title: Highly resistant Salmonella Newport-MDRAmpC transmitted through the domestic US food supply: a FoodNet case-control study of sporadic Salmonella Newport infections, 2002-2003.
abstract: BACKGROUND
  A new multidrug-resistant (MDR) strain of Salmonella serotype Newport, Newport-MDRAmpC, has recently emerged. We sought to identify the medical, behavioral, and dietary risk factors for laboratory-confirmed Salmonella Newport infection, including that with Newport-MDRAmpC.
  
  
  METHODS
  A 12-month population-based case-control study was conducted during 2002-2003 in 8 sites of the Foodborne Diseases Active Surveillance Network (FoodNet), with 215 case patients with Salmonella Newport infection and 1154 healthy community control subjects.
  
  
  RESULTS
  Case patients with Newport-MDRAmpC infection were more likely than control subjects to have taken an antimicrobial agent to which Newport-MDRAmpC is resistant during the 28 days before the onset of diarrheal illness (odds ratio [OR], 5.0 [95% confidence interval {CI}, 1.6-16]). Case patients with Newport-MDRAmpC infection were also more likely to have eaten uncooked ground beef (OR, 7.8 [95% CI, 1.4-44]) or runny scrambled eggs or omelets prepared in the home (OR, 4.9 [95% CI, 1.3-19]) during the 5 days before the onset of illness. International travel was not a risk factor for Newport-MDRAmpC infection but was a strong risk factor for pansusceptible Salmonella Newport infection (OR, 7.1 [95% CI, 2.0-24]). Case patients with pansusceptible infection were also more likely to have a frog or lizard in their household (OR, 2.9 [95% CI, 1.1-7.7]).
  
  
  CONCLUSIONS
  Newport-MDRAmpC infection is acquired through the US food supply, most likely from bovine and, perhaps, poultry sources, particularly among persons already taking antimicrobial agents.
authors.affiliation: Epidemic Intelligence Service, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, Atlanta, GA 30333, USA.
authors.forename: Jay K
authors.initials: JK
authors.lastname: Varma
authors.forename: Ruthanne
authors.initials: R
authors.lastname: Marcus
authors.forename: Sara A
authors.initials: SA
authors.lastname: Stenzel
authors.forename: Samir S
authors.initials: SS
authors.lastname: Hanna
authors.forename: Sharmeen
authors.initials: S
authors.lastname: Gettner
authors.forename: Bridget J
authors.initials: BJ
authors.lastname: Anderson
authors.forename: Tameka
authors.initials: T
authors.lastname: Hayes
authors.forename: Beletshachew
authors.initials: B
authors.lastname: Shiferaw
authors.forename: Tessa L
authors.initials: TL
authors.lastname: Crume
authors.forename: Kevin
authors.initials: K
authors.lastname: Joyce
authors.forename: Kathleen E
authors.initials: KE
authors.lastname: Fullerton
authors.forename: Andrew C
authors.initials: AC
authors.lastname: Voetsch
authors.forename: Frederick J
authors.initials: FJ
authors.lastname: Angulo
mesh_terms: D000818:Animals; D000900:Anti-Bacterial Agents / Q000494:pharmacology; D001426:Bacterial Proteins / Q000378:metabolism*; D016022:Case-Control Studies; D002417:Cattle; D024901:Drug Resistance, Multiple, Bacterial; D004531:Eggs / Q000382:microbiology; D005516:Food Microbiology; D006801:Humans; D008460:Meat / Q000382:microbiology; D016017:Odds Ratio; D012307:Risk Factors; D012475:Salmonella / Q000145:classification* / Q000187:drug effects / Q000201:enzymology / Q000302:isolation & purification*; D012480:Salmonella Infections / Q000453:epidemiology* / Q000382:microbiology / Q000635:transmission*; D014481:United States / Q000453:epidemiology; D001618:beta-Lactamases / Q000378:metabolism*
chemical_list: D000900:Anti-Bacterial Agents; