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Topic:Salmonellosis

Salmonellosis in horses is an infectious disease caused by the bacterium Salmonella. This condition can lead to a range of clinical signs, from asymptomatic carriage to severe diarrhea and systemic illness. Horses can acquire Salmonella through contaminated feed, water, or contact with infected animals. The disease is of particular concern in equine facilities due to its potential for rapid spread and zoonotic risk. Diagnosis typically involves bacterial culture or polymerase chain reaction (PCR) testing of fecal samples. Management of salmonellosis includes isolation of affected animals, supportive care, and biosecurity measures to prevent transmission. This page compiles peer-reviewed research studies and scholarly articles that explore the epidemiology, pathogenesis, clinical presentation, and management strategies of salmonellosis in horses.
Granulomatous typhlocolitis, lymphangitis, and lymphadenitis in a horse infected with Listeria monocytogenes, Salmonella Typhimurium, and cyathostomes.
Veterinary pathology    June 11, 2012   Volume 50, Issue 2 252-255 doi: 10.1177/0300985812450717
Nemeth NM, Blas-Machado U, Hopkins BA, Phillips A, Butler AM, Sánchez S.A 15-year-old American Quarter horse mare was euthanized because of poor response to therapy for severe diarrhea. Significant gross findings were limited to the large intestines. The walls of the cecum and colon were thickened with widely scattered nodules in the mucosa and submucosa that extended into the enlarged colic lymph nodes. Microscopically, there was severe granulomatous typhlocolitis, lymphangitis, and lymphadenitis, with many intralesional Gram-positive, non-acid-fast coccobacilli and few cyathostomes. Intralesional bacteria were immunohistochemically and polymerase chain reaction ...
Treatment with histamine-type 2 receptor antagonists and omeprazole increase the risk of diarrhoea in neonatal foals treated in intensive care units.
Equine veterinary journal. Supplement    May 19, 2012   Issue 41 80-86 doi: 10.1111/j.2042-3306.2011.00499.x
Furr M, Cohen ND, Axon JE, Sanchez LC, Pantaleon L, Haggett E, Campbell R, Tennent-Brown B.The use of anti-ulcer medication in the neonatal intensive care unit (ICU) is common due to the concern for development of catastrophic gastric ulcerdisease. In man, however, the use of acid-suppressive medication has been shown in some studies to be a substantial riskfactorfor the development of Clostridium difficile-associated diarrhoea (CDAD), bacteraemia and neonatal sepsis. Objective: The purpose of the study reported herein is to evaluate the influence of anti-ulcer medications on the development of diarrhoea in the neonatalfoal. Objective: The use of anti-ulcer medication does not alter...
Salmonella enterica shedding in hospitalized horses and associations with diarrhea occurrence among their stablemates and gastrointestinal-related illness or death following discharge.
Journal of the American Veterinary Medical Association    March 3, 2012   Volume 240, Issue 6 726-733 doi: 10.2460/javma.240.6.726
Hartnack AK, Van Metre DC, Morley PS.To evaluate the potential association between Salmonella enterica shedding in hospitalized horses and the risk of diarrhea among stablemates, and to characterize gastrointestinal-related illness and death following discharge among horses that shed S. enterica while hospitalized. Methods: Retrospective cohort study [corrected]. Methods: 221 horses (59 that shed S. enterica during hospitalization and 162 that tested negative for S. enterica shedding ≥ 3 times during hospitalization). Methods: Information from medical records (signalment, results of microbial culture of fecal samples, clinical ...
Pathology in practice. Severe proliferative enteritis caused by Lawsonia intracellularis and acute diffuse severe colitis due to Salmonella sp. infection.
Journal of the American Veterinary Medical Association    February 16, 2012   Volume 240, Issue 5 529-531 doi: 10.2460/javma.240.5.529
Kumar S, Carothers EA, Cooley AJ.No abstract available
Colic in competing endurance horses presenting to referral centres: 36 cases.
Equine veterinary journal    November 3, 2011   Volume 44, Issue 4 472-475 doi: 10.1111/j.2042-3306.2011.00462.x
Fielding CL, Dechant JE.Colic is a common reason for elimination from equine endurance competitions and has recently been identified as the leading cause of mortality in this group of horses. Hydration and electrolyte derangements are often severe, but are probably related to endurance exercise and not necessarily the episode of colic. Better understanding of the causes of colic and the expected outcome is needed to guide treatment decisions in endurance horses. Objective: To describe the history, case details, clinical examination, laboratory, treatment and outcomes for horses presenting to equine referral centres f...
