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

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 larg...

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Bibliographic Details
Published in:Journal of veterinary internal medicine 2010-09, Vol.24 (5), p.1138-1146
Main Authors: Dallap Schaer, B.L, Aceto, H, Rankin, S.C
Format: Article
Language:English
Subjects:
algorithms
Animals
Biosecurity
Cross Infection - epidemiology
Cross Infection - mortality
Cross Infection - veterinary
decontamination
disease control
Disease Outbreaks - veterinary
economic impact
Feces - microbiology
Horse Diseases - epidemiology
Horse Diseases - microbiology
Horse Diseases - mortality
Horses
hospitals
Hospitals, Animal
Infection Control - organization & administration
Infection Control - standards
Infection control program
medicine
monitoring
mortality
multiple drug resistance
Nosocomial
patients
Pennsylvania - epidemiology
phenotype
remediation
retrospective studies
Salmonella enterica
Salmonella enterica - classification
Salmonella enterica - isolation & purification
Salmonella enterica subsp. enterica serovar Newport
Salmonella Infections, Animal - epidemiology
Salmonella Infections, Animal - microbiology
Salmonella Infections, Animal - mortality
salmonellosis
Schools, Veterinary
serotypes
Time Factors
Citations: Items that cite this one
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Summary: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).
ISSN:0891-6640
1939-1676
1939-1676
DOI:10.1111/j.1939-1676.2010.0546.x