Lactobacillus plantarum Restores Intestinal Permeability Disrupted by Salmonella Infection in Newly-hatched Chicks.

Salmonella infections in newly hatched chicks result in enteric and systemic diseases with a high mortality. Probiotics can improve the health of a host. The purpose of the present study was to investigate the effect of Lactobacillus plantarum LTC-113 on the gut permeability in the presence or absence of Salmonella (Salmonella Typhimurium) infection. Newly hatched chicks were randomly allocated to 4 treatments (i) NC (negative control); (ii) LAC (the L. plantarum LTC-113-treated group); (iii) SAL (the Salmonella-infected group), and (iv) LAC + SAL (the L. plantarum LTC-113-treated and Salmonella-infected group). Compared with the NC group, the intestinal permeability and claudin-2 (CLDN-2) were significantly increased, while mRNA levels of zonula occludens-1 (ZO-1) and claudin-5 (CLDN-5) were significantly decreased in the SAL group. However, these changes were eliminated in the LAC + SAL group. Additionally, numbers of Salmonella in liver, spleen and ceca were significantly reduced in the LAC + SAL group compared with the SAL group. Moreover, L. plantarum LTC-113 prevented the increase of inflammatory meditators myeloperoxidase (MPO), LITAF, IL-1ß, IL-6 and inflammation scores induced by Salmonella. These findings indicate that L. plantarum LTC-113 can protect hosts from Salmonella induced intestinal barrier disruption by regulating expression of tight junction genes and inflammatory meditators and decreasing Salmonella colonization.

Salmonella Infection in Middle-Aged and Older Adults: Incidence and Risk Factors from the 45 and Up Study.

BACKGROUND: Salmonella infection is one of the most common foodborne bacterial pathogens, and causes a significant health burden globally. We investigated the incidence and risk factors for notification and hospitalization due to Salmonella infection in older adults. MATERIALS AND METHODS: We used the 45 and Up Study, a large-scale Australian prospective study of adults aged ≥45 years, with record linkage to multiple databases for the years 2006-2012 to estimate the incidence of notification and hospitalization for Salmonella infection and estimate hazard ratios using Cox regression. RESULTS: Over a total follow-up of 1,120,242 person-years, 333 adults had laboratory-confirmed Salmonella infection and 101 were hospitalized; the notification and hospitalization incidence were 29.7 (95% confidence interval [CI]: 26.9-33.3) and 9.0 (95% CI: 7.4-10.9) per 100,000 person-years, respectively. The risk of Salmonella infection notification did not differ by age, but risk of hospitalization increased with age. Elderly males had the highest risk of infection-related hospitalization. The risk of notification was higher for those living in rural or remote areas (adjusted hazard ratio [aHR] 1.7, 95% CI 1.3-2.2), those taking proton pump inhibitors (aHR 1.9, 95% CI 1.4-2.4), and those reporting chicken/poultry intake at least seven times per week (aHR 3.2, 95% CI 1.3-7.9). CONCLUSIONS: Chicken consumption remains a significant risk factor for Salmonella infection, highlighting the importance of reducing contamination of poultry and improving food safety advice for older people.

Impact of a pilot pathway for the management of gastroenteritis-like symptoms in an emergency department: A case study following a Salmonella outbreak.

OBJECTIVE: This research aims to describe the effect of standard care (control) versus a clinical management pathway (intervention) on patient length of stay and admission rates during a public health emergency at one Australian ED. METHODS: A retrospective audit of hospital records for patients who presented in May 2013 with gastroenteritis-like symptoms was undertaken following a surge in patient presentations from a Salmonella outbreak. Patients who presented with gastroenteritis-like symptoms between 15 and 19 May 2013 received care according to a clinical management pathway (intervention). The focus of the intervention was based on symptom management, including a standardised approach to analgesia, anti-emetics and rehydration. Patient characteristics, such as age and gender are described using descriptive statistics. A Mann-Whitney test was used to compare continuous data, and a Fisher's exact test was used to compare categorical data, between the two groups. RESULTS: Over an 8 day period, 110 patients presented with gastroenteritis-like symptoms. The median length of stay was statistically different between the two groups (P < 0.001). More patients were admitted to hospital from the control group (n = 5) when compared with the intervention group (n = 0); however, given the small number of patients in these groups, inferential statistical analysis was not a reasonable consideration. CONCLUSION: The length of stay for patients between the two groups was statistically different, suggesting that the implementation of a clinical management pathway for patients with gastroenteritis-like symptoms reduced the ED length of stay. This finding is useful in future planning for similar public health emergency responses and/or for use when patients present with gastroenteritis-like symptoms on a daily basis.