A preliminary study of Salmonella, verocytotoxigenic Escherichia coli/Escherichia coli O157 and Campylobacter on four mixed farms.
Zoonoses and public health    September 28, 2011   Volume 59, Issue 3 217-228 doi: 10.1111/j.1863-2378.2011.01438.x
Bolton DJ, O'Neill CJ, Fanning S.The aims of this study were to investigate the incidence of Salmonella, verocytotoxigenic Escherichia coli (VTEC)/Escherichia coli O157 and Campylobacter on four mixed farms and to characterize the isolates in terms of a range of virulence factors. Eighty-nine composite (five different samples from the same animal species combined) faecal [cattle (24), pigs (14), sheep (4), poultry (4), horses (7), deer (4), dogs (9), rodents (2) and wild birds (20)] samples, 16 composite soil samples plus 35 individual water samples were screened using culture-based, immunomagnetic separation and molecular me...
Onset of diarrhea and pyrexia and time to detection of Salmonella enterica subsp enterica in feces in experimental studies of cattle, horses, goats, and sheep after infection per os.
Journal of the American Veterinary Medical Association    May 17, 2011   Volume 238, Issue 10 1333-1339 doi: 10.2460/javma.238.10.1333
Aceto H, Miller SA, Smith G.To determine time to first detection of Salmonella organisms in feces of animals after experimental infection PO and times to onset of diarrhea and pyrexia to evaluate a common method for identifying nosocomial infections on the basis of time of admission and onset of clinical signs (ie, the 3-day criterion). Methods: Meta-analysis. Methods: Cattle, horses, goats, and sheep experimentally infected PO with Salmonella enterica subsp enterica. Methods: Online databases were searched for published reports describing results of experimental infection of cattle, horses, goats, and sheep PO with salm...
Treatment with Ca(OH)2 for inactivation of Salmonella Typhimurium and Enterococcus faecalis in soil contaminated with infected horse manure.
Journal of applied microbiology    April 20, 2011   Volume 110, Issue 6 1515-1523 doi: 10.1111/j.1365-2672.2011.05006.x
Nyberg KA, Vinnerås B, Lewerin SS, Kjellberg E, Albihn A.To investigate the inactivation of Salmonella enterica serovar Typhimurium and the faecal indicator Enterococcus faecalis in horse manure:soil mixtures by application of hydrated lime (Ca(OH)(2)). Results: In laboratory incubations, the inhibitory effect of different concentrations of Ca(OH)(2), as well as different application techniques, was tested. Other variables were horse manure:soil ratio, incubation temperature (6 and 14°C) and soil type (sand/clay). Bacterial enumeration by the plate count method in samples taken at increasing intervals revealed that Ca(OH)(2) effectively reduced Sal...
Salmonella enterica subsp. Enterica in Cattle Egret (Bubulcus ibis) chicks from central Texas: prevalence, serotypes, pathogenicity, and epizootic potential.
Journal of wildlife diseases    August 7, 2010   Volume 46, Issue 2 379-389 doi: 10.7589/0090-3558-46.2.379
Phalen DN, Drew ML, Simpson B, Roset K, Dubose K, Mora M.Cattle Egrets have a worldwide distribution, feed in proximity to cattle and other domestic animals, and often nest in large colonies in urban woodlots. Over a 3-yr period, nestlings from five Cattle Egret colonies from Central Texas, USA, were surveyed for salmonellosis. Prevalence of infection ranged from 29% to 95%. Seventeen Salmonella enterica subsp. enterica serotypes were isolated, of which the 4,5,12:i-monophasic serotype predominated in cultures of both the digestive tract and pooled spleen and liver. Of 11 4,5,12:i-monophasic isolates phage typed, eight were determinate type 193. The...
Outbreak of salmonellosis caused by Salmonella enterica serovar Newport MDR-AmpC in a large animal veterinary teaching hospital.
