Increased Salmonella Schwarzengrund prevalence and antimicrobial susceptibility of Salmonella enterica isolated from broiler chickens in Kagoshima Prefecture in Japan between 2013 and 2016

Determination of Antimicrobial Resistance Megaplasmid-Like pESI Structures Contributing to the Spread of Salmonella Schwarzengrund in Japan

BACKGROUND/OBJECTIVES

The acquisition of antimicrobial resistance by foodborne pathogens is a serious human health concern. In Japan, combinations of antimicrobial resistance genes in Salmonella from chicken meat were common among several serovars. Therefore, we hypothesized that different S. enterica serovars share a common antimicrobial resistance plasmid.

METHODS

Antimicrobial resistance transfer was tested in S. Infantis and S. Schwarzengrund, the major serovars used as donors. The plasmid structure was determined by subjecting S. Infantis Sal_238 and S. Schwarzengrund Sal_249 to short- and long-read sequencing.

RESULTS

The high homology between pSal_249Sch and pSal_238Inf suggests they have a common ancestor. Because the sequences of pSal_238Inf and pSal_249Sch were highly homologous to pESI (a plasmid for emerging S. Infantis), pSal_238Inf and pSal_249Sch were identified as pESI-like plasmids. S. Schwarzengrund is the third Salmonella serovar to expand its distribution related to pESI-like plasmid acquisition. Core-genome multilocus sequence-type analysis revealed that S. Schwarzengrund isolates with pESI-like plasmids from Japan (core-genome sequence-type [cgST] 167363 and cgST287831), the UK (cgST167363), and the USA (cgST167363, cgST196045, and cgST287831) were closely related; they are also suggested to share a common ancestor. The transfer of antimicrobial resistance was observed in combinations of both serovars. Specifically, the tentative plasmid sequence obtained via short-read sequencing, PCR, and conjugation experiments identified deletions of antimicrobial resistance genes (aadA, sul1, and tetA), class 1 integron, mercury resistance operon, and/or plasmid transfer region in the pESI-like plasmid.

CONCLUSION

These data on the structural diversity of pESI-like plasmids suggest that some time has passed since S. Schwarzengrund acquired them.

Biocontrol of Salmonella Schwarzengrund and Escherichia coli O157:H7 planktonic and biofilm cells via combined treatment of polyvalent phage and sodium hexametaphosphate on foods and food contact surfaces

Salmonella Schwarzengrund and Escherichia coli O157:H7 are ones of foodborne pathogens that can produce biofilms and cause serious food poisoning. Bacteriophages are an emerging antibacterial strategy used to prevent foodborne pathogen contamination in the food industry. In this study, the combined antibacterial effects of the polyvalent phage PS5 and sodium hexametaphosphate (SHMP) against both pathogens were investigated to evaluate their effectiveness in food applications. The combined treatment with phage PS5 (multiplicity of infection, MOI = 10) and 1.0% SHMP inhibited the growth of S. Schwarzengrund and E. coli O157:H7, and the viable counts of both decreased by more than 2.45 log CFU/mL. In KAGOME vegetable and fruit mixed juice, the combined treatment with PS5 (MOI = 100) and 1.0% SHMP also resulted in significant pathogen inactivation at 4 °C after 24 h. PS5 (1010 PFU/mL) and 1.0% SHMP showed stronger synergistic effects on biofilm formation and the removal of established biofilms on polystyrene plates. Additionally, we evaluated their combined effects on reducing the biofilms of S. Schwarzengrund and E. coli O157:H7 on glass tubes and cabbage leaves at 4 °C. These findings indicate the utility of this approach in the biocontrol of the planktonic and biofilm cells of S. Schwarzengrund and E. coli O157:H7 on foods and food contact surfaces.

