Association between raw milk and human Salmonella dublin infection

Decoding the invasive nature of a tropical pathogen of concern: The invasive non-Typhoidal Salmonella strains causing host-restricted extraintestinal infections worldwide

Invasive-Non-Typhoidal Salmonella (iNTS) are the major cause of health concern in the low-income, under-developed nations in Africa and Asia that lack proper sanitation facilities. Around 5% of the NTS cases give rise to invasive, extraintestinal diseases leading to focal infections like osteomyelitis, meningitis, osteoarthritis, endocarditis and neonatal sepsis. iNTS serovars like S. Typhimurium, S. Enteritidis, S. Dublin, S. Choleraesuis show a greater propensity to become invasive than others which hints at the genetic basis of their emergence. The major risk factors attributing to the invasive diseases include immune-compromised individuals having co-infection with malaria or HIV, or suffering from malnutrition. The rampant use of antibiotics leading to the emergence of multi-drug resistant strains poses a great challenge in disease management. An extensive understanding of the iNTS pathogenesis and its epidemiology will open up avenues for the development of new vaccination and therapeutic strategies to restrict the spread of this neglected disease.

Invasive Non-typhoidal Salmonella (iNTS) Infections

Salmonella enterica invade the host via the intestinal tract. There are ~ 2 thousand distinct serovars of non-typhoidal Salmonella (NTS) that can cause gastroenteritis in normal hosts, but bacteremia is an uncommon complication of gastroenteritis except at the extremes of age [1]. In contrast, enteric fever and invasive NTS infections (iNTS) are each caused by only a few serovars of S. enterica (Table 1), and bacteremia not gastroenteritis is their principal manifestation.

Molecular Detection of Coxiella burnetii in Unstandardized Minas Artisanal Cheese Marketed in Southeastern Brazil

Q fever is a zoonotic disease caused by Coxiella burnetii. The causative pathogen has been detected in dairy products, which raises the possibility of consumption of dairy products as a possible route of transmission; however, this has not been adequately described. Therefore, the aim of the present study was to investigate the presence of C. burnetii in 87 samples of artisanal cheeses made from unpasteurized raw milk sold in Minas Gerais, southeastern Brazil. The cheese samples were analyzed using quantitative real-time PCR (qPCR), and the products from positive samples were sequenced. In addition, 150 people were interviewed to outline the profile of consumers and the consumption of non-inspected dairy products. The results showed that 4.6% (4/87) of the samples were positive for C. burnetii, with 99.84% identity with the reference 16S gene. Responses from consumer interviews indicate that 95.3% (143/150) of respondents consume milk and dairy products; 50% (75/150) consume fresh Minas artisanal cheese and milk at least once a day; 64.58% (93/144) do not check the inspection stamps on the packaging at the time of purchase; and 81.56% (122/146) do not know the meaning of these stamps. Thus, the presence of C. burnetii DNA in the analyzed cheeses and the consumption of unstandardized dairy products raise an alert for the risk of transmission of Q fever in the population that consumes them.

Narrative Review Comparing Principles and Instruments Used in Three Active Surveillance and Control Programmes for Non-EU-regulated Diseases in the Danish Cattle Population

The objective of this paper is to provide a comparative review of three active surveillance and control programmes in the Danish cattle sector to highlight important differences for decision makers to develop successful programmes. The focus is on differences in purpose, principles, design and instruments applied to achieve the goals stated for each programme for bovine viral diarrhoea (BVDV), paratuberculosis and Salmonella Dublin. The purposes of the programmes are to reduce economic consequences and improve animal welfare, and for S. Dublin also to prevent zoonotic risk, with varying importance as motivation for the programmes over time. The targets of the BVDV and S. Dublin programmes have been to eradicate the diseases from the Danish cattle population. This goal was successfully reached for BVDV in 2006 where the programme was changed to a surveillance programme after 12 years with an active control programme. The S. Dublin dairy herd-level prevalence decreased from 25% in 2003 to 6% in 2015, just before the milk quota system was abandoned. Over the last 5 years, the prevalence has increased to 8–9% test-positive dairy herds. It is mandatory to participate, and frequent updates of legislative orders were used over two decades as critical instruments in those two programmes. In contrast, participation in the paratuberculosis programme is voluntary and the goals are to promote participation and reduce the prevalence and economic and welfare consequences of the disease. The daily administration of all three programmes is carried out by the major farmers' organisation, who organise surveillance, IT-solutions and other control tools, projects and communication in collaboration with researchers from the universities, laboratories and, for BVDV and S. Dublin, the veterinary authorities. Differences among the programme designs and instruments are mainly due to the environmental component of paratuberculosis and S. Dublin, as the bacteria able to survive for extended periods outside the host. This extra diffuse source of infection increases the demand for persistent and daily hygiene and management efforts. The lower test sensitivities (than for BVDV) lead to a requirement to perform repeated testing of herds and animals over longer time periods calling for withstanding motivation among farmers.

