Abstract
Monophasic variant of Salmonella enterica subspecies enterica serovar Typhimurium (monophasic S. Typhimurium), with antigenic structure 1,4,[5],12:i:-, appears to be of increasing importance in Europe. In Italy, monophasic S. Typhimurium represented the third most frequent Salmonella serovar isolated from human cases between 2004 and 2008. From June 2013 to October 2014, a total of 206 human cases of salmonellosis were identified in Abruzzo region (Central Italy). Obtained clinical isolates characterised showed S. Typhimurium 1,4,[5],12:i:- with sole resistance to nalidixic acid, which had never been observed in Italy in monophasic S. Typhimurium, neither in humans nor in animals or foods. Epidemiological, microbiological and environmental investigations were conducted to try to identify the outbreak source. Cases were interviewed using a standardised questionnaire and microbiological tests were performed on human as well as environmental samples, including samples from fruit and vegetables, pigs, and surface water. Investigation results did not identify the final vehicle of human infection, although a link between the human cases and the contamination of irrigation water channels was suggested.
Highlights
Monophasic variant of Salmonella enterica subspecies enterica serovar Typhimurium
Typhimurium), with antigenic structure 1,4 [5],12:i:, is considered an emergent pathogen in many European countries [1]. It accounted for 4.6%, 7.2% and 8.6% of total cases of salmonellosis reported to the European Surveillance System (TESSy) in 2011, 2012 and 2013 respectively [2], and ranked third among the Salmonella serovars identified in humans in the European Union (EU) during this period
The outbreak strain was repeatedly isolated in sewage treatment plants and surface water, including water used for irrigation in the region
Summary
Monophasic variant of Salmonella enterica subspecies enterica serovar Typhimurium Typhimurium), with antigenic structure 1,4 [5],12:i:-, is considered an emergent pathogen in many European countries [1]. It accounted for 4.6%, 7.2% and 8.6% of total cases of salmonellosis reported to the European Surveillance System (TESSy) in 2011, 2012 and 2013 respectively [2], and ranked third among the Salmonella serovars identified in humans in the European Union (EU) during this period. Fresh beef and pork account for the major sources of infection, but dried sausages and frozen chicken pies have been implicated in food-borne outbreaks, as well as vegetables and juices. Human outbreaks potentially related to environmental sources, including water, have been observed [4,5,6,7,8]
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