An outbreak of Salmonella blockley infections following smoked eel consumption in Germany.

In June 1998, an increased number of persons with Salmonella blockley infection were reported from one German state. Because S. blockley is extremely uncommon in Germany, a case-control study was performed in order to find the source. A total of 13 patients met the case definition. Nine of 12 cases and 2 of 21 controls with food consumption histories reported eating smoked eel (OR 28.5; 95% CI 3.9-235.3). The consumed eel came from four different local smokeries, but could be traced back to fish farms in Italy. This outbreak indicates that eel may be a vehicle for salmonella infection and that the smoking process may not eliminate bacterial contamination from raw fish.

Clonal relationship of Salmonella enterica serovar typhimurium phage type DT104 in Germany and Austria.

A new epidemic clone of Salmonella enterica serovar Typhimurium designated definitive phage type (DT) 104 has been emerging since 1990 to become most common type among S. Typhimurium isolates in Germany and Austria. Molecular fingerprinting (PFGE-pattern, plasmid profiles, IS200 pattern, ribotype, ERIC-type, OMP and MLE patterns) revealed the majority of the DT104 isolates to have clonal identity; they were designated as type 1 (about 95%). Moreover, clonal type 1 of DT104 was found to occur in sensitive as well as in a range of multiply drug-resistant variants and in a variety of plasmid profile types (in particular with small cryptic plasmids in the range of 1.0 to 5.0 Md). Since the clonal type 1 of DT104 has been identified among isolates from other countries, too, including such from the United Kingdom, the United Arab Emirates, the Philippines, and the Netherlands, its pandemic spread in man indicates that the import/export of this pathogen continues. About 5% of the DT104 isolates have been identified as genetically diverse indicating the independent appearance of the same multiple drug resistance and phage pattern phenotype among different Salmonella ancestor strains.

[Epidemiological and microbiological studies on salmonellosis in Russia]. / Epidemiologische und mikrobiologische Untersuchungen zur Salmonellose in Russland.

The occurrence of the most important Salmonella serovars in Russia from 1980 to 1993 is reported. Selected Salmonella strains isolated in Russia from 1951 to 1993 were characterized by serotype, phage type, resistance pattern, plasmid profile and detection of aerobactin production. The incidence of salmonellosis was different in the various administrative districts and varied between 0-235 cases/100,000 inhabitants. Since the middle of the eighties both the overall increase of salmonellosis and the replacement of S. typhimurium by S. enteritidis was also demonstrable in Russia. Nosocomial infections due to multiply resistant S. infantis strains and S. typhimurium strains which caused severe septicaemic courses in children were a special epidemic problem. These infections mainly occurred via faecal-oral transmission. In contrast ot Western Europe most of the S. enteritidis strains isolated in Russia belonged to phage type 1/1. Eight phage types were determined additionally. The S. typhimurium strains isolated in nosocomial infections belonged to a definite phage type and carried a 95 MDa plasmid. This plasmid was also detected in the nosocomial S. infantis strains, S. haifa strains, and S. panama strains. All these nosocomial strains formed aerobactin.

Identification of infant food as a vehicle in a nosocomial outbreak of Citrobacter freundii: epidemiological subtyping by allozyme, whole-cell protein and antibiotic resistance.

A total of 38 Citrobacter freundii strains was isolated from patients and their environment at a neonatal intensive care unit of a large hospital where colonization and clinical diseases due to the agent had been observed. Epidemiological investigations were carried out by subtyping, for which a combination of allozyme, whole-cell protein and resistance pattern analysis was used. Infant formula was identified as a vehicle of nosocomial spread. This shows that the role of foods in the transmission of hospital infections should not be underestimated. The combination of methods applied, in particular a limited enzyme set, is recommended also for epidemiological investigations of food-borne infections and establishment of their causes.

[Outbreak of Salmonella paratyphi B infections in connection with consumption of smoked fish]. / Ausbruch von Salmonella paratyphi B-Infektionen im Zusammenhang mit dem Genuss von Räucherfisch.

In the period from 2-10 August 1991 an outbreak caused by S. paratyphi B occurred in five rural areas of the district of Leipzig. Eleven patients and one excreter were involved, and mild forms of disease were observed in most cases. In three of the patients a mixed infection with S. litchfield was diagnosed. Moreover at the same time 21 cases of enteritis caused by S. litchfield and three excreters associated with this serovar were registered in these five rural areas. Both infections with S. paratyphi B and S. litchfield occurred 1-3 days after consumption of smoked halibut. The fish smoked in a smokehouse in the Grimma rural area was delivered to the shops every day. The inspection of the smokehouse and the dispatch department provided no signs of contaminations. In the smoked fish samples investigated subsequently, Salmonella were no longer detectable. The results of typing confirm the identity of all S. paratyphi B strains isolated. The possibilities of contamination of the smoked halibut are discussed. This study emphasises the possible transmission of salmonella by way of the food fish. On that occasion also a non-frequent serovar such as S. paratyphi B can be isolated and a light course of disease as e.g. febrile gastroenteritis can be observed and may attain epidemiological significance.

[Clonal spreading of a multidrug resistance Citrobacter freundii strain at a neonatal intensive care unit]. / Untersuchungen zur klonalen Verbreitung eines multiresistenten Citrobacter-freundii-Stammes auf einer neonatologischen Intensivtherapiestation.

This paper reports on the epidemic spreading of a multiresistant Citrobacter (C.) freundii strain at a neonatal intensive care unit. A premature baby of the 27th week of pregnancy died from septic shock caused by this strain. According to the result of a statistical analysis of risk factors a connection between the colonization of neonates and the feeding with an enteral feeding tube was probably. This suspicion could be confirmed by the detection of the multiresistant strain in the infant formula. Plasmid analysis, examination of outer membrane proteins and lipopolysaccharides of these C. freundii strains demonstrated the identity of all isolates. The resistance to antibiotics of this multiresistant C. freundii clone was determined by a plasmid belonging to incompatibility group C with a molecular weight of 110 MDa. This plasmid was involved also in other nosocomial outbreaks. It persisted more than 7 years in the hospital flora of the intensive care unit.

[Salmonella montevideo from a hospital outbreak with different antibiograms determined by a plasmid]. / Salmonella montevideo-Hospitalismus mit unterschiedlichen Antibiogrammen durch ein Plasmid.

From May to June 1984 an outbreak of Salmonella montevideo occurred in the neonatal ward of a district's hospital. 26 babies were involved and mild forms of disease were observed in the most cases. The infants were hospitalized from different reasons and treated chemotherapeutically prior to the nosocomial infection. The Salmonella montevideo strains isolated from the faeces of the infants showed five different antibiograms. In all strains the multiple drug resistance was determined by a single plasmid belonging to the incompatibility group C and with a molecular weight of 110 Md or 100 Md in the threefold resistant strains. These plasmids were found also in the faecal flora (E. coli and Klebsiella) of all patients. It is suggested that a transfer of the plasmids from E. coli or Klebsiella to Salmonella montevideo occurred under in vivo condition, since distinct patients excreted susceptible as well as resistant Salmonellae. This example shows the necessity to include antibiogram and plasmid analysis as epidemiological markers.

[Effect of the composition of the nutrient media and culture conditions on the growth of strains of Campylobacter jejuni and C. coli]. / Izuchenie vliianiia sostava pitatel'nykh sred i uslovii kul'tivirovaniia na rost shtammov Campylobacter jejuni i C. coli.

The influence of the composition of culture media and cultivation conditions on the growth of Campylobacter strains has been studied. Blood-containing media have been found to ensure the most favorable growth conditions. No differences between the use of RCT supplement (rifampicin, cephalothin and trimethoprim in amounts of 10, 15 and 5 mg/l respectively) and DC supplement (0.1% of sodium deoxycholate and 15 mg/l of cephalothin), as well as between different methods used for the creation of microaerophilic conditions, have been established.

[Malignant hyperthermia. I. Observations in connection with its pathogenesis and course (author's transl)]. / Maligne Hyperthermie. I. Beobachtungen im Zusammenhang mit ihrem Entstehen und Verlauf.

Malignant hyperthermia developed in the 94th minute of anesthesia undergone by a nearly 5-year-old girl. Two minutes after re-filling the halothane vaporizer, muscle rigor and tachyarrhythmia occurred. Massive myoglobinuria setting in on the day of operation reached its peak on the 1st postoperative day. Only following this were the highest CK activities to be recorded. CK-BB could not be detected at any time.