Disentangling a complex nationwide Salmonella Dublin outbreak associated with raw-milk cheese consumption, France, 2015 to 2016

On 18 January 2016, the French National Reference Centre for Salmonella reported to Santé publique France an excess of Salmonella enterica serotype Dublin (S. Dublin) infections. We investigated to identify the source of infection and implement control measures. Whole genome sequencing (WGS) and multilocus variable-number tandem repeat analysis (MLVA) were performed to identify microbiological clusters and links among cases, animal and food sources. Clusters were defined as isolates with less than 15 single nucleotide polymorphisms determined by WGS and/or with identical MLVA pattern. We compared different clusters of cases with other cases (case–case study) and controls recruited from a web-based cohort (case–control study) in terms of food consumption. We interviewed 63/83 (76%) cases; 2,914 controls completed a questionnaire. Both studies’ findings indicated that successive S. Dublin outbreaks from different sources had occurred between November 2015 and March 2016. In the case–control study, cases of distinct WGS clusters were more likely to have consumed Morbier (adjusted odds ratio (aOR): 14; 95% confidence interval (CI): 4.8–42) or Vacherin Mont d’Or (aOR: 27; 95% CI: 6.8–105), two bovine raw-milk cheeses. Based on these results, the Ministry of Agriculture launched a reinforced control plan for processing plants of raw-milk cheeses in the production region, to prevent future outbreaks.

Geography Shapes the Population Genomics of Salmonella enterica Dublin

Salmonella enterica serotype Dublin (S. Dublin) is a bovine-adapted serotype that can cause serious systemic infections in humans. Despite the increasing prevalence of human infections and the negative impact on agricultural processes, little is known about the population structure of the serotype. To this end, we compiled a manually curated data set comprising of 880 S. Dublin genomes. Core genome phylogeny and ancestral state reconstruction revealed that region-specific clades dominate the global population structure of S. Dublin. Strains of S. Dublin in the UK are genomically distinct from US, Brazilian, and African strains. The geographical partitioning impacts the composition of the core genome as well as the ancillary genome. Antibiotic resistance genes are almost exclusively found in US genomes and are mediated by an IncA/C2 plasmid. Phage content and the S. Dublin virulence plasmid were strongly conserved in the serotype. Comparison of S. Dublin to a closely related serotype, S. enterica serotype Enteritidis, revealed that S. Dublin contains 82 serotype specific genes that are not found in S. Enteritidis. Said genes encode metabolic functions involved in the uptake and catabolism of carbohydrates and virulence genes associated with type VI secretion systems and fimbria assembly respectively.

Epidemiology of Salmonella enterica Serotype Dublin Infections among Humans, United States, 1968-2013

Infection incidence and antimicrobial drug resistance are increasing.

Salmonella enterica serotype Dublin is a cattle-adapted bacterium that typically causes bloodstream infections in humans. To summarize demographic, clinical, and antimicrobial drug resistance characteristics of human infections with this organism in the United States, we analyzed data for 1968–2013 from 5 US surveillance systems. During this period, the incidence rate for infection with Salmonella Dublin increased more than that for infection with other Salmonella. Data from 1 system (FoodNet) showed that a higher percentage of persons with Salmonella Dublin infection were hospitalized and died during 2005−2013 (78% hospitalized, 4.2% died) than during 1996–2004 (68% hospitalized, 2.7% died). Susceptibility data showed that a higher percentage of isolates were resistant to >7 classes of antimicrobial drugs during 2005–2013 (50.8%) than during 1996–2004 (2.4%).

Salmonella Dublin patients in Denmark and their distance to cattle farms

BACKGROUND

The Salmonella serotype Dublin is specifically adapted to cattle but may infect humans leading to severe disease. We described human S. Dublin cases and investigated a potential spatial relation between their addresses and cattle farms in Denmark.

METHODS

We extracted S. Dublin patient surveillance data, 2000-2014, and performed descriptive analyses. We geocoded residential and cattle farm addresses and mapped their incidence by region, province and municipality. We used linear correlation and spatial autocorrelation analysis at the municipality level and calculated the direct network distance from the nearest farm to the residential address of cases and 20,000 randomly selected citizens representing the background population.

RESULTS

We identified 484 S. Dublin cases, 57% were male, median age 65 years. Seven patients (1%) acquired their infection abroad. The 30 days all-cause mortality was 13%. Overall, cumulative incidence was 8.0 per 100,000 inhabitants. Cattle farms were located predominantly in the western part of the country. Neither visual inspection nor correlation analysis indicated a relationship between municipalities with high incidences of human cases and cattle farms. Global Moran's Index analysis showed municipalities with high incidence of cases to be randomly distributed. We found equal direct network distances between cattle farms and both addresses of S. Dublin cases and the background population.

CONCLUSIONS

We found S. Dublin infections in Denmark to affect the elderly, be serious and acquired domestically. Our findings indicate that the risk of infection with S. Dublin in Denmark is independent of living in the proximity to cattle farms.

Isolation, Identification, and Antibiotic Susceptibility Testing of Salmonella from Slaughtered Bovines and Ovines in Addis Ababa Abattoir Enterprise, Ethiopia: A Cross-Sectional Study

Salmonellae are ubiquitous, found in animals, humans, and the environment, a condition which facilitates transmission and cross contamination. Salmonella enterica serotypes exert huge health and economic impacts due to their virulence or carriage of antibiotic resistance traits. To address this significant issues with regard to public health, availability of adequate information on the prevalence and antibiotic resistance patterns of Salmonella, and establishment of adequate measures to control contamination and infection are needed. A cross-sectional study was conducted to assess the level of Salmonella infection in slaughtered bovines and ovines at Addis Ababa abattoir. Samples were collected randomly and processed for identification and antimicrobial susceptibility testing of Salmonella spp. From 280 animals examined, 13 (4.64%) (8 bovines and 5 ovines) were positive, with most samples (12/13, 92%) comprising Salmonella Dublin. Very high level of resistance to some antibiotics used in human medicine was detected. Most isolates were susceptible to gentamycin and amikacin. Nine (69%) of all isolates were resistant to multiple antibiotics. Serotyping revealed 12 of 13 isolates to be of the Dublin serotype with 9,12:g,p:- antigenic formula. This study emphasizes the importance of improving the evisceration practice during slaughtering and restricting the use of antibiotics in farm animals.