Salmonella enterica serovar Schwarzengrund: Distribution, Virulence, and Antimicrobial Resistance

The global incidence of Salmonella enterica serovar Schwarzengrund has risen in recent years. This serotype has been isolated from poultry, retail meat, and other food products, leading to multiple outbreaks. Alongside the increase in infections, there are growing concerns about the increasing levels of antimicrobial resistance (AMR) among S. Schwarzengrund strains. This study aims to better understand the genetic factors possibly contributing to the rising prevalence of S. Schwarzengrund by analyzing the sequences of 2058 isolates from both human patients (N = 313) and food- and animal-associated sources, including chicken (N = 1145), turkey (N = 300), pork (N = 132), and other sources (N = 168). Data were obtained from GenBank and analyzed for AMR genes using AMRFinder. Additionally, putative virulence genes and plasmid transfer genes were assessed using the Virulence and AMR Plasmid Transfer Factor Database. AMR genes were found in 1269 (61.7%) of the isolates, with a total of 2478 AMR genes among the isolates, the most common being aph(3″)-Ib (N = 969, 47.1%), tet(A) (N = 190, 9.2%), and sul2 (N = 150, 7.3%), which are responsible for resistance to aminoglycoside, tetracycline, and sulfonamide, respectively. Additionally, 1060 (51.5%) isolates carried multiple plasmid transfer genes associated with IncFIB-FIC(FII) plasmids. Other plasmid types found in at least 1% of the strains included IncI1 (N = 101, 4.9%), IncHI2 (N = 62, 3.0%), or IncHI1 (N = 24, 1.2%). The virulence gene profiles of human isolates showed diversity but largely overlapped with those from different food sources. Notably, the aerobactin iron acquisition genes, associated with Salmonella's virulence and colonization, were highly prevalent among chicken isolates (N = 1019, 89.0%) but less frequent in isolates from other sources (N = 65, 7.2%). IncFIB-FIC(FII) plasmids, commonly harboring the aerobactin operon, were highly prevalent among chicken-related isolates and present in about 10% of human isolates. The diverse plasmid, AMR, and virulence gene profiles in human-associated isolates suggest that multiple factors may contribute to the increased virulence in S. Schwarzengrund.

Salmonella enterica Serovar Infantis in Broiler Chickens: A Systematic Review and Meta-Analysis

Salmonella enterica subsp. enterica serovar Infantis poses a growing threat to public health, due to its increasing prevalence worldwide and its association with high levels of antimicrobial resistance. Among livestock, S. Infantis is especially isolated from broilers. Following the Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) guidelines, a systematic review was conducted by searching in three databases (Web of Science, Scopus, and PubMed) for English-language studies (1957-2023) that reported the prevalence of S. Infantis in broiler farms. Eligible studies included epidemiological investigations conducted in broiler chickens by sampling the house environment (flock-level prevalence) or the birds (individual-level prevalence). A random-effect model was applied to calculate S. Infantis pooled prevalence estimates with 95% confidence intervals (CIs). Furthermore, to assess between-study heterogeneity, the inconsistency index statistic (I2) was calculated. Among 537 studies retrieved, a total of 9 studies reporting flock-level prevalence of S. Infantis and 4 reporting individual-level prevalence were retained for analysis. The flock-level pooled prevalence was estimated to be 9% (95% CI: 1-26%) and a high between-study heterogeneity was found (I2 = 99%, p < 0.01). Concerning individual-level prevalence, a meta-analysis was not performed due to the scarcity of eligible studies. The data presented underscore the significant occurrence of S. Infantis in broilers at the farm level. By summarizing the existing literature, this work provides useful insights for conducting future surveys of Salmonella spp. in live broiler chickens as a preliminary step for developing more efficient control strategies.

Geographical Variation of Antimicrobial Resistance of Salmonella in Japanese Chicken

Chicken is a potent source of Salmonella infection in humans. Occasionally, patients with severe Salmonella enteritis require antimicrobial therapy. Antimicrobials are used to prevent and treat bacterial infections in broiler and breeder farms. Herein, we investigated the prevalence and antimicrobial resistance of Salmonella in 337 vacuum-packed chicken breast products manufactured in Japan between June and December 2021. Salmonella was isolated from 287 samples (85.2%). Among the products from Eastern Japan, the lowest Salmonella prevalence was observed in those processed in September (65.6%), which was significantly (p < 0.05) lower than that in November or December. Among the products from Western Japan, the lowest Salmonella prevalence was observed in those processed in August (61.9%), which was significantly (p < 0.05) lower than that in June, November, and December. The most frequent serovar was Salmonella Schwarzengrund (223 isolates), followed by S. Infantis (53 isolates), S. Manhattan (9 isolates), and S. Enteritidis (1 isolate). High rates of antimicrobial resistance were observed for streptomycin (64.5%), kanamycin (50.2%), tetracycline (65.2%), nalidixic acid (11.5%), and trimethoprim (35.9%). Resistance rates against these five antimicrobials in S. Schwarzengrund isolates were markedly higher in the isolates from Western Japan than in those from Eastern Japan. All 287 Salmonella isolates were susceptible to ciprofloxacin which belongs to fluoroquinolones and cefotaxime which belongs to third-generation cephalosporins. Salmonella prevalence in chicken products in Japan was found to be extremely high; therefore, chicken meat should be thoroughly heated before consumption. In Japan, fluoroquinolones and third-generation cephalosporins are recommended as the first- and second-choice antimicrobials for patients with severe Salmonella enteritis, respectively. The results of this study show that administering fluoroquinolones or third-generation cephalosporins is an effective option for patients with Salmonella enteritis caused by consuming chicken meat, and efficient strategies for Salmonella management on broiler farms and chicken-processing plants need to be developed.

