Outbreak of salmonellosis caused by Salmonella enterica serovar Newport MDR-AmpC in a large animal veterinary teaching hospital.
Abstract: 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 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: 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.
Publication Date: 2010-06-24 PubMed ID: 20584143DOI: 10.1111/j.1939-1676.2010.0546.xGoogle Scholar: Lookup
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- Journal Article
- Research Support
- Non-U.S. Gov't
Summary
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The research focuses on an outbreak of Salmonella Newport at a large animal veterinary teaching hospital, despite an existing Infection Control Program (ICP). The outbreak infected 61 animals mainly horses and led to a significant fatality rate. This required the hospital’s closure, extensive decontamination, and large financial costs.
Methods of research
The researchers conducted a retrospective study to understand more about the outbreak. They collected various data from the infected animals, including:
- The animal’s species, breed, age, and gender (signalment)
- The reason the animal was brought to the hospital (presenting complaint)
- How long the animal was hospitalized
- Whether the animal was discharged or died (discharge status)
- The costs related to each infected animal
In addition, they performed phenotypic and genotypic characterization on the Salmonella isolates to understand more about the specific strain causing the outbreak.
Research findings
The research findings highlighted several major issues:
- The outbreak happened even though the hospital had an ICP in place. This suggests the ICP was not effective enough in preventing such an outbreak.
- The patient surveillance was not proactive but was instead triggered only when certain clinical signs appeared, possibly allowing the infection to spread before being detected.
- A total of 61 animals were infected by Salmonella Newport, the majority of which were horses. Nearly 36.1% of these cases were fatal, suggesting the severity of the outbreak.
- The S. Newport isolates showed high genetic similarity and all had the MDR-AmpC phenotype, indicating resistance to multiple antibiotics.
- The persistent presence of the bacteria in the environment meant that the hospital had to be closed for extensive decontamination. This incurred substantial financial costs, with a reported impact of US$4.12 million.
Conclusions and implications
The researchers concluded that the ineffective ICP resulted in the nosocomial outbreak of Salmonella Newport, causing financial strain and disruption to the hospital’s operation. This incidient served as a strong reminder of the importance of having a stringent ICP and biosecurity measures in place in a veterinary teaching hospital to prevent future outbreaks. Furthermore, more proactive patient surveillance methods should be considered for early detection of infections.
Cite This Article
APA
Dallap Schaer BL, Aceto H, Rankin SC.
(2010).
Outbreak of salmonellosis caused by Salmonella enterica serovar Newport MDR-AmpC in a large animal veterinary teaching hospital.
J Vet Intern Med, 24(5), 1138-1146.
https://doi.org/10.1111/j.1939-1676.2010.0546.x Publication
Researcher Affiliations
- Department of Clinical Studies, University of Pennsylvania School of Veterinary Medicine, Kennett Square, PA, USA. bldallap@vet.upenn.edu
MeSH Terms
- Animals
- Cross Infection / epidemiology
- Cross Infection / mortality
- Cross Infection / veterinary
- Disease Outbreaks / veterinary
- Feces / microbiology
- Horse Diseases / epidemiology
- Horse Diseases / microbiology
- Horse Diseases / mortality
- Horses
- Hospitals, Animal
- Infection Control / organization & administration
- Infection Control / standards
- Pennsylvania / epidemiology
- Salmonella Infections, Animal / epidemiology
- Salmonella Infections, Animal / microbiology
- Salmonella Infections, Animal / mortality
- Salmonella enterica / classification
- Salmonella enterica / isolation & purification
- Schools, Veterinary
- Time Factors
Citations
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