Non-typhoidal Salmonella Typhimurium ST313 isolates that cause bacteremia in humans stimulate less inflammasome activation than ST19 isolates associated with gastroenteritis

Salmonella is an enteric pathogen that causes a range of diseases in humans. Non-typhoidal Salmonella (NTS) serovars such as Salmonella enterica serovar Typhimurium generally cause a self-limiting gastroenteritis whereas typhoidal serovars cause a systemic disease, typhoid fever. However, S. Typhimurium isolates within the multi-locus sequence type ST313 have emerged in sub-Saharan Africa as a major cause of bacteremia in humans. The S. Typhimurium ST313 lineage is phylogenetically distinct from classical S. Typhimurium lineages, such as ST19, that cause zoonotic gastroenteritis worldwide. Previous studies have shown that the ST313 lineage has undergone genome degradation when compared to the ST19 lineage, similar to that observed for typhoidal serovars. Currently, little is known about phenotypic differences between ST313 isolates and other NTS isolates. We find that representative ST313 isolates invade non-phagocytic cells less efficiently than the classical ST19 isolates that are more commonly associated with gastroenteritis. In addition, ST313 isolates induce less Caspase-1-dependent macrophage death and IL-1β release than ST19 isolates. ST313 isolates also express relatively lower levels of mRNA of the genes encoding the SPI-1 effector sopE2 and the flagellin, fliC, providing possible explanations for the decrease in invasion and inflammasome activation. The ST313 isolates have invasion and inflammatory phenotypes that are intermediate; more invasive and inflammatory than Salmonella enterica serovar Typhi and less than ST19 isolates associated with gastroenteritis. This suggests that both phenotypically and at the genomic level ST313 isolates are evolving signatures that facilitate a systemic lifestyle in humans.

Prevalence of human Salmonellosis in Ethiopia: a systematic review and meta-analysis

BACKGROUND

Human Salmonellosis is one of the major diseases in Ethiopia and several factors including under and mal-nutrition and HIV-AIDS may substantially contribute to its occurrence. Despite its importance, surveillance and monitoring systems are not in place and a comprehensive picture of its epidemiology is not available. The objectives of this study were to systematically review and estimate the prevalence of the disease and identify the dominant serogroups and serotypes in Ethiopia.

METHODS

Published studies on Salmonellosis in Ethiopia were electronically and manually searched. Eligible studies were selected by using inclusion and exclusion criteria. Generic, methodological and statistical information were extracted from the eligible studies. The extracted data included sample sizes, the numbers of Salmonella positive samples, serogroups and serotypes. The variations in prevalence estimates attributable to heterogeneities were assessed and pooled prevalence was estimated by the random effects model.

RESULTS

Twenty studies carried out between 1974 and 2012 were eligible. The pooled prevalence estimates of Salmonella in stool samples of diarrheic children, diarrheic adults and carriers were 8.72%, 5.68%, and 1.08% respectively. Invasive infections in children (5.71%) and adults (0.76%) were significantly different (p < 0.001). Non-typhi isolates accounted for 57.9% of the isolates from patients. Serogroup D occurred more frequently than serogroups C and B. S. Concord, S. Typhi, S. Typhimurium and S. Paratyphi were dominant and accounted for 82.1% of the serotypes isolated from patients.

CONCLUSION

The prevalence of Salmonellosis is considerable and most infections are due to four serotypes. The results imply the need for a policy to promote public hygiene and regularly screen individuals in contact with food items for public consumption.

Only one of the two type VI secretion systems encoded in the Salmonella enterica serotype Dublin genome is involved in colonization of the avian and murine hosts

The type VI secretion system (T6SS) is a virulence factor for many Gram-negative bacteria. Salmonella genus harbors five phylogenetically distinct T6SS loci encoded in Salmonella Pathogenicity Islands (SPIs) SPI-6, SPI-19, SPI-20, SPI-21 and SPI-22, which are differentially distributed among serotypes. The T6SSs encoded in SPI-6 and SPI-19 contribute to pathogenesis of serotypes Typhimurium and Gallinarum in mice and chickens, respectively. Salmonella Dublin is a pathogen restricted to cattle where it causes a systemic disease. Also, it can colonize other hosts such as chickens and mice, which can act as reservoirs of this serotype. Salmonella Dublin harbors the genes for both T6SS_SPI-6 and T6SS_SPI-19. This study has determined the contribution of T6SS_SPI-6 and T6SS_SPI-19 to host-colonization by Salmonella Dublin using avian and murine models of infection. Competitive index experiments showed that, a mutant strain lacking both T6SSs (∆T6SS_SPI-6/∆T6SS_SPI-19) presents a strong colonization defect in cecum of chickens, similar to the defect observed for the ∆T6SS_SPI-6 mutant, suggesting that this serotype requires a functional T6SS_SPI-6 for efficient colonization of the avian gastrointestinal tract. Colonization of mice was also defective, although to a lesser extent than in chickens. In contrast, the T6SS_SPI-19 was not necessary for colonization of either chickens or mice. Transfer of T6SS_SPI-6, but not T6SS_SPI-19, restored the ability of the double mutant to colonize both animal hosts. Our data indicate that Salmonella Dublin requires only the T6SS_SPI-6 for efficient colonization of mice and chickens, and that the T6SS_SPI-6 and T6SS_SPI-19 are not functionally redundant.