Changes in the Phenotypes of Salmonella spp. in Japanese Broiler Flocks

Salmonella infections represent a leading cause of foodborne illnesses; resistance to third-generation cephalosporins (TGCs), which are a first-choice antimicrobial for treating human Salmonella enteritis, has become a serious public health concern worldwide. Because the consumption of undercooked chicken meat products is a major cause of foodborne salmonellosis in Japan, we conducted three surveys at different periods between 2017 and 2022, with the cooperation of four abattoirs (two in Eastern and two in Western Japan). The first survey was conducted at abattoir A, which is located in Eastern Japan. Salmonella was detected in 84.4% of broiler flocks tested (27/32); among them, all the TGC-resistant isolates obtained from one farm (farm FA) were identified as S. Infantis. Salmonella was recovered from 62.5% of breast meat samples (20/32), with one case suggesting cross-contamination. The second survey was conducted at three other abattoirs to examine the prevalence of TGC-resistant Salmonella, in both Western (abattoirs B and C) and Eastern (abattoir D) Japan. Salmonella was detected in 90.6% of broiler flocks examined (29/32). TGC-resistant S. Infantis was isolated from 2 flocks until 2018 and not thereafter. Subsequently, isolates were identified as TGC-susceptible S. Schwarzengrund in both regions. The third survey was performed at abattoir A to elucidate whether there were changes in the phenotypes. Of the 11 broiler flocks introduced from farm FA, 10 were positive for Salmonella (90.9%); all the isolates were S. Schwarzengrund susceptible to TGC. This study shows that TGC-susceptible S. Schwarzengrund has replaced the resistant phenotypes among broiler flocks in both Eastern and Western Japan. Although chicken meat products could be cross-contaminated with Salmonella during the slaughtering process, reducing the prevalence of Salmonella in broiler flocks remains important to decrease Salmonella enteritis in humans.

Genetic relatedness and virulence potential of Salmonella Schwarzengrund strains with or without an IncFIB-IncFIC(FII) fusion plasmid isolated from food and clinical sources

A total of 55 food and clinical S. Schwarzengrund isolates were assayed for plasmid content, among which an IncFIB-IncFIC(FII) fusion plasmid, conferring streptomycin resistance, was detected in 17 isolates. Among the 17 isolates, 9 were food isolates primarily collected from poultry meat, and 8 clinical isolates collected from stool, urine, and gallbladder. SNP-based phylogenetic analyses showed that the isolates carrying the fusion plasmid formed a subclade indicating the plasmid was acquired and is now maintained by the lineage. Phylogenetic analysis of the plasmid suggested it is derived from avian pathogenic plasmids and might confer an adaptive advantage to the S. Schwarzengrund isolates within birds. IncFIB-IncFIC(FII) fusion plasmids from all food and three clinical isolates were self-conjugative and successfully transferred into E. coli J53 by conjugation. Food and clinical isolates had similar virulome profiles and were able to invade human Caco-2 cells. However, the IncFIB-IncFIC(FII) plasmid did not significantly add to their invasion and persistence potential in human Caco-2 cells.

