39:75-85. [PMID: 11136752 PMCID: PMC87683 DOI: 10.1128/jcm.39.1.75-85.2001] [Citation(s) in RCA: 68] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [What about the content of this article? (0)] [Affiliation(s)] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/26/2000] [Accepted: 10/06/2000] [Indexed: 11/20/2022] Open
Abstract
Since 1990, the frequency of Neisseria meningitidis serogroup C (NMSC) outbreaks in the United States has increased. Based on multilocus enzyme electrophoresis (MEE), the current molecular subtyping standard, most of the NMSC outbreaks have been caused by isolates of several closely related electrophoretic types (ETs) within the ET-37 complex. We chose 66 isolates from four well-described NMSC outbreaks that occurred in the United States from 1993 to 1995 to evaluate the potential of pulsed-field gel electrophoresis (PFGE) to identify outbreak-related isolates specific for each of the four outbreaks and to differentiate between them and 50 sporadic isolates collected during the outbreak investigations or through active laboratory-based surveillance from 1989 to 1996. We tested all isolates collected during the outbreak investigations by four other molecular subtyping methods: MEE, ribotyping (ClaI), random amplified polymorphic DNA assay (two primers), and serotyping and serosubtyping. Among the 116 isolates, we observed 11 clusters of 39 NheI PFGE patterns. Excellent correlation between the PFGE and the epidemiological data was observed, with an overall sensitivity of 85% and specificity of 71% at the 95% pattern relatedness breakpoint using either 1.5 or 1.0% tolerance. For all four analyzed outbreaks, PFGE would have given public health officials additional support in declaring an outbreak and making appropriate public health decisions.
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Affiliation(s)
- T Popovic
- Meningitis and Special Pathogens Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA
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