Antimicrobial resistance of Salmonella enterica isolates from bulk tank milk and milk filters in the United States

Salmonella isolates were recovered from bulk tank milk as part of the National Animal Health Monitoring System (NAHMS) Dairy 2002 and 2007 surveys. In-line milk filters were also tested in the 2007 survey. The objective of this study was to determine the prevalence of antimicrobial resistance among Salmonella enterica isolates from bulk milk and milk filters in the NAHMS Dairy 2002 and 2007 surveys and to further characterize resistant isolates. Susceptibilities to 15 antibiotics were determined for 176 Salmonella isolates of 26 serotypes using an automated antimicrobial susceptibility system. Resistant isolates were screened by PCR for the presence of the extended-spectrum β-lactamase (bla(CMY)) gene and class I integrons and further characterized by pulsed-field gel electrophoresis. Thirty isolates (17.0%) representing six S. enterica serotypes exhibited resistance to at least one antimicrobial agent (serotypes Newport [14 of 14 isolates exhibited resistance], Dublin [7 of 7], Typhimurium [3 of 5], Kentucky [4 of 22], Anatum [1 of 13], and Infantis [1 of 2]). Twenty isolates (11.4%), including all 14 Newport, 3 Dublin, 2 Typhimurium, and 1 Infantis isolate, displayed the typical multidrug-resistant, bla(CMY)-positive (MDR-AmpC) phenotype which included resistance to ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline, plus resistance to amoxicillin-clavulanic acid and extended-spectrum cephalosporins. Five of the MDR-AmpC isolates carried class I integrons (2.8%). Two-enzyme (XbaI and BlnI) pulsed-field gel electrophoresis discerned clades within serotypes and, together with the resistance profiles, identified strains that appeared to have persisted temporally and geographically. These results suggest that there is a low but appreciable risk of infection with MDR Salmonella from consumption of nonpasteurized milk and dairy products.

The Role of the spv Genes in Salmonella Pathogenesis

Salmonella strains cause three main types of diseases in people: gastroenteritis, enteric (typhoid) fever, and non-typhoid extra-intestinal disease with bacteremia. Genetic analysis indicates that each clinical syndrome requires distinct sets of virulence genes, and Salmonella isolates differ in their constellation of virulence traits. The spv locus is strongly associated with strains that cause non-typhoid bacteremia, but are not present in typhoid strains. The spv region contains three genes required for the virulence phenotype in mice: the positive transcriptional regulator spvR and two structural genes spvB and spvC. SpvB and SpvC are translocated into the host cell by the Salmonella pathogenicity island-2 type-three secretion system. SpvB prevents actin polymerization by ADP-ribosylation of actin monomers, while SpvC has phosphothreonine lyase activity and has been shown to inhibit MAP kinase signaling. The exact mechanisms by which SpvB and SpvC act in concert to enhance virulence are still unclear. SpvB exhibits a cytotoxic effect on host cells and is required for delayed cell death by apoptosis following intracellular infection. Strains isolated from systemic infections of immune compromised patients, particularly HIV patients, usually carry the spv locus, strongly suggesting that CD4 T cells are required to control disease due to Salmonella that are spv positive. This association is not seen with typhoid fever, indicating that the pathogenesis and immunology of typhoid have fundamental differences from the syndrome of non-typhoid bacteremia.

Animal models of Salmonella infections: enteritis versus typhoid fever

The most common disease syndromes caused by Salmonella serotypes in humans, typhoid fever and enteritis, can be modeled using Salmonella enterica serotype Typhimurium infections in mice and calves, respectively. This article reviews murine typhoid and bovine enteritis and discusses strengths, limitations and distinctive features of these animal models.

Risk factors for fecal shedding of Salmonella in 91 US dairy herds in 1996

In 1996, data on management practices used on US dairy operations were collected and analyzed for association with fecal shedding of Salmonella by dairy cows. A total of 4299 fecal samples from 91 herds was cultured for Salmonella isolation. Herd-size (adjusted odds ratios (OR) = 5.8, 95% CI 1.1, 31.3), region (OR = 5.7, CI 1.4, 23.5), use of flush water systems (OR = 3.5, CI 0.9, 14.7), and feeding brewers' products to lactating cows (OR = 3.4, CI 0.9, 12.9) were identified as the most important predictive risk factors. The population attributable risks (PARs) for herd-size, region, flush water system, and feeding brewers' products to lactating cows were 0.76, 0.46, 0.37, and 0.42, respectively. The estimated PAR for all four risk factors combined was 0.95. The effects of these factors need to be more-closely evaluated in more-controlled studies, in order to develop intervention programs that reduce Salmonella shedding.

