Swanson Stephen J, Snider Cynthia, Braden Christopher R, Boxrud David, Wünschmann Arno, Rudroff Jo Ann, Lockett Jana, Smith Kirk E
Epidemic Intelligence Service Program, Centers for Disease Control and Prevention, Atlanta, USA.
N Engl J Med. 2007 Jan 4;356(1):21-8. doi: 10.1056/NEJMoa060465.
An estimated 1.4 million salmonella infections occur annually in the United States. The majority of these infections are foodborne, but many are acquired by contact with animals. In August 2004, isolates of Salmonella enterica serotype Typhimurium, which were indistinguishable from one another by pulsed-field gel electrophoresis (PFGE), were obtained from eight hamsters from a Minnesota pet distributor. We conducted an investigation to determine whether human cases of salmonella could be linked to this rodent-borne strain.
To identify cases of human infection with S. enterica serotype Typhimurium potentially related to pet rodents, we reviewed salmonella PFGE patterns submitted to the National Molecular Subtyping Network for Foodborne Disease Surveillance. Patients with isolates matching the hamster strain were interviewed about exposure to pet rodents. Implicated rodents were traced to pet stores, distributors, and breeders.
We identified matching S. enterica serotype Typhimurium isolates from 28 patients in whom the onset of illness occurred between December 2003 and September 2004. Of 22 patients (or in the case of children, their parents) interviewed, 13 patients (59%) in 10 states reported exposure to pet hamsters, mice, or rats, and 2 (9%) had secondary infections. The median age of the 15 patients with primary or secondary rodent exposure was 16 years, and 6 patients (40%) were hospitalized. Thirteen associated pet stores supplied by seven distributors were identified in 10 states. No single source of the rodents was identified. The outbreak strain of S. enterica serotype Typhimurium was cultured from a patient's pet mouse and from seven hamsters from pet stores. Closely related S. enterica serotype Typhimurium isolates were cultured from rodent cages and reusable transport containers at a pet distributor. Human, rodent, and environmental isolates were resistant to ampicillin, chloramphenicol, streptomycin, sulfisoxazole, and tetracycline.
Pet rodents probably are an underrecognized source of human salmonella infection.
美国每年估计有140万例沙门氏菌感染病例。这些感染大多数是食源性的，但许多是通过与动物接触而获得的。2004年8月，从明尼苏达州一家宠物经销商的8只仓鼠中分离出肠炎沙门氏菌鼠伤寒血清型菌株，这些菌株通过脉冲场凝胶电泳（PFGE）无法区分。我们进行了一项调查，以确定人类沙门氏菌病例是否可能与这种啮齿动物传播的菌株有关。
为了识别可能与宠物啮齿动物相关的肠炎沙门氏菌鼠伤寒血清型人类感染病例，我们查阅了提交给食源性疾病监测国家分子分型网络的沙门氏菌PFGE模式。对分离出与仓鼠菌株匹配的患者进行了关于接触宠物啮齿动物的访谈。对涉及的啮齿动物追溯到宠物店、经销商和饲养者。
我们从28例患者中鉴定出匹配的肠炎沙门氏菌鼠伤寒血清型菌株，这些患者的发病时间在2003年12月至2004年9月之间。在接受访谈的22例患者（或儿童的父母）中，10个州的13例患者（59%）报告接触过宠物仓鼠、小鼠或大鼠，2例（9%）有继发感染。15例有原发性或继发性啮齿动物接触的患者的中位年龄为16岁，6例（40%）住院治疗。在10个州确定了由7个经销商供应的13家相关宠物店。未确定啮齿动物的单一来源。从一名患者的宠物小鼠和宠物店的7只仓鼠中培养出肠炎沙门氏菌鼠伤寒血清型的暴发菌株。从一家宠物经销商的啮齿动物笼子和可重复使用的运输容器中培养出密切相关的肠炎沙门氏菌鼠伤寒血清型菌株。人、啮齿动物和环境分离株对氨苄青霉素、氯霉素、链霉素、磺胺异恶唑和四环素耐药。
宠物啮齿动物可能是人类沙门氏菌感染的一个未被充分认识的来源。
