A European outbreak of Salmonella enterica serotype typhimurium definitive phage type 204b in 2000

Paul Crook, J. F. Aguilera, John Threlfall, S. J. O'Brien*, G. Sigmundsdóttir, Deborah Wilson, Ian Fisher, A. Ammon, H. Briem, J. M. Cowden, M. E. Locking, H. Tschäpe, W. van Pelt, L. R. Ward, M. A. Widdowson

*Corresponding author for this work

Research output: Contribution to journalArticlepeer-review

41 Citations (Scopus)

Abstract

Objective. To describe the clinical, epidemiologic and microbiological features of a large outbreak of infection with a multiresistant Salmonella enterica serotype Typhimurium definitive type DT204b infection involving at least 392 people in five European countries. Methods. Icelandic public-health doctors responded to a report on an Internet news site of an outbreak of infection with a multiresistant strain of Typhimurium DT104 in England by contacting the Public Health Laboratory Service (PHLS) Communicable Disease Surveillance Centre (CDSC). An international alert was sent out through Enter-net. All strains from England & Wales, The Netherlands, Scotland and Germany, and 17 of the outbreak isolates from Iceland, were phage-typed, screened for antimicrobial resistance, and subjected to molecular typing. Hypothesis-generating interviews were conducted, followed by case-control studies performed in Iceland and England. Results. Isolates from cases in Iceland, England and Wales, The Netherlands, Scotland and Germany were identified as Typhimurium DT204b. The antimicrobial resistance pattern was ACGNeKSSuTTmNxCpL. All strains tested displayed an identical plasmid profile. Strains from five cases in England & Wales and five cases in Iceland possessed identical pulsed-field profiles. Although a common source was suspected, only Iceland implicated imported lettuce as a vehicle, with an analytic epidemiologic study (OR = 40.8; P = 0.005; 95% CI 2.7-3175). Conclusion. The identification of international outbreaks, necessary for investigation and control, can be facilitated by standardized phage-typing techniques, the electronic transfer of molecular typing patterns, formal and informal links established through international surveillance networks, and the early reporting of national outbreaks to such networks.

Original languageEnglish
Pages (from-to)839-845
Number of pages7
JournalClinical Microbiology and Infection
Volume9
Issue number8
DOIs
Publication statusPublished - 1 Aug 2003

Bibliographical note

Funding Information:
The international surveillance network for enteric pathogens (Enter-net) is funded by the European Commission, Health and Consumer Protection Directorate, agreement No. SI2.326441. The European Programme for Intervention Epidemiology Training (EPIET) is funded by the European Commission, Health and Consumer Protection Directorate, agreement No. SI2.74030.

Keywords

  • Antimicrobial resistance
  • Food-borne
  • International outbreak
  • Salmonella
  • Surveillance

Fingerprint

Dive into the research topics of 'A European outbreak of Salmonella enterica serotype typhimurium definitive phage type 204b in 2000'. Together they form a unique fingerprint.

Cite this