title: An outbreak of multidrug-resistant Salmonella enterica subsp. enterica serotype Typhimurium, DT104L linked to dried anchovy in Singapore.
abstract: Multidrug-resistant Salmonella enterica subsp. enterica serotype Typhimurium DT104L was first reported in Singapore from mid-July to mid-October 2000. Salmonella strains isolated from clinical laboratories were submitted to a reference laboratory for serotyping, phage-typing and pulsed-field gel electrophoresis (PFGE) using XbaI restriction endonuclease. An epidemiological investigation was conducted to determine the source of infection and mode of transmission using a structured questionnaire. A total of 33 cases involving mainly infants and toddlers were detected in the 3-month long outbreak. The outbreak strain was of the R-type ACGSTSu, i.e. resistant to ampicillin, chloramphenicol, gentamicin, streptomycin, tetracycline and sulphonamide. PFGE showed all isolates had an indistinguishable pattern, indicating a common source of infection. Consumption of imported dried anchovy was found to be the vehicle of transmission after adjusting for all confounding variables in the case-control study using stepwise logistic regression (OR 25.6; 95% CI 3.9-167.9; P = 0.001). Imported dried seafood should be properly processed, packed, labelled, and thoroughly cooked to prevent transmission of multidrug-resistant S. Typhimurium.
authors.affiliation: Department of Pathology, Singapore General Hospital, Singapore.
authors.forename: M L
authors.initials: ML
authors.lastname: Ling
authors.forename: K T
authors.initials: KT
authors.lastname: Goh
authors.forename: G C Y
authors.initials: GC
authors.lastname: Wang
authors.forename: K S
authors.initials: KS
authors.lastname: Neo
authors.forename: T
authors.initials: T
authors.lastname: Chua
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D015986:Confounding Factors, Epidemiologic; D003296:Cooking; D004196:Disease Outbreaks; D004351:Drug Resistance; D018432:Drug Resistance, Multiple; D016521:Electrophoresis, Gel, Pulsed-Field; D016021:Epidemiologic Studies; D005260:Female; D005506:Food Contamination; D006801:Humans; D007223:Infant; D007231:Infant, Newborn; D008297:Male; D008875:Middle Aged; D012480:Salmonella Infections / Q000188:drug therapy* / Q000453:epidemiology* / Q000473:pathology; D012477:Salmonella enteritidis / Q000187:drug effects / Q000302:isolation & purification / Q000472:pathogenicity*; D017747:Seafood; D012698:Serologic Tests; D012846:Singapore / Q000453:epidemiology