Genomic diversity of Salmonella enterica isolated from raw chicken at retail establishments in Mexico

The genomic diversity of circulating non-typhoidal Salmonella in raw chicken was investigated in three states of central Mexico. A total of 192 S. enterica strains from chicken meat samples collected at supermarkets, fresh markets, and butcher shops were analyzed by whole-genome sequencing. The serovar distribution, occurrence of genes encoding for antimicrobial resistance, metal resistance, biocide resistance, plasmids and virulence factors, and clonal relatedness based on single nucleotide polymorphism (SNP) analysis were investigated. Serovars Infantis, Schwarzengrund and Enteritidis predominated among twenty identified. The distribution of serovars and proportion of AMR genes was different according to the state, year, season, and retail establishment (p < 0.001). Genes encoding metals resistance were identified in all the strains. A total of 145 virulence genes were identified and strains were classified into 32 virulotypes; serovars Infantis, Typhimurium, and Enteritidis showed the highest number of virulence genes. The strains matched 34 SNP clusters in the NCBI Pathogen Detection server and 59 %, which corresponded to Infantis, Schwarzengrund, Saintpaul, and Enteritidis, were associated with five major clusters and matched with chicken, environmental and clinical isolates from at least three countries. These results provide useful information to understand the epidemiology of Salmonella, conduct microbial risk assessment, and design risk-based control measures.

[Quantitative Analysis and Characteristics of Salmonella from Retail Chicken Meat Products in Japan]

From October 2020 to February 2021, a total of 95 retail chicken meat products from 39 retail meat shops in Tokyo Metropolis and Kanagawa Prefecture, Japan, were collected and examined for the prevalence of Salmonella to assess public health implications. If a sample tested positive for Salmonella, a quantitative analysis was performed using the three-tube most probable number (MPN) method. Of 95 retail chicken meat products, Salmonella was isolated from 30 samples (31.6%). The levels of Salmonella contamination ranged from <0.3 to 4.3 MPN/g. The most frequent level was <0.3 MPN/g (63.3%). Of the 33 Salmonella strains isolated, four serotypes were identified: S. Schwarzengrund (60.6%), S. Infantis (24.2%), S. Agona (12.1%), and S. Manhattan (3.0%). Multilocus sequence typing (MLST) analysis classified most S. Schwarzengrund isolates into sequence type (ST) 241, the same ST found in chicken meat in Japan, except for one isolate. Of the 33 Salmonella isolates, 29 (87.9%) were antibiotic resistant. Twenty-six isolates (78.8%) showed multidrug resistance to two or more antibiotics. Therefore, these results indicate that retail chicken meat products in Japan are an important source of Salmonella infection in humans and that Salmonella contamination in retail chicken products seems to originate from chicken meat.

The phenotypic and genotypic antimicrobial resistance patterns of Salmonella isolated from chickens and meat at poultry slaughterhouses in Japan and Thailand

Background and Aim

Poultry meat is a popular food consumed globally. However, poultry farming is a source of Salmonella contamination which causes human salmonellosis. This study aimed to estimate the prevalence and antimicrobial resistance (AMR) of Salmonella among chickens and meat at poultry slaughterhouses in province study areas in Thailand and Japan.

Materials and Methods

Chicken meat and feces samples were collected in Thailand and Japan. In Nakhon Ratchasima Province, Thailand, 558 samples were obtained from slaughterhouses from January 2021 to March 2022. In Gifu Prefecture, Japan, 140 samples (70 each of intestinal contents and meat) were purchased from slaughterhouses from June to October 2022. For Salmonella detection, the samples were cultivated according to the International Organization for Standardization 6579:2002/AMD 1:2007 method and confirmed using polymerase chain reaction (PCR) and agglutination tests for serotyping. Isolated Salmonella were tested for AMR to nine antibiotics using the disk diffusion method. Selected phenotypic multidrug-resistant (MDR) isolates were evaluated for AMR genes (AMRGs) using PCR.

Results

Salmonella prevalence from chickens and meat at slaughterhouses in Thailand and Japan was 41.2% and 40.7%, respectively. All the Salmonella isolates in Japan were serotyped as Schwarzengrund, and no Salmonella isolates were resistant to the nine antibiotics tested. In contrast, most of the Thai Salmonella isolates from chicken cloacal swabs and meat were resistant to doxycycline (78.3%) and colistin (63.5%). The prevalence of MDR Salmonella (MDRS) in chickens and meat from Thailand and Japan was 29.1% (67/230) and 0% (0/57), respectively. However, the most frequent AMRGs found in MDRS in Thailand were extended-spectrum beta-lactamase-Temoneira (ESBL-TEM) (45.1%). All isolated Salmonella from Japan revealed a class 1 integron gene (Int-1).