Salmonella enterica serotype Dublin infection: an emerging infectious disease for the northeastern United States

Salmonella enterica subspecies enterica serotype Dublin (S. enterica Dublin) emerged for the first time in New York, Pennsylvania, and Ohio in 1988. Since that time this host-adapted serotype has spread throughout the veal- and dairy beef-raising operations in the region; very few dairy farms have experienced clinical S. enterica Dublin infections. This study details the epidemiology of the outbreaks in cattle. During the period 1988 through 1995, nine New York and four Pennsylvania counties have been affected; 13 different locations were involved in New York, and 10 were involved in Pennsylvania. The morbidity and mortality and seasonal distribution of outbreaks, which totaled 35, is described. The antimicrobial susceptibility pattern of isolates revealed that many of the strains were resistant to a number of commonly used drugs. Clinical case details and pathology information are provided, with a caution to clinicians and microbiologists presented with suspect animals, i.e., most cases occurred in older calves, which is atypical for salmonellosis for this region (calves were 8 or more weeks old) and presented as pneumonia and septicemia rather than the primarily diarrheal syndrome that is more typically recognized for the region. The epidemiology of cases is analyzed through cluster analysis of bacterial isolates and their fatty acid methyl ester profiles; at least six clones appeared in the region during the study period. Results of the epidemiology analysis are used to support a hypothesis regarding the source of S. enterica Dublin for the region and its manner of dissemination.

Profile of raw milk consumers in California

OBJECTIVES

The authors sought to determine the prevalence of raw milk consumption in California--the largest producer of certified raw milk in the United States--and to describe the demographic and behavioral characteristics of raw milk consumers in that state.

METHODS

The authors analyzed responses to questions on the 1994 California Behavioral Risk Factor Surveillance System Survey that asked respondents about whether they drank raw milk, the amount consumed, the reason for drinking raw milk, and where raw milk was most often obtained.

RESULTS

Among 3999 survey respondents, 3.2% reported drinking raw milk in the previous year. Raw milk drinkers were more likely than nondrinkers to be younger than age 40, male, and Hispanic and to have less than a high school education.

CONCLUSIONS

Raw milk continues to be consumed by some residents of California despite the documented hazards associated with this dietary practice.

Evaluation of an O antigen enzyme-linked immunosorbent assay for screening of milk samples for Salmonella dublin infection in dairy herds

Levels of antibodies to the O antigens (O:1,9,12) of Salmonella dublin were tested in 1355 serum, 1143 cow milk and 160 bulk milk samples from dairy herds using an enzyme-linked immunosorbent assay (ELISA). In order to define the background reaction, milk samples from all lactating cows and serum samples from 9 animals were collected in each of 20 salmonellosis-free herds located on the island of Bornholm, where cattle salmonellosis has not been reported. Similar samples were collected from all stalled animals in 10 herds with recent (< 6 months) outbreaks of salmonellosis located in Jutland, where salmonella infection is enzootic. Using herd history of salmonellosis, herd location and clinical status of the herds as criteria, the optimal cutoff in the milk ELISA was determined as being at least 5% of the samples having optical density > 0.5, resulting in herd sensitivity of 1.0 and herd specificity of 0.95. While none of the sera in the herds from Bornholm was ELISA positive, 2 herds had a few reactors in the milk ELISA. Using the same cutoff, all but 1 bulk milk sample from 150 herds on Bornholm was ELISA-negative, and all 10 salmonellosis-positive herds from Jutland were ELISA-positive. A significant correlation was found between ELISA reactions in milk and in serum of cows (34% and 32% respectively, rs = 0.69, P < 0.001).(ABSTRACT TRUNCATED AT 250 WORDS)

Serodiagnosis of Salmonella dublin infection in Danish dairy herds using O-antigen based enzyme-linked immunosorbent assay

Usefulness of two enzyme-linked immunosorbent assays (ELISA) for screening of dairy herds for antibodies to lipopolysaccharide (LPS) of Salmonella dublin (O:1,9,12) was investigated. Sera (3097) were collected from 40 dairy herds located in three areas of Denmark with different prevalence of salmonellosis: ten salmonellosis-free herds from the island of Samsø where there is no history of salmonellosis, ten salmonellosis-free herds from the island of Sealand where outbreaks are infrequent, and 20 salmonella infected herds from Jutland where salmonellosis is enzootic. The samples were analyzed for antibodies to S. dublin LPS using an indirect (O:9,12) and a blocking (O:9) ELISA. Using herd history of salmonellosis, herd location and clinical state of the herds as reference, the herd sensitivity and herd specificity of the tests were 100% and 100% in the indirect ELISA and 95% and 100% in the blocking ELISA, respectively. A significant correlation was found between the two tests (rs = 0.46, p < 0.001). However, the indirect ELISA detected more seropositive animals than the blocking ELISA (17% vs. 7%, respectively). In calves from Sealand, level of background reaction was significantly lower (p < 0.001) compared to the heifers and the cows. The percentages of seropositive calves in both tests were higher (p < 0.01) in comparison to cows (19 vs. 8 in indirect ELISA, and 14 vs. 6 in blocking ELISA, respectively). Results of the study indicated that it is possible to apply LPS ELISA in serological screening for salmonellosis.

Stress induction of the virulence proteins (SpvA, -B, and -C) from native plasmid pSDL2 of Salmonella dublin

The virulence region of the wild-type plasmid pSDL2 contained in Salmonella dublin is highly conserved among plasmids from several nontyphoid Salmonella serotypes and is essential for the development of systemic infection in BALB/c mice. Polyclonal antibodies against three proteins (SpvA, -B, and -C) expressed from a 4.1-kb EcoRI subclone of the plasmid virulence region were generated. These antibodies were used to detect expression of the Spv proteins when S. dublin was grown in vitro under stress-inducing conditions, such as nutrient deprivation and increased temperature, that the bacteria may encounter during the course of infection within the host. Glucose starvation resulted in expression of all three proteins shortly after the lag phase. When the bacteria were grown to the late-log phase without glucose, heat shock strongly induced expression of SpvA but not SpvB or SpvC. The addition of 0.2% glucose to the medium resulted in loss of expression of the proteins until the late-log to stationary phase. Iron limitation or lowered pH induced expression of the proteins during exponential growth even in the presence of glucose. Insertion mutations into the positive regulator gene spvR upstream from spvABC and insertions into spvA and spvC resulted in loss of expression of SpvA, -B, and -C, suggesting a complex regulation of expression. These studies define a variety of environmental conditions that induce expression of the Spv virulence proteins from the wild-type plasmid pSDL2 in S. dublin in vitro.