Clinical features of human salmonellosis caused by bovine-associated subtypes in New York.

The objective of this study was to identify patient symptoms and case outcomes that were more likely to occur as a result of Salmonella infections caused by bovine-associated subtypes (isolates that matched contemporary bovine isolates from New York by serovar and pulsed-field gel electrophoresis pattern), as compared to salmonellosis caused by non-bovine-associated subtypes. Data were collected in 34 counties of New York that comprise the Foodborne Diseases Active Surveillance Network (FoodNet) catchment area of the Centers for Disease Control and Prevention Emerging Infections Program. Patients with specimen collection dates between March 1, 2008 and March 1, 2010 were included. Symptoms and outcomes of 40 cases infected with bovine-associated Salmonella subtypes were compared to those of 379 control-cases infected with Salmonella isolates that were not bovine-associated. Cases were significantly more likely to have invasive salmonellosis (odds ratio, 3.8; p-value=0.02), after adjusting for age group, gender, and race. In addition, there was a marginal association between case status and the presence of blood in the stool (p-value=0.1) while ill. These findings might have implications for patient management, as a history of consuming undercooked foods of bovine origin or having direct contact with cattle in the few days prior to illness could be useful for suggesting a more proactive diagnostic approach as well as close monitoring for the need to implement more aggressive therapy.

[Clinical and epidemiological description of severe outbreak of foodborne infection by Salmonella Enteritidis]. / Descripción clínica y epidemiológica de un grave brote de salmonelosis transmitida por alimentos.

BACKGROUND: Foodborne diseases have increased considerably. AIM: To report a foodborne outbreak, remarking the importance of early notification to activate the epidemiological surveillance system. RESULTS: During February 2011 we observed a Salmonella Enteritidis outbreak. 31.6% of the cases were seen in the same Emergency Care Unit where all required intravenous fluid rehydration, and 41.7% were hospitalized because of severe dehydration. In the Emergency Room 45.5% of cases required a second visit to be diagnosed correctly. DISCUSSION: Physicians under report the cases of this disease, delaying the activation of the epidemiological surveillance system. CONCLUSIONS: Besides providing good treatment to patients, physicians need to be qualified to recognize foodborne diseases and communicate early the suspicion of an outbreak to the epidemiological surveillance system in order to prevent new cases of disease in the community.

Descripción clínica y epidemiológica de un grave brote de salmonelosis transmitida por alimentos / Clinical and epidemiological description of severe outbreak of foodborne infection by Salmonella Enteritidis

Background: Foodborne diseases have increased considerably. Aim: To report a foodborne outbreak, remarking the importance of early notification to activate the epidemiological surveillance system. Results: During February 2011 we observed a Salmonella Enteritidis outbreak. 31.6% of the cases were seen in the same Emergency Care Unit where all required intravenous fluid rehydration, and 41.7% were hospitalized because of severe dehydration. In the Emergency Room 45.5% of cases required a second visit to be diagnosed correctly. Discussion: Physicians under report the cases of this disease, delaying the activation of the epidemiological surveillance system. Conclusions: Besides providing good treatment to patients, physicians need to be qualified to recognize foodborne diseases and communicate early the suspicion of an outbreak to the epidemiological surveillance system in order to prevent new cases of disease in the community.