Conclusion

Phenotypic MDRS isolates from Thailand showed the greatest correlation to AMRG and ESBL-TEM. Although there were no phenotypic AMR Salmonella isolates found in Japan, they can be found associated with Int-1, which may carry other AMRGs within the gene cassettes.

Pyogenic sacroiliitis caused by Salmonella schwarzengrund in a young healthy woman: a case report and literature review

BACKGROUND

Salmonella species are a leading cause of diarrheal diseases worldwide. Recent epidemiological studies have shown that Salmonella schwarzengrund (S. schwarzengrund) is highly prevalent in various regions. Herein, we report that S. schwarzengrund caused sacroiliac joint (SIJ) infection with septic shock in a young woman, although she was immunocompetent.

CASE PRESENTATION

A 20-year-old woman presented with left hip pain, accompanied by vasopressor-requiring hypotension. Her imaging examinations showed fluid collection in her SIJ and a small abscess in the left iliac muscle. Later, the blood and aspiration fluid culture and genetic analysis revealed the presence of S. schwarzengrund. We diagnosed sacroiliac joint (SIJ) infection with septic shock caused by S. schwarzengrund. Her condition improved after performing several interventional radiology (IVR) procedures for SIJ abscesses and providing appropriate antibiotic treatment. Finally, she was discharged without any sequelae. Screening tests and genetic analysis about her immunodeficiency did not indicate a congenital disorder.

CONCLUSION

These clinical courses indicate that S. schwarzengrund could cause the fatal SIJ infection irrespective of the host immunocompetence. Considering the recent increase in the diagnostic rate of S. schwarzengrund, this case emphasized the need to be more cautious about Salmonella species infection.

Decreasing trend of β-Lactam Resistance in Salmonella Isolates from Broiler Chickens due to the Cessation of Ceftiofur in ovo Administration

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The most prevalence of S. enterica isolated in 2017 and 2018 were S. Manhattan and S. Schwarzengrund.

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S. enterica prevalence showed a declining trend over an extended period.

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β-lactam resistance was absent in the predominant serovars in 2018.

Ceftiofur, a third-generation cephalosporin antimicrobial, was used in Japanese hatcheries for many years before 2012. We continue to study Salmonella in broilers and their antimicrobial resistance. The current study aimed to express how the cessation of ceftiofur affects the antimicrobial resistance of Salmonella isolated from broiler chickens in Kagoshima Prefecture, Japan in 2017 and 2018. A total of 274 Salmonella isolates were recovered from 1535 cecal content samples obtained from 96 broiler flocks over years 2017 and 2018. Among the S. enterica isolates, the predominant serovars were S. Manhattan (128/274, 46.7%), S. Schwarzengrund (120/274, 43.8%), and S. Infantis (26/274, 9.5%). The isolates showed a high proportion of antimicrobial resistance for oxytetracycline, sulfamethoxazole, and streptomycin. However, the β-lactam resistance rates were significantly decreased (p < 0.01) in 2017, while no β-lactam resistant isolates detected in 2018. The highlight of this study was the complete disappearance of β-lactam resistance in Salmonella isolates from broiler chicken in Kagoshima, Japan.

Genomic characteristics and comparative genomics of Salmonella enterica subsp. enterica serovar Schwarzengrund strain S16 isolated from chicken feces

Background

Salmonella enterica subsp. enterica serovar Schwarzengrund (S. Schwarzengrund) is most frequently isolated from commensals humans or poultry. Here we report S. Schwarzengrund strain S16, the first sequenced genome in the Republic of Korea. Additionally, genome sequencing for strain S16 was performed and compared with other S. Schwarzengrund genomes obtained from public database.

