Molecular epidemiologic surveillance of salmonellosis in Arkansas.
OBJECTIVE
Salmonella serotype Newport and Salmonella serotype Typhimurium are the most commonly identified serotypes of Salmonella causing human disease in the state of Arkansas. The purpose of our study was to compare the results of standard and molecular epidemiologic methods of investigating human salmonellosis cases due to Salmonella serotype Newport and Salmonella serotype Typhimurium.


METHODS
All isolates of Salmonella serotype Newport and Salmonella serotype Typhimurium collected and submitted to the Arkansas Department of Health between July 1, 1997 and June 30, 1998 were gathered and underwent pulsed-field gel electrophoresis (PFGE). Patients from whom the isolates were collected were contacted and completed a questionnaire.


RESULTS
There were 84 patients from whom Salmonella serotype Newport was isolated and 83 from whom Salmonella serotype Typhimurium was isolated during the study period. In the 124 patients (74%) who completed the questionnaire, Salmonella serotype Newport was more likely to be the infecting agent in younger, white, and pet-owning patients (P < 0.05). The use of PFGE confirmed that approximately 20% of the organisms had genetic fingerprint patterns identical to those of at least one other individual in the state. One third of the patients from whom these isolates were obtained were linked by standard epidemiologic methods.


CONCLUSIONS
The use of PFGE on our state's most common isolates provides additional confirmation that despite being linked by time of onset and location of residence, the majority of the human salmonellosis cases in our region are still sporadic. Low-level, intermittent transmission of these organisms through environmental contamination and contact with asymptomatically infected individuals would be likely vehicles of transmission in our state. Molecular techniques are important in surveillance systems that investigate human salmonellosis. Eighty-one percent of the Salmonella serotype Newport and 92% of the Salmonella serotype Typhimurium cases that appeared to be outbreak-related based upon time of onset and location were actually found not to be outbreak-related by PFGE. Using techniques such as PFGE will allow for more focused evaluations of potential outbreaks and will save the already limited financial and human resources that would otherwise be spent on investigations that are not warranted.
Schutze
Gordon E
GE
Department of Pediatrics, School of Medicine, University of Arkansas for Medical Sciences, Little Rock, AR, USA. schutzegordone@uams.edu
Flick
Ellie L
EL
Stefanova
Rossina
R
Spencer
H J
HJ
Lensing
Shelly Y
SY
Berry
Dennis A
DA
Cave
M Donald
MD
D000293:Adolescent; D000328:Adult; D001131:Arkansas / Q000453:epidemiology; D002648:Child; D016172:DNA Fingerprinting; D016521:Electrophoresis, Gel, Pulsed-Field; D005260:Female; D006801:Humans; D008297:Male; D017720:Molecular Epidemiology; D011159:Population Surveillance; D012307:Risk Factors; D012475:Salmonella / Q000145:classification / Q000235:genetics*; D012480:Salmonella Infections / Q000453:epidemiology*; D012486:Salmonella typhimurium / Q000235:genetics / Q000302:isolation & purification; D016036:Seroepidemiologic Studies; D012703:Serotyping; D014871:Water Microbiology