Journal of veterinary internal medicine    June 24, 2010   Volume 24, Issue 5 1138-1146 doi: 10.1111/j.1939-1676.2010.0546.x
Dallap Schaer BL, Aceto H, Rankin SC.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. Methods: 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...
[Antimicrobial susceptibility and resistance genes among Salmonella enterica Serovar Weltevreden isolates from humans, farm animals, and the environment in Okinawa Prefecture between 1992 and 2007].
Kansenshogaku zasshi. The Journal of the Japanese Association for Infectious Diseases    February 23, 2010   Volume 84, Issue 1 24-27 doi: 10.11150/kansenshogakuzasshi.84.24
Matayoshi M, Kudaka J.Between 1992 and 2007, a total of 86 isolates of Salmonella enterica Weltevreden were obtained from clinical human samples (n = 41), 45 farm animals and their environment on 20 farms, including poultry (n = 25), beef cattle (n = 5), swine (n = 5), dairy cattle (n = 3), mice (n = 2), pony (n = 1), fly (n = 1) and feed samples (n = 3), in Okinawa Prefecture, Japan. Only seven isolates (8.1%) of the isolates were resistance to one or more antimicrobial agents tested; six streptomycin (7.0%), six oxytetracycline (7.0%), two ampicillin (2.3%), two kanamycin, (2.3%), two chloramphenicol (2.3%), two ...
Improving the sensitivity of Salmonella testing in horses: how good is good enough?
Veterinary journal (London, England : 1997)    February 13, 2010   Volume 187, Issue 2 147-148 doi: 10.1016/j.tvjl.2010.01.003
McKenzie HC, Hodgson JL.No abstract available
Use of quantitative real-time PCR for the detection of Salmonella spp. in fecal samples from horses at a veterinary teaching hospital.
Veterinary journal (London, England : 1997)    September 17, 2009   Volume 186, Issue 2 252-255 doi: 10.1016/j.tvjl.2009.08.022
Pusterla N, Byrne BA, Hodzic E, Mapes S, Jang SS, Magdesian KG.A quantitative real-time (RT)-PCR assay was developed to detect Salmonella spp. in the feces of 911 equine species admitted to a veterinary hospital. Fresh feces and feces enriched for 24h in selenite broth were assessed by conventional culture and by RT-PCR targeting the Salmonella invA gene. The detection limit for the RT-PCR assay was 3 and 10 organisms, respectively, when spiked samples were purified from selenite broth and feces. The analytical specificity was 100% based on the detection of a panel of 40 salmonella serotypes from five serogroups and the lack of cross-reactivity with non-r...
Infectious agents detected in the feces of diarrheic foals: a retrospective study of 233 cases (2003-2008).
Journal of veterinary internal medicine    September 11, 2009   Volume 23, Issue 6 1254-1260 doi: 10.1111/j.1939-1676.2009.0383.x
Frederick J, Giguère S, Sanchez LC.Diarrhea is common in foals but there are no studies investigating the relative prevalence of common infectious agents in a population of hospitalized diarrheic foals. Objective: To determine the frequency of detection of infectious agents in a population of hospitalized foals with diarrhea and to determine if detection of specific pathogens is associated with age, outcome, or clinicopathologic data. Methods: Two hundred and thirty-three foals < or = 10 months of age with diarrhea examined at a referral institution. Methods: Retrospective case series. Each foal was examined for Salmonella s...
Antimicrobial resistance and genetic characteristics of Salmonella Typhimurium isolated from horses in Hokkaido, Japan.
The Journal of veterinary medical science    September 2, 2009   Volume 71, Issue 8 1115-1119 doi: 10.1292/jvms.71.1115
Niwa H, Anzai T, Izumiya H, Morita-Ishihara T, Watanabe H, Uchida I, Tozaki T, Hobo S.In this study, we examined the antimicrobial susceptibility of 16 Salmonella Typhimurium isolates obtained from horses, and applied several genetic methods, namely polymerase chain reaction (PCR) for detecting class 1 integrons, multiplex PCR for detecting multidrug resistant S. Typhimurium definitive phage type 104 (MR-DT104), and fluorescent amplified-fragment length polymorphism (FAFLP). Seven isolates with an ampicillin, chloramphenicol, streptomycin, sulfonamide, and tetracycline (ACSSuT) type resistance pattern, harbored two class 1 integrons with sizes of 1.2 and 1.0 kb, and were identi...
