Jansen A, Frank C, Prager R, Oppermann H, Stark K
Abteilung für Infektionsepidemiologie, Robert Koch-Institut, Berlin.
Z Gastroenterol. 2005 Aug;43(8):707-13. doi: 10.1055/s-2005-858256.
In spring and summer 2004, a multistate outbreak of infections caused by Salmonella enterica serovar Give (S. Give), a relatively rare serovar in Germany, was detected. In order to identify a common exposure and to describe the characteristics of infections caused by S. Give, an outbreak investigation was performed.
In addition to passive surveillance through mandatory case-reporting, active case-finding was conducted. A case-control study was undertaken in order to identify the probable vehicle of infection. S. Give strains were isolated and molecular subtyping was performed by pulsed-field gel electrophoresis (PFGE). Rates of hospitalization were assessed in patients with S. Give infection, and compared to the rates found in patients infected by the most common serovar in Germany, S. enteritidis.
From March to July 2004, 115 cases of gastroenteritis caused by S. Give were identified, with highest incidences being observed in the states of Lower Saxony and Saxony-Anhalt. Consumption of raw minced pork was strongly associated with S. Give infections (OR: 8.0; 95% CI 2.3-27.7; P = 0.001). This result was confirmed by the detection of common outbreak strains in isolates from both patients and pork, using PFGE. Infections caused by S. Give lead to hospitalization in 55% of patients > or = 60 years, but only in 17 % of younger patients (OR: 6.0; 95% CI 2.1-16.3; P < 0.001) and 33% in patients > or = 60 years with infections caused by S. enteritidis (OR: 2.5; 95% CI 1.1-5.4; P = 0.02).
This is, to our knowledge, the first documented multistate outbreak of salmonellosis associated with the consumption of raw minced pork in Germany. Since contamination of pork meat with Salmonella cannot be avoided, people with risk factors for severe infection should generally avoid the consumption of raw minced pork. The high hospitalization rates in patients > or = 60 years infected with S. Give possibly indicate a higher virulence of this specific serovar. Even in non-typhoidal salmonellosis, early antibiotic therapy should be considered depending on infecting serovar, age and medical history of the patient.
2004年春夏，德国检测到一起由肠炎沙门氏菌Give血清型（S. Give）引起的多州感染暴发，该血清型在德国相对罕见。为确定共同暴露因素并描述S. Give引起的感染特征，开展了一次暴发调查。
除通过强制病例报告进行被动监测外，还开展了主动病例搜索。进行了一项病例对照研究以确定可能的感染源。分离出S. Give菌株，并通过脉冲场凝胶电泳（PFGE）进行分子分型。评估了S. Give感染患者的住院率，并与德国最常见血清型肠炎沙门氏菌感染患者的住院率进行比较。
2004年3月至7月，共确诊115例由S. Give引起的肠胃炎病例，下萨克森州和萨克森 - 安哈尔特州发病率最高。食用生碎猪肉与S. Give感染密切相关（比值比：8.0；95%置信区间2.3 - 27.7；P = 0.001）。使用PFGE在患者和猪肉分离株中检测到共同的暴发菌株，证实了这一结果。S. Give引起的感染导致60岁及以上患者中有55%住院，但60岁以下患者中仅17%住院（比值比：6.0；95%置信区间2.1 - 16.3；P < 0.