Salmonellae, salmonellosis, and dairy foods: a review

Salmonellae continue to be a major concern for the dairy industry because these bacteria have caused recent outbreaks of illness and have been isolated from various dairy products in the market place. Salmonellae are generally not heat resistant and normally grow at 35 to 37 degrees C, but they can grow at much lower temperatures, provided that the incubation time is suitably extended. To minimize problems, foods should be held at or below 2 to 5 degrees C at all times. Both conventional and rapid methods are available to isolate salmonellae from dairy foods and to identify the bacteria. Salmonellae behave differently in different kinds of cheese: they survived in ripening Cheddar cheese for up to 7 mo at 13 degrees C and for 10 mo at 7 degrees C; in coldpack cheese food for several weeks, depending on the pH and preservative used; and in Domiati cheese 13 to 36 d, depending on the manufacturing process used. When Mozzarella cheese was made, temperatures of stretching and molding (60 degrees C) killed all salmonellae present, but, in cottage cheese, survival of the pathogen depended on the cooking temperature of curd. Spray drying of skim milk killed substantial numbers of salmonellae, but some survivors remained. Butter readily supported growth of salmonellae at room temperature, and neither freezing nor refrigeration for brief periods eliminated salmonellae from butter. Use of appropriate hygienic procedures, e.g., Hazard Analysis Critical Control Point system, during processing should reduce the likelihood of salmonellosis outbreaks associated with dairy foods.

Disease determinants of sporadic salmonellosis in four northern California counties. A case-control study of older children and adults

A population-based, case-control study of sporadic salmonellosis was conducted in 1988 and 1989 in four northern California counties. The study included 120 patients and 265 control subjects. Conditional logistic regression analysis (adjusted for age) revealed that patients were more likely to consume undercooked chicken prior to the onset of disease (odds ratio [OR], 23.57; 95% confidence interval [CI], 2.89 to 192.30). Elevated associations were also found with recent travel to foreign countries (OR, 9.69; 95% CI, 3.18 to 29.56), diabetes (OR, 6.29; 95% CI, 1.56 to 25.34), hormonal replacement therapy (principally conjugated estrogen) in older women (OR, 4.20; 95% CI, 1.82 to 9.71), and antibiotic therapy prior to illness (OR, 1.96; 95% CI, 0.86 to 4.37). The problems of studying self-selected cases that may lead to alternative explanations for these findings are also discussed.

Plasmid profile analysis, phage typing, and antibiotic sensitivity of Salmonella dublin from clinical isolates in the United States

One hundred clinical isolates of Salmonella choleraesuis subsp. choleraesuis serovar dublin (Salmonella dublin) were examined for phage sensitivity, antibiotic resistance patterns, and plasmid content. Computer analysis of the lysis patterns observed by using 27 typing phages divided the S. dublin isolates into 26 groups. One lytic pattern (Designated pattern 16) contained 52% of the isolates examined whereas 16 isolates had unique patterns, and nine patterns had fewer than ten members. Although 14 antibiotic resistance patterns were observed among the 100 isolates, 79% of the isolates grouped in three major patterns. Seven plasmid groups were identified and designated A-G based on the large plasmids found in the isolates. Of the 100 isolates, 28 contained the plasmid profile of Group A, 28 were Group B, 7 were Group C, 34 were Group D, and 1 isolate each was observed in Groups E, F, and G. The strong association between antibiotic resistance pattern and plasmid type suggest that the drug resistance genes are plasmid borne.

Persistent experimental Salmonella dublin intramammary infection in dairy cows

Experimental intramammary infections were induced in five post-parturient Holstein cows by inoculation of low numbers (5000 colony forming units) of virulent Salmonella dublin via the teat canal of mammary gland quarters. Rectal temperature, pulse and respiratory rates, milk yield, and milk quality as assessed by the California Mastitis Test (CMT) and somatic cell counts (SCC) were recorded every 12 hours at milking. Bacteriologic cultures of foremilk quarter samples and feces were obtained daily, as were complete blood counts. ELISA titers for IgG and IgM recognizing S. dublin lipopolysaccharide (LPS) were obtained weekly on serum and quarter milk samples. All cows excreted S. dublin intermittently from infected quarters, but no changes were detected in rectal temperature, appearance of the mammary gland or secretions, CBC, milk yield, and pulse and respiratory rates. Somatic cell counts were modestly increased in infected quarters as compared with uninfected quarters (P = .015, paired t test); however, CMT scores after infection remained low, and were not significantly different from pre-infection scores (P greater than .10, sign test). After infection, administration of dexamethasone resulted in signs of clinical mastitis and increased excretion of S. dublin from mammary quarters (P = .0004, paired t test). One cow had necrotizing mastitis and S. dublin septicemia and was euthanatized. In the four surviving cows, clinical improvement was observed after systemic gentamicin therapy and intramammary infusion with polymyxin B, but all cows continued to excrete S. dublin intermittently from one or more quarters and occasionally from feces for the remaining period of observation. All infected cows demonstrated a rise in IgG and IgM ELISA titers recognizing S. dublin LPS in serum and milk. At necropsy (13-25 weeks postinfection), S. dublin was recovered only from the mammary tissue or supramammary lymph nodes in three of four cows. In one cow, mammary gland and lymph-node samples were negative for S. dublin despite positive milk cultures. In all cows, histopathologic examination revealed multifocal areas of chronic active mastitis. These lesions were similar to histopathologic findings from mammary gland carriers with naturally acquired S. dublin infection.

Non-typhoid Salmonella bacteraemia in Greater Copenhagen 1984 to 1988

A retrospective survey of non-typhoid Salmonella bacteraemia in the period 1984 to 1988 was carried out by the five departments of clinical microbiology in Greater Copenhagen. A total of 168 patients were identified. A gradual increase was observed from 11 cases in 1984 to 58 cases in 1988. The corresponding incidence per 100,000 inhabitants in Copenhagen rose from 0.9 in 1984 to 5.0 in 1988. During the same period the total registered incidence of human Salmonella infections in Denmark increased from 17.6 to 67.4 per 100,000 inhabitants. The serotype most often isolated from bacteraemic patients was Salmonella dublin followed by Salmonella enteritidis and Salmonella typhimurium. Salmonella dublin demonstrated enhanced invasive and pathogenic properties. Predisposing factors were present in 56% of the patients; the most common was malignant disease. A fatal or complicated course of the bacteraemia was observed more frequently in patients with underlying diseases than in persons who had previously been healthy. A total of 17% of the patients died; one-fifth of these had a ruptured aortic aneurysm. It is concluded that the substantial increase in the number of cases and the often serious course taken by the infection demonstrate a need for increased efforts at prophylaxis.

Identification of proteins expressed by the essential virulence region of the Salmonella dublin plasmid

An 8 kilobase pair (kb) fragment from the Salmonella dublin 2229 plasmid is sufficient to restore virulence for mice to a cured strain of S. dublin. Deletion analysis of this virulence fragment identified at least one specific region required for virulence expression. Plasmid-directed protein synthesis in minicells has indicated the presence of at least four genes within the essential virulence region of the S. dublin plasmid, encoding proteins of 70, 33, 30 and 26 kDa. Analysis of the proteins expressed by the deletion derivatives suggested that expression of the 33 kDa polypeptide was linked to that of the 30 kDa polypeptide. The proteins expressed by the essential virulence region of the S. dublin plasmid appeared to be similar to the plasmid-encoded virulence proteins recently identified in S. typhimurium.

Splenic Rupture in Chronic Lymphoid Disorders: Possible Role of Opportunistic Infections

Two patients with lymphoproliferative disorders, one with chronic lymphocytic leukemia and the other hairy cell leukemia, developed spontaneous rupture of the spleen during the course of their disease. In both cases, this rare complication occurred during systemic atypical infections with Salmonella Dublin and Candida tropicalis respectively. We suggest that severe infection may sometimes play a decisive role in the development of the splenic rupture in some patients who have splenomegaly due to these disorders.

Extraintestinal salmonellosis

Between 1969 and 1984, 6564 non-typhoid salmonella strains were isolated at the Liverpool Public Health Laboratory of which 194 (3.0%) were from extraintestinal sites. Blood (34%) and urine (32%) isolates accounted for two-thirds of these, with the remainder being recovered from pus and inflammatory tissue (23%), bone (5%), cerebrospinal fluid (5%) and sputum (3%). Certain serotypes tended to cause more invasive disease than others, i.e. Salmonella choleraesuis, S. dublin, S. london, S. virchow and S. panama: this association for S. london has not previously been described. The spectrum of disease caused by non-typhoid strains was broad. This survey confirms the importance of non-typhoid salmonellas as occasional causes of invasive disease and local sepsis outside the gastrointestinal tract.

Physical and genetic mapping of the Salmonella dublin virulence plasmid pSDL2. Relationship to plasmids from other Salmonella strains

Plasmids of approximately 80 kb in size are found in nearly all clinical isolates of Salmonella dublin and are believed to be essential for virulence. We have shown previously that the 80-kb plasmid pSDL2 is required for the S. dublin Lane strain to establish a lethal systemic infection in BALB/c mice after oral or intraperitoneal inoculation. We now present a physical and genetic characterization of pSDL2. We have established a complete restriction endonuclease cleavage map of pSDL2 for five enzymes: Xba I, Bam HI, Xho I, Sal I, and Hind III. The region specifying autonomous replication has been localized to a 10.5-kb region of the Sal I A fragment by subcloning on the vector pBR322. Using transposon insertion mutagenesis with Tn5-oriT, a region encoding the virulence phenotype has been mapped within a 6.4-kb portion of the Sal I B fragment. Deletions generated by partial Eco RI restriction digestion demonstrate that at least 50 kb of the plasmid DNA are not required for replication or virulence functions, confirming the map location of these phenotypes. Plasmids of different sizes and restriction patterns were found in mouse virulent strains of S. dublin Vi+, S. enteritidis, and S. choleraesuis. By Southern hybridization, these putative virulence plasmids share a common 4-kb Eco RI fragment with the virulence region of pSDL2, and the plasmids from S. dublin Vi+ and S. enteritidis were shown to express mouse virulence comparable to pSDL2.