Introducción: Las enfermedades transmitidas por alimentos (ETA) han aumentado considerablemente. Objetivo: Reportar un grave brote de ETA destacando la importancia de la notificación precoz para la activación del sistema de vigilancia epidemiológica. Resultados: Durante febrero de 2011 se observó un brote de Salmonella Enteritidis. Un 31,6% de los casos fueron atendidos en un mismo servicio de urgencia, donde todos requirieron la administración de fluidos endovenosos y 41,7% fueron hospitalizados por deshidratación grave. El 45,5% de los casos necesitó de una segunda consulta para ser diagnosticados correctamente. Discusión: La identificación de pacientes integrantes de un brote de ETA es difícil en los servicios de urgencia y los médicos sub-reportan los casos, retrasando al sistema de vigilancia epidemiológica. Conclusiones: Junto con brindar un adecuado tratamiento, los médicos deben estar capacitados para reconocer las ETA y comunicar tempranamente la sospecha de un brote para prevenir nuevos casos en la comunidad.

Surveillance and management of salmonella food poisoning.

Reports of Salmonella Montevideo in UK chocolate have put foodborne disease back in the headlines. This article looks at the nature, prevalence and management of this public health problem and highlights the importance of surveillance.

Profile of Salmonella enterica subsp. enterica (subspecies I) serotype 4,5,12:i:- strains causing food-borne infections in New York City.

Strains of newly emerging Salmonella enterica subsp. enterica (subspecies I) serotype 4,5,12:i:- causing food-borne infections, including a large food poisoning outbreak (n = 86) characterized by persistent diarrhea (14% bloody), abdominal pain, fever, and headache, were examined. The organisms were found in the stool samples from the patients. The biochemical profile of the organisms is consistent with that of S. enterica subsp. I serotypes, except for decreased dulcitol (13%) and increased inositol (96%) utilization. Twenty-eight percent of the strains showed resistance to streptomycin, sulfonamides, or tetracycline only; all three antimicrobial agents; or these agents either alone or in combination with ampicillin, trimethoprim, and trimethoprim-sulfamethoxazole. None of the serotype 4,5,12:i:- strains showed resistance or decreased susceptibility to chloramphenicol or ciprofloxacin. On pulsed-field gel electrophoresis (PFGE), the strains showed 11 or 12 resolvable genomic fragments with 18 banding patterns and three PFGE profile (PFP) clusters (i.e., PFP/A, PFP/B, and PFP/C). Seventy-five percent of the isolates fingerprinted were closely related (zero to three band differences; similarity [Dice] coefficient, 86 to 100%); 63% of these were indistinguishable from each other (PFP/A(1)). PFP/A(1) was common to all strains from the outbreak and 11 hospital sources. Strains from six other hospitals shared clusters PFP/B and PFP/C. PFP/C(4), of the environmental isolate, was unrelated to PFP/A and PFP/B. Nine band differences (similarity coefficient, 61%) were noted between PFP/A(1) and PFP/E of the multidrug-resistant S. enterica subsp. enterica serotype Typhimurium definitive type 104 strains. Whether these emerging Salmonella strains represent a monophasic, Dul(-) variant of serotype Typhimurium or S. enterica subsp. enterica serotype Lagos or a distinct serotype of S. enterica subsp. I is not yet known. Some of the phenotypic and genotypic properties of the serotype 4,5,12:i:- strains are described here.

Salmonella and Shigella species.

Salmonella and Shigella are the second and third most common causes of bacterial food-borne disease in the United States and are a major global health problem. The prevention and treatment of disease caused by these organisms are complicated by the increase in multidrug-resistant strains and the lack of an effective vaccine. This article discusses the epidemiology, clinical features, and diagnostic techniques for both enteric pathogens.

Raw egg ingestion and salmonellosis in body builders.

Four patients with Salmonella enteritidis infection are reported. All were body builders who regularly consumed substantial quantities of raw eggs. They presented with a severe febrile illness and diarrhoea--presumably reflecting a large bacterial inoculum. Advice regarding the potential hazards of raw egg ingestion has been repeatedly issued by the Department of Health--but this report highlights the fact that this practice continues in spite of this. The epidemiology of S. enteritidis infection in relation to raw egg ingestion is discussed.

