Outbreak of salmonellosis caused by Salmonella enterica serovar Newport MDR-AmpC in a large animal veterinary teaching hospital.

Autor: Dallap Schaer BL; Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA. bldallap@vet.upenn.edu, Aceto H, Rankin SC
Jazyk: angličtina
Zdroj: Journal of veterinary internal medicine [J Vet Intern Med] 2010 Sep-Oct; Vol. 24 (5), pp. 1138-46. Date of Electronic Publication: 2010 Jun 24.
DOI: 10.1111/j.1939-1676.2010.0546.x
Abstrakt: Background: Nosocomial salmonellosis is an important problem for large animal veterinary teaching hospitals (VTHs).
Objective: To describe failure of an Infection Control Program (ICP) that resulted in an outbreak of salmonellosis caused by Salmonella Newport multidrug resistant (MDR)-AmpC at a large animal VTH.
Animals: Sixty-one animals identified with the outbreak strain of Salmonella.
Methods: Retrospective study: Data collected included signalment, presenting complaint, duration of hospitalization, discharge status, and financial information. Phenotypic and genotypic characterization was performed on Salmonella isolates.
Results: The outbreak occurred despite an existing ICP; the ICP was reviewed and weaknesses identified. Routine patient surveillance was not performed before or during the outbreak; fecal sampling was triggered only by a patient algorithm based on clinical signs. Sixty-one animals were infected with the outbreak strain of S. Newport, and the majority were horses (n = 54). Case fatality rate was 36.1%. S. Newport isolates demonstrated high genetic similarity (Dice ≥ 0.96), and all had the MDR-AmpC phenotype. Environmental persistence of the organism necessitated complete hospital closure, extensive decontamination, and remediation of the facility. A paradigm shift in the relevance of biosecurity in a VTH and the establishment of a stringent ICP were integral components of successful hospital reopening.
Conclusions and Clinical Importance: An ineffective ICP resulted in a nosocomial outbreak caused by a MDR S. Newport in a VTH. Closure of a VTH affected all missions of the institution and had substantial financial impact (US$4.12 million).
(Copyright © 2010 by the American College of Veterinary Internal Medicine.)
Databáze: MEDLINE
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