Immunisation of the equine uterus against Streptococcus equi subspecies zooepidemicus using an intranasal attenuated Salmonella vector.
Veterinary journal (London, England : 1997)    May 30, 2009   Volume 184, Issue 2 156-161 doi: 10.1016/j.tvjl.2009.05.001
Causey RC, Artiushin SC, Crowley IF, Weber JA, Homola AD, Kelley A, Stephenson LA, Opitz HM, Guilmain S, Timoney JF.Attenuated Salmonella enterica serovar Typhimurium MGN707, expressing the SzP protective protein of the MB9 serovar of Streptococcus equi subspecies zooepidemicus (SzP-MB9) was tested for its safety and efficacy as a nebulised intranasal vaccine against streptococcal uterine infections in mares. In a preliminary study, vaccinated mares (n=5) displayed serum, nasal and uterine responses (P<0.05) to S. Typhimurium lipopolysaccharide (St-LPS). Subsequently, vaccinated mares (expressor group, n=7), but not mares vaccinated with the vector only (control group, n=7), displayed significant increas...
Drug resistance patterns of Salmonella isolates of equine origin from India.
Journal of infection in developing countries    March 1, 2009   Volume 3, Issue 2 141-147 doi: 10.3855/jidc.61
Singh BR, Jyoti J, Chandra M, Babu N, Sharma G.Salmonellosis is a zoonosis, and one of the most serious public health and animal health problems. Methods: We studied 111 isolates of Salmonella belonging to 14 S. enterica subspecies enterica serovars namely S. Abortusequi (45), S. Weltevreden (1), S. Dumfries (2), S. Tshiongwe (1), S.I. 4,5,12:r,i:1,5 (12), S. Bovismorbificans (3), S. Drogana (8), S. Lagos (4), S. Kottbus (3), S. Richmond (1), S. Typhimurium (6), S. Newport (7), S. Paratyphi B var Java (17) and S. Saintpaul (5) isolated from equids in India. Results: All strains studied were resistant to one or more antimicrobials. Strains ...
Epidemiologic analysis of nosocomial Salmonella infections in hospitalized horses.
Journal of the American Veterinary Medical Association    January 6, 2009   Volume 234, Issue 1 108-119 doi: 10.2460/javma.234.1.108
Ekiri AB, MacKay RJ, Gaskin JM, Freeman DE, House AM, Giguère S, Troedsson MR, Schuman CD, von Chamier MM, Henry KM, Hernandez JA.To examine the relationship between abdominal surgery and nosocomial Salmonella infections and the relationship between high caseload in combination with abdominal surgery and nosocomial Salmonella infections in hospitalized horses with signs of gastrointestinal tract disease. Methods: 140 horses. Methods: Case-control study. Methods: To accomplish the first objective, 1 to 4 control horses were matched with each nosocomial case horse on the basis of admission date of a primary case horse. The frequency of abdominal surgery and other investigated exposure factors were compared between nosocomi...
Ulcerative colitis: diagnosis and treatment.
American family physician    November 21, 2007   Volume 76, Issue 9 1323-1330 
Langan RC, Gotsch PB, Krafczyk MA, Skillinge DD.Ulcerative colitis is a chronic disease with recurrent symptoms and significant morbidity. The precise etiology is still unknown. As many as 25 percent of patients with ulcerative colitis have extraintestinal manifestations. The diagnosis is made endoscopically. Tests such as perinuclear antineutrophilic cytoplasmic antibodies and anti-Saccharomyces cerevisiae antibodies are promising, but not yet recommended for routine use. Treatment is based on the extent and severity of the disease. Rectal therapy with 5-aminosalicylic acid compounds is used for proctitis. More extensive disease requires t...
Effects of an adapted intravenous amiodarone treatment protocol in horses with atrial fibrillation.
Equine veterinary journal    August 29, 2007   Volume 39, Issue 4 344-349 doi: 10.2746/042516407x182811
De Clercq D, van Loon G, Baert K, Tavernier R, Croubels S, De Backer P, Deprez P.Good results have been obtained with a human amiodarone (AD) i.v. protocol in horses with chronic atrial fibrillation (AF) and a pharmacokinetic study is required for a specific i.v. amiodarone treatment protocol for horses. Objective: To study the efficacy of this pharmacokinetic based i.v. AD protocol in horses with chronic AF. Methods: Six horses with chronic AF were treated with an adapted AD infusion protocol. The protocol consisted of 2 phases with a loading dose followed by a maintenance infusion. In the first phase, horses received an infusion of 6.52 mg AD/kg bwt/h for 1 h followed by...