The Persistent Isolation of Salmonella typhimurium from the Mammary Gland of a Dairy Cow

The contamination of cheese by Salmonella typhimurium serotype 10 resulted in the bacteriological examination of raw milk from 327 farms on Prince Edward Island. A milk sample from a bulk tank from one farm was positive for this pathogen. The possible source was linked to the isolation of the strain from the milk from one quarter of one cow. Although the cow was asymptomatic for any clinical illness other than a chronic staphylococcal mastitis in two quarters, the animal continued to shed Salmonella in the milk during a 36 day period. Necropsy failed to reveal a source of the infection.

Plasmid-mediated virulence in Salmonella dublin demonstrated by use of a Tn5-oriT construct

Salmonella dublin, a serotype which causes invasive disease in cattle and humans, carries a characteristic 80-kilobase plasmid (pSDL2). We were able to cure the plasmid from a strain of S. dublin. The cured strain was avirulent for mice by either the oral or intraperitoneal route of infection. A derivative of Tn5 which contains the transfer origin of the broad-host-range plasmid RK2 (Tn5-oriT) was transposed onto pSDL2, allowing mobilization of the plasmid by an RK2 helper plasmid. Reintroduction of the pSDL2 derivative plasmid into the cured strain restored virulence, demonstrating that the plasmid is necessary for virulence. These studies also demonstrate the usefulness of the Tn5-oriT construct for genetic manipulations.

Salmonellosis in calves

Despite the efforts of both physicians and veterinarians, the number of cases of salmonellosis per year has held steady or risen. The ability of the organism to live in many different animal species and under inhospitable environmental conditions is likely responsible for Salmonella's prevalence today. Diverse clinical signs occur in salmonellosis; they range from unthriftiness to explosive, necrotizing diarrheas with high mortality. Secondary complications of pneumonia, bone and joint infections, and meningoencephalitis can result from calfhood infections. Treatment of enteric salmonellosis is chiefly aimed at maintaining fluid, acid-base, and electrolyte balance. Bacteremic or septicemic calves also require systemic antibiotics. The control measures for salmonellosis are based on sanitation and management. Individual calf hutches or pens provide adequate isolation if sufficient spacing and good sanitation are maintained. The Salmonella vaccines presently available provide limited protection; however, live vaccines made from auxotrophic strains of Salmonella appear to be more efficacious.

Detection of Salmonella spp. in milk by using Felix-O1 bacteriophage and high-pressure liquid chromatography

A method is described whereby the presence of less than five salmonellae was detected per milliliter of milk within 24 h of sample collection. Salmonellae were removed from milk by means of electropositive large-pore filters. Eluates from the filters were analyzed for the presence of Salmonella spp. by Felix-O1 bacteriophage and high-pressure liquid chromatographic techniques. The method gave only a positive response when salmonellae were present in the milk. Of the serotypes and strains of Salmonella spp. tested, Salmonella dublin (10 strains), Salmonella typhimurium (5 strains), Salmonella anatum, Salmonella krefeld, and Salmonella saint-paul gave positive responses. One strain of Salmonella agona (three strains tested) and three strains of Salmonella enteritidis (seven strains tested) were not detectable by the method described herein.

Invasive Salmonella dublin infections associated with drinking raw milk

Salmonella dublin is a serotype of Salmonella that is host-adapted to cattle and rarely infects people. In one year (1980-1981) we diagnosed five cases of salmonellosis due to S dublin at the Veterans Administration Medical Center, San Diego. Four patients had positive blood cultures and one died. A sixth patient, diagnosed in 1978, had a mycotic aortic aneurysm but survived. Compared with nine patients who had Salmonella infections due to other serotypes, the S dublin patients were older, had a greater number of underlying chronic illnesses and were more seriously ill with their infections. Four of the six S dublin cases occurred in association with drinking "certified" raw milk from a commercial dairy.Two microbiologic features of S dublin strains circulating in San Diego were distinctive. They failed to ferment arabinose and could not be grown in a minimal medium using citrate as the sole carbon source. Chronically ill elderly patients should be cautioned against drinking raw milk, an increasingly popular "health food."

Distinctive biochemical features of Salmonella dublin isolated in California

We examined 34 strains of Salmonella dublin that were isolated in California between 1978 and 1982. All were of a characteristic biotype; they did not grow on Simmons citrate or acetate and did not ferment arabinose. Their apparent inability to use citrate as the only carbon source was due to a nutritional requirement for nicotinic acid. Because S. dublin strains are of a characteristic biotype, are host adapted to bovines, and are unusually virulent for humans, we suggest that S. dublin be considered a separate species of the genus Salmonella. It is important that clinical laboratories recognize and differentiate this organism from less pathogenic salmonellae so that they can alert clinicians to the presence of this invasive microorganism.

Veterinary surgeons as vectors of Salmonella dublin

Salmonella dublin is an important bovine pathogen, causing dysentery, abortion, and death from septicaemia. S dublin dermatitis, a little-recognised occupational hazard for veterinary surgeons, does not cause serious disability or inconvenience. During a survey of brucellosis in south-west Wales four cases of S dublin dermatitis were seen in veterinary surgeons. One surgeon was reinfected three years later. On all five occasions the veterinary surgeons had not worn or had discarded polyethylene gloves. An apparently healthy cow may serve as a latent carrier of S dublin. Thus when disease starts in a closed, protected herd reactivation of infection within the herd is usually blamed and its introduction by extraneous agents considered to be unlikely. Veterinary surgeons should be regarded as potential vectors of S dublin.