Robert Koch Institute, Division of Enteropathogenic Bacteria and Legionella, National Reference Centre for Salmonella and Other Enteric Pathogens, Wernigerode, Germany.
European Programme for Intervention Epidemiology Training, Robert Koch Institute, Berlin, Germany.
J Hosp Infect. 2018 Dec;100(4):e233-e238. doi: 10.1016/j.jhin.2018.03.035. Epub 2018 Mar 31.
Repeated outbreaks of salmonellosis caused by Salmonella enterica serovar Infantis at a rehabilitation clinic in Germany were investigated microbiologically from August 2002 to August 2009.
To identify the sources of transmission and characterize the S. enterica serovar Infantis isolates.
Associated with these outbreaks, isolates from 98 patients, two kitchen staff, five food samples, four swabs of kitchen facilities, three samples of chicken faeces and one sample of sewage water were evaluated by phage typing. All S. enterica serovar Infantis isolates investigated (N=113) were related to phage type (PT) 29. Additionally, 44 of the 113 isolates were selected at random for typing by XbaI macrorestriction and pulsed-field gel electrophoresis (PFGE).
Typing of the 44 isolates showed that the recurrent infections were caused by the single clone PT 29/XB27+44 (42/44, 95.5%). The most likely route of transmission was only identified in the last outbreak in 2009 within the present study. It was found to be cross-contamination in the kitchen facilities (emanating from a contaminated wooden panel), in combination with carriers among the kitchen staff.
This study demonstrated important details of hospital-specific epidemiological processes, and alludes to a long-term reservoir of an epidemic clone of S. enterica serovar Infantis either in a backyard flock of poultry or in an inanimate kitchen reservoir.
2002 年 8 月至 2009 年 8 月，德国一家康复诊所发生了由肠炎沙门氏菌血清型婴儿型引起的沙门氏菌反复暴发，对此进行了微生物学调查。
确定传播源并对肠炎沙门氏菌血清型婴儿型分离株进行特征描述。
与这些暴发相关的是，对 98 名患者、2 名厨房工作人员、5 个食品样本、4 个厨房设施拭子、3 个鸡粪便样本和 1 个污水水样的分离株进行噬菌体分型。所调查的所有肠炎沙门氏菌血清型婴儿型分离株（N=113）均与噬菌体型（PT）29 相关。此外，随机选择 113 个分离株中的 44 个进行 XbaI 宏观限制和脉冲场凝胶电泳（PFGE）分型。
44 个分离株的分型表明，反复感染是由单一克隆 PT 29/XB27+44（42/44，95.5%）引起的。只有在本研究中 2009 年的最后一次暴发中才确定了最可能的传播途径，即厨房设施（源自受污染的木板）的交叉污染，加上厨房工作人员中的携带者。
本研究展示了医院特定流行病学过程的重要细节，并暗示肠炎沙门氏菌血清型婴儿型的流行克隆长期存在于后院禽群或无生命的厨房储库中。