Prevalence, distribution and characterisation of ceftiofur resistance in Salmonella enterica isolated from animals in the USA from 1999 to 2003.
International journal of antimicrobial agents    May 24, 2007   Volume 30, Issue 2 134-142 doi: 10.1016/j.ijantimicag.2007.03.013
Frye JG, Fedorka-Cray PJ.Third-generation cephalosporin (3GC) antimicrobials are the drugs of choice for treatment of salmonellosis in children. Salmonella isolated in the USA are assayed by the National Antimicrobial Resistance Monitoring System (NARMS) for resistance to antimicrobials including first-, second- and third-generation cephalosporins. From 1999 to 2003, 34,411 Salmonella were isolated from animals in the USA, of which 10.9% were found to be resistant to ceftiofur, a 3GC used in animals, whilst only 0.3% were resistant to ceftriaxone, a 3GC used in human medicine. Ceftiofur resistance rose from 4.0% in 19...
Characterization of multidrug resistant Salmonella recovered from diseased animals.
Veterinary microbiology    March 7, 2007   Volume 123, Issue 1-3 122-132 doi: 10.1016/j.vetmic.2007.03.001
Zhao S, McDermott PF, White DG, Qaiyumi S, Friedman SL, Abbott JW, Glenn A, Ayers SL, Post KW, Fales WH, Wilson RB, Reggiardo C, Walker RD.Three hundred and eighty Salmonella isolates recovered from animal diagnostic samples obtained from four state veterinary diagnostic laboratories (AZ, NC, MO, and TN) between 2002 and 2003 were tested for antimicrobial susceptibilities and further characterized for bla(CMY) beta-lactamase genes, class 1 integrons and genetic relatedness using PFGE. Forty-seven serovars were identified, the most common being S. Typhimurium (26%), S. Heidelberg (9%), S, Dublin (8%), S. Newport (8%), S. Derby (7%), and S. Choleraesuis (7%). Three hundred and thirteen (82%) isolates were resistant to at least one ...
A novel Salmonella genomic island 1 and rare integron types in Salmonella Typhimurium isolates from horses in The Netherlands.
The Journal of antimicrobial chemotherapy    February 9, 2007   Volume 59, Issue 4 594-599 doi: 10.1093/jac/dkl531
Vo AT, van Duijkeren E, Fluit AC, Gaastra W.To investigate the genotypic resistance of integron-carrying Salmonella Typhimurium isolates from horses and their genetic relationship. Methods: Sixty-one Salmonella isolates were screened for the presence of class 1 integrons by PCR. The gene cassettes of integron-positive isolates were detected by PCR, restriction fragment length polymorphism typing, and sequencing. The potential for the transfer of resistance determinants was investigated by conjugation experiments. The presence of Salmonella genomic island 1 (SGI1) or its variants was studied by PCR and nucleotide sequencing. PFGE was use...
Antigenic competition among different ‘O’ antigens of Salmonella enterica subspecies enterica serovars during hyperimmunization in pony mares.
Indian journal of experimental biology    December 21, 2006   Volume 44, Issue 12 1022-1025 
Singh BR, Chandra M, Agrawal RK, Nagrajan B.The present study on antigenic competition among somatic 'O' antigens of different Salmonella groups (A, B, C1, C2, D and E1) in mares revealed that the immune response to most of the antigens was not (A, B, C2) or little (C1, D) affected by antigenic competition. However, E1 group antigen, which induced high antibody titres (Avg. 12967.3) when given alone, produced almost 3.5 log2 lower antibody titres on giving with other antigens, indicating the antigenic competition among some Salmonella group antigens. The antigenic competition varied for different antigens even of the similar chemical na...
Malabsorptive maldigestive disorder with concurrent Salmonella in a 3-year-old quarter horse.
The Veterinary clinics of North America. Equine practice    April 22, 2006   Volume 22, Issue 1 85-94 doi: 10.1016/j.cveq.2005.12.005
Plummer PJ.No abstract available
Development of an indirect enzyme-linked immunosorbent assay for detecting equine serum antibodies to the lipopolysaccharide of Salmonella abortusequi.
Research in veterinary science    February 17, 2006   Volume 81, Issue 2 215-217 doi: 10.1016/j.rvsc.2005.11.004
Gall D, Nielsen K, Bermudez RM, Muñoz del Real MC, Halbert G, Groulx R, Moreno F, Chow EY, Checkley SL.An indirect enzyme-linked immunosorbent assay (IELISA) was developed for the detection of equine serum antibodies to lipopolysaccharide of Salmonella enterica subsp. enterica serovar Abortusequi (LPS), a causative organism of Equine Paratyphoid. The data presented demonstrates that horses immunized with S. abortusequi LPS developed antibodies detectable by the IELISA. By comparison, the tube agglutination test (TAT) did not detect antibody to S. abortusequi LPS as consistently as the IELISA. The data suggests that the IELISA may be a more suitable test for the detection of serum antibodies to ...
Detection of a bla(SHV) extended-spectrum {beta}-lactamase in Salmonella enterica serovar Newport MDR-AmpC.
Journal of clinical microbiology    November 8, 2005   Volume 43, Issue 11 5792-5793 doi: 10.1128/JCM.43.11.5792-5793.2005
Rankin SC, Whichard JM, Joyce K, Stephens L, O'shea K, Aceto H, Munro DS, Benson CE.Salmonella enterica serovar Newport MDR-AmpC expressing TEM-1b and extended-spectrum beta-lactamase SHV-12 was isolated from affected animals during an outbreak of salmonellosis that led to a 3-month closure of one of the largest equine hospitals in the United States.
Meningoencephalomyelitis in a foal due to Salmonella agona infection.
New Zealand veterinary journal    July 21, 2005   Volume 49, Issue 4 159-161 doi: 10.1080/00480169.2001.36224
Patterson-Kane JC, Bain FT, Donahue JM, Harrison LR.A neonatal Thoroughbred foal was presented with rib fractures and left forelimb lameness secondary to dystocia. Results: The foal developed a head tilt, seizures and watery diarrhoea during hospitalisation and died at 7 days of age. Histological examination of the brain and spinal cord revealed a suppurative meningoencephalomyelitis with vasculitis, and numerous intralesional, gram-negative bacilli. Similar microscopic lesions were noted in the lungs, renal medullary interstitium, and umbilicus. Bacilli in the brain, spinal cord and umbilicus were identified immunohistochemically as Salmonella...
Evaluation of a PCR to detect Salmonella in fecal samples of horses admitted to a veterinary teaching hospital. Ward MP, Alinovi CA, Couëtil LL, Wu CC.The diagnostic accuracy of a PCR used to identify horses shedding Salmonella spp. in their feces during hospitalization was estimated, relative to bacterial culture of serially collected fecal samples, using longitudinal data. Five or more fecal samples were collected from each of 116 horses admitted as inpatients, for reasons other than gastrointestinal disease, between July 26, 2001 and October 25, 2002. All 873 fecal samples collected were tested with a PCR based on oligonucleotide primers defining a highly conserved segment of the histidine transport operon gene of Salmonella typhimurium, ...
Investigation and control of an outbreak of salmonellosis caused by multidrug-resistant Salmonella typhimurium in a population of hospitalized horses.
Veterinary microbiology    February 26, 2005   Volume 107, Issue 3-4 233-240 doi: 10.1016/j.vetmic.2005.01.019
Ward MP, Brady TH, Couëtil LL, Liljebjelke K, Maurer JJ, Wu CC.An outbreak of salmonellosis in a population of hospitalized horses resulted in the closure of a teaching hospital for a period of 10 weeks. Fecal samples were collected from suspected cases and cultured for Salmonella. Salmonella isolates were characterized using antimicrobial susceptibility testing, pulsed-field gel electrophoresis (PFGE) and phage typing. Thirty-three cases of infection by a multidrug-resistant strain of S. typhimurium were detected. The index case was admitted on 26 August 1999. Fifteen (45%) cases occurred between April and June 2000. PFGE results suggested that this stra...