Results

Strain S16 was isolated from chicken feces. The complete genome consists of one chromosome and one plasmid. The genome size is 4,822,755 bp with 4852 coding sequences. Strain S16 was determined as serovar Schwarzengrund by in silico serotyping and typed as sequence type (ST) 96. Forty-six S. Schwarzengrund genomes yielded a pangenome of 7112 genes, core-genome of 3374 genes, accessory-genome of 2906 genes, and unique-genome of 835 genes. Eighty-one genes were unique to strain S16, including hypothetical proteins and transcriptional regulators. Genotypic analysis of antibiotic resistance of strain S16 confirmed resistance to amikacin, ciprofloxacin, sulfamethoxazole, streptomycin, and tetracycline. Unlike other S. Schwarzengrund genomes, strain S16 had a mutation of gyrB. Moreover, similar to other S. Schwarzengrund genomes reported in other countries, strain S16 was harbored for 153 virulence genes including Saf operon and cdtB gene. All the antibiotic resistance genes and virulence genes were present in the core- or accessory-genomes.

Conclusions

Complete genome of strain S16 was sequenced. Comparative genomic analysis revealed several genes responsible for antibiotic resistance and specific genomic features of strain S16 and identified virulence factors that might contribute to the human and animal pathogenicity of other S. Schwarzengrund genomes.

Supplementary Information

The online version contains supplementary material available at 10.1186/s13099-021-00476-8.

Molecular Characteristics and Antimicrobial Resistance of Salmonella enterica Serovar Schwarzengrund from Chicken Meat in Japan

Our previous study revealed that Salmonella enterica serovar Schwarzengrund-contaminated areas of broiler chickens have expanded from West Japan to East Japan. The present study investigated the antimicrobial resistance and molecular characteristics of 124 S. Schwarzengrund isolates obtained from chicken meat produced in East and West Japan from 2008 to 2019. Comparing the isolates obtained in 2008 and 2015–2019, an increase in the proportion of those resistant to kanamycin [51.4–89.7% (p < 0.001)] was observed. In contrast, the proportion of isolates resistant to both streptomycin and tetracycline and those that harbored a 1.0-kb class 1 integron, aadA1, and tetA, significantly decreased from 100% in 2008 to 47.1% in 2015–2019 (p < 0.001). A 1.0-kb class 1 integron containing aadA1, harbored by 78 isolates, was different from that reported in globally distributed S. Schwarzengrund strains (1.9 kb, containing the dfrA12-aadA2 gene cassette). Twenty-five isolates from different product districts and years of isolation were typed as sequence type (ST) 241 with multilocus sequence typing. Our results suggest that S. Schwarzengrund, which contaminates chicken meat in Japan, shares a common ancestor regardless of the product district from 2008 to recent years. Moreover, S. Schwarzengrund ST241 may have spread from western to eastern Japan.

Prevalence of IncFIB Plasmids Found among Salmonella enterica Serovar Schwarzengrund Isolates from Animal Sources in Taiwan Using Whole-Genome Sequencing

Salmonella enterica serovar Schwarzengrund is one of the most frequently isolated Salmonella serotypes responsible for human and poultry infections in Taiwan, and it has raised public health concerns. To better facilitate the understanding of transmission patterns and the dynamics of epidemics, sharing molecular data on pathogen profiles is urgently needed. The objectives of the current study were to determine and establish baseline data of S. enterica serovar Schwarzengrund isolates from 23 epidemiologically unrelated sources from year 2000 to 2018 and examine their phenotypic and genotypic characteristics. Genomic DNA of the Salmonella isolates was extracted and subjected to whole-genome sequencing using an Illumina platform. Results showed that all selected isolates exhibited multidrug resistance, and six of those were resistant to ciprofloxacin phenotypically. Genotypically, these isolates carried genes resistant to aminoglycoside (100%), phenicol (91.3%), β-lactams (69.5%), folate pathway antagonist (100%), tetracycline (82.6%), and fluoroquinolone (4.3%). Moreover, these isolates harbor integrons with five different gene cassettes identified for the first time, which are associated with resistance to trimethoprim, streptomycin, tetracycline, sulfonamide, chloramphenicol, and gentamicin. Furthermore, prevalence of IncFIB plasmid was found among studied isolates, which may increase its ability to colonize the chicken cecum and cause extra-intestinal disease. Salmonella pathogenicity islands SPI-1 to SPI-5, SPI-13, and SPI-14, as well as C63PI locus, were also detected in all isolates. This study demonstrated that a considerable high antimicrobial resistance with high virulence levels of Salmonella were found from animal sources. Sharing data on these pathogen profiles can not only help increase the reproducibility and accessibility of genomic analysis but can also support surveillance and epidemiological investigations for salmonellosis in the region.