Cummings Kevin J, Rodriguez-Rivera Lorraine D, Mitchell Katharyn J, Hoelzer Karin, Wiedmann Martin, McDonough Patrick L, Altier Craig, Warnick Lorin D, Perkins Gillian A
1 Department of Veterinary Integrative Biosciences, Texas A&M University , College Station, Texas.
Vector Borne Zoonotic Dis. 2014 Jul;14(7):496-502. doi: 10.1089/vbz.2013.1467. Epub 2014 Jun 5.
Nosocomial salmonellosis continues to pose an important threat to veterinary medical teaching hospitals. The objectives of this study were to describe an outbreak of salmonellosis caused by Salmonella enterica serovar Oranienburg within our hospital and to highlight its unique features, which can be used to help mitigate or prevent nosocomial outbreaks in the future. We retrospectively analyzed data from patients that were fecal culture-positive for Salmonella Oranienburg between January 1, 2006, and June 1, 2011, including historical, clinical, and pulsed-field gel electrophoresis (PFGE) data. Salmonella Oranienburg was identified in 20 horses, five alpacas, and three cows during this time frame, with dates of admission spanning the period from August, 2006, through January, 2008. We consider most of these patients to have become infected through either nosocomial or on-farm transmission, as evidenced by molecular subtyping results and supportive epidemiologic data. Interpretation of PFGE results in this outbreak was challenging because of the identification of several closely related Salmonella Oranienburg subtypes. Furthermore, a high percentage of cases were fecal culture-positive for Salmonella Oranienburg within 24 h of admission. These patients initially appeared to represent new introductions of Salmonella into the hospital, but closer inspection of their medical records revealed epidemiologic links to the hospital following the index case. Cessation of this outbreak was observed following efforts to further heighten biosecurity efforts, with no known cases or positive environmental samples after January, 2008. This study demonstrates that a Salmonella-positive culture result within 24 h of admission does not exclude the hospital as the source of infection, and it underscores the important role played by veterinary medical teaching hospitals as nodes of Salmonella infection that can promote transmission outside of the hospital setting.
医院获得性沙门氏菌病继续对兽医教学医院构成重大威胁。本研究的目的是描述我院由肠炎沙门氏菌奥兰宁堡血清型引起的沙门氏菌病暴发情况，并突出其独特特征，这些特征可用于帮助减轻或预防未来的医院感染暴发。我们回顾性分析了2006年1月1日至2011年6月1日期间粪便培养出奥兰宁堡沙门氏菌呈阳性的患者的数据，包括病史、临床和脉冲场凝胶电泳（PFGE）数据。在此期间，在20匹马、5只羊驼和3头牛中鉴定出奥兰宁堡沙门氏菌，入院日期从2006年8月至2008年1月。根据分子分型结果和支持性的流行病学数据，我们认为这些患者中的大多数是通过医院内感染或农场传播而感染的。由于鉴定出几种密切相关的奥兰宁堡沙门氏菌亚型，此次暴发中PFGE结果的解读具有挑战性。此外，高比例的病例在入院后24小时内粪便培养出奥兰宁堡沙门氏菌呈阳性。这些患者最初似乎代表沙门氏菌新传入医院，但仔细检查他们的病历后发现，在首例病例之后，他们与医院存在流行病学联系。在进一步加强生物安全措施后，此次暴发得到控制，2008年1月之后没有已知病例或环境样本呈阳性。这项研究表明，入院后24小时内沙门氏菌培养结果呈阳性并不排除医院是感染源，并且强调了兽医教学医院作为沙门氏菌感染节点在促进医院外传播方面所起的重要作用。