[The pathogenetic therapy of patients with food poisonings and a complicated course]. / Patogeneticheskaia terapiia bol'nykh pishchevymi toksikoinfektsiiami s oslozhnennym techeniem.

The complicated and combined course of alimentary toxicoinfections are practically the main causes of all the lethal outcomes in these diseases. In this work the data on the recent progress in the rehydration therapy of acute enteric infections are presented. The authors established that combined forms constituted 15.3% and complicated ones constituted 2% of alimentary toxicoinfections. The results of the treatment of alimentary toxicoinfections combined with ischemic heart disease, hypertension and chronic alcoholism, as well as complicated by shock and pneumonia, are presented. The general principles of treatment in combined and complicated cases are the maintenance of the usual (under given conditions) volume of liquid for rehydration with the limitation of the rate of its introduction.

[The effect of oral rehydration therapy on pancreatic function in patients with acute intestinal infections]. / Vliianie oral'noi regidratatsionnoi terapii na funktsiiu podzheludochnoi zhelezy u bol'nykh ostrymi kishechnymi infektsiiami.

The results of the study of the level of pancreatic hormones (insulin, glucagon, C-peptide and trypsin), carried out with the aim of finding out the character of relationship between hormonal disturbances and the state of carbohydrate metabolism, as well as the influence of oral rehydration therapy (ORT) with glucose-salt solutions on the function of the pancreas, are summarized. All subjects to be examined were divided into two groups receiving different kinds of ORT. The patients in group 1 (153 subjects) were treated with glucosolan and in group 2 (73 subjects), with sodium citrate in an amount of 2.5-5 lit. over the 6-hour period of treatment. The determination of the content of immunoreactive insulin, glucagon C-peptide and trypsin in the blood as the characteristics of the hormonal activity of the pancreas has made it possible to find out disturbances in the incretory and excretory activity of the pancreas in patients with acute enteric infections of different etiology. ORT with glucosolan and sodium citrate facilitates the restoration of pancreatic function in 65-70% of in patients with acute enteric infections of different etiology.

Brote epidemico de salmonelosis entre los trabajadores del Hospital Almanzor Aguinaga Asenjo IPSS de Chiclayo / Salmonelosis in Hospital Almanzor Aguinaga Asenjo IPSS de Chiclayo

Se presenta un bote epidémico de salmonelosis ocurrido entre los trabajadores del Hospital Amanzor Aguinaga Asenjo de Chiclayo, Lambayeque-Perú en la víspera de la navidad de 1992. Cuarenta y un trabajadores presentaron diarreas, vomitos, fiebre y dolor abdominal despues de haber consumido mayonesa. Se aisló Salmonella tipo C en las heces de los enfermos y en la mayonesa.

[Administration of super-ORS solution in the treatment of patients with acute intestinal infections]. / Opyt primeneniia rastvora super-ORS v lechenii bol'nykh ostrymi kishechnymi infektsiiami.

Therapeutic effectiveness of an oral rehydration solution of the second generation Super-ORS based on rice and salt has been tried in 28 patients with food poisoning. Administration of the solution produced a marked clinical effect superior to that of the first generation solutions Glucosalan, Citroglucosalan, Rehydron.

Human infection with Salmonella dublin.

Twenty-seven cases of human infection with Salmonella dublin were identified over a 12-year period at the University of California at San Diego-affiliated hospitals. Important epidemiologic risk factors were the ingestion of unpasteurized dairy products or treatment with nutritional therapy that included raw calf-liver extracts. Nearly all patients had underlying chronic diseases. Like Salmonella choleraesuis, S. dublin infections were associated with a high incidence of bacteremia (91%), metastatic sites of infection (30%), and mortality (26%) relative to other non-typhoidal Salmonellae. This pattern of disease expression may be related to a plasmid-encoded virulence factor common to both of these organisms.