Association between pigs with high caecal Salmonella loads and carcass contamination.

Contaminated pork is a significant source of foodborne Salmonella infections. Pork is contaminated at the slaughterhouse; however, the mechanisms driving Salmonella contamination of carcasses are still poorly understood. The aim of this study was to investigate whether the amount of Salmonella carried by slaughtered pigs in their guts has an influence on carcass contamination. On that account, we tested whether the number of carcasses contaminated during a slaughter day was associated with the prevalence of highly contaminated pigs (HCP: Salmonella caecal loads ≥3log/g), or with the prevalence of pigs that simply carry Salmonella spp. in their guts. Three hundred and six pigs were sampled in a slaughterhouse from Central Italy. Salmonella loads in the caecum and on the carcass of each pig were estimated by the most probable number (MPN) technique. The overall prevalence of Salmonella was 34.64% and 7.19% for the caeca and carcasses, respectively. S. Derby and Salmonella enterica 4,[5],12:i:- were the most frequently isolated serovars. The prevalence of HCP was 11.44%. We found a higher number of contaminated carcasses on days of high prevalence of HCP than on days of low prevalence of HCP (p=0.0011). Conversely, carcass contamination did not vary with the prevalence of pigs that simply carried Salmonella spp. in their guts (p=0.7970). Therefore, the prevalence of HCP, but not the prevalence of pigs carrying Salmonella spp., was related to carcass contamination. Taken together, these findings suggest that reduction of Salmonella loads in the guts of slaughtered pigs would result in fewer contaminated carcasses, and consequently, help to minimise the risk of human infection due to the consumption of contaminated pork.

Characterisation of Yersinia pseudotuberculosis isolated from animals with yersiniosis during 1996-2013 indicates the presence of pathogenic and Far Eastern strains in Italy.

Yersinia pseudotuberculosis is a pathogen that infects both animals and humans worldwide. The epidemiology of infection caused by Y. pseudotuberculosis is poorly understood; however, its outbreaks have been traced back to a probable source in wildlife. This study aimed to characterise Y. pseudotuberculosis isolates collected from animals with yersiniosis. This study included 90 isolates of Y. pseudotuberculosis collected from different animals with yersiniosis between 1996 and 2013 in Italy. The isolates were tested for antimicrobial susceptibility and were biotyped. Genes associated with virulence plasmid pYV and those encoding O-antigen, high pathogenicity island (HPI), and superantigenic toxin (YPM) were determined by performing PCR. Pulsed-field gel electrophoresis (PFGE) was performed using NotI and SpeI enzymes, and 3 dendrograms were generated. No antibiotic resistance was found. The presence of pYV was shown in 57 out of 90 isolates. Virulence profiles of majority of the isolates indicated that they belonged to O:1a and O:1b serotypes, biotype 1, and genetic type 2. Isolates belonging to O:2a serotype were detected in sheep and cattle and were found to be associated (for the first time) with septicemia in hares. Y. pseudotuberculosis isolates belonging to O:5a and O:12-O13 serotypes were also detected in hares. To our knowledge, this is the first study to detect Y. pseudotuberculosis isolates belonging to the O:12-O13 serotype from a clinical case in Europe. Results of PFGE indicated that it was a reliable method for investigating the genetic relatedness of Y. pseudotuberculosis isolates. Thus, characterisation of Y. pseudotuberculosis infection in animals should be considered a possible tool for the surveillance of pseudotuberculosis.

Atypical Yersinia pseudotuberculosis serotype O:3 isolated from hunted wild boars in Italy.

Atypical Yersinia pseudotuberculosis serotype O:3 was isolated from rectal contents of two wild boars hunted in Italy within a regional wildlife management program. No outbreak of yersiniosis was reported in this area in the same period and no lesions were found by the veterinarian at post-mortem inspection. Nevertheless, after histological examination, granulomatous lesions were detected in submandibular lymph nodes of one of the two wild boars. Microbiological and bio molecular characterization of the isolates revealed a melibiose-negative, biotype 2, wbyK+O:3 genotype, carrying inv, yop (yopH and yopB), virF, and R-HPI. Strains showing the same profile, matching to the criteria of genetic group 5, have been recently reported in fatal cases of yersiniosis in cynomolgus macaques and in farmed deer and atypical O:3 serotype has been suggested as a pathogenic subtype of O:3. This is the third report of an atypical O:3 Y. pseudotuberculosis strain, the first outside the American continent and the first one not associated to fatal yersiniosis. Wild boars could be a possible reservoir of this emerging pathogen.

ROSES: role of self-monitoring of blood glucose and intensive education in patients with Type 2 diabetes not receiving insulin. A pilot randomized clinical trial.

AIMS: To estimate the efficacy of a self-monitoring-based disease management strategy in patients with Type 2 diabetes treated with oral agent monotherapy. METHODS: This was an open-label, randomized, pilot study, primarily led by diabetes nurses. Patients were randomly allocated to either a self-monitoring-based disease management strategy or usual care (ratio 3:1) and followed up for 6 months. Education was centred on how to modify lifestyle according self-monitoring readings. Self-monitoring of blood glucose results were discussed during monthly telephone contact. The primary endpoint was mean change in HbA(1c) levels, estimated with an ANOVA for repeated measures. All analyses were intention to treat. RESULTS: Three diabetic clinics recruited 62 patients, of whom five were lost to follow-up. At baseline, both groups had a mean HbA(1c) value of 7.9% ± 0.6% (63 ± 6 mmol/mol). After 6 months, mean HbA(1c) reduction was 1.2 ± 0.1% (-13 ± 1 mmol/mol) in the intervention group and 0.7 ± 0.2 (-8 ± 2 mmol/mol) in the control group, with an absolute mean difference between groups of -0.5% (95% CI -0.9 to -0.0%; P = 0.04) (-5 mmol/mol, 95% CI -10 to 0). At study end, 61.9% of patients in the intervention group and 20.0% in the control group reached the target level of HbA(1c) < 7.0% (< 53 mmol/mol) (P = 0.005). Body weight reduction was significantly greater in the intervention group than in the control group (between-group absolute mean difference: -3.99 kg; 95% CI -7.26 to -0.73; P = 0.02). Therapy changes were more frequent in the control group. CONCLUSIONS: A self-monitoring disease management strategy, primarily led by diabetes nurses and allowing a timely and efficient use of self-monitoring readings, is able to improve metabolic control, primarily through lifestyle modifications leading to weight loss.

Contamination of Salmonella spp. in a pig finishing herd, from the arrival of the animals to the slaughterhouse.

The aim of the present study was to investigate the contamination sources and the transmission of Salmonella within a pig finishing herd in Italy. Nine sets of samples were collected during the fattening period from cleaned and disinfected pens, animals at different ages (4 days after arrival, 90, 150, 170 and 240 days of age) and at slaughter. Salmonella was isolated from cleaned pens, individual faecal samples, the truck used to transport the pigs to the abattoir and after slaughter (cecal contents, mesenteric lymph nodes and carcasses). Several serovars were isolated: Salmonella typhimurium and Salmonella derby on farm; Salmonella bovismorbificans, Salmonella bredeney, Salmonella blockley, Salmonella hadar and Salmonella corvallis from the truck; S. derby, S. hadar, S. bredeney, S. bovismorbificans and Salmonella infantis at slaughter. Antibiotic resistance of the strains was tested and PFGE was carried out to investigate the on-farm epidemiology of Salmonella. The results showed that the environmental contamination may have represented a major source of infection for the pigs both on farm and during transport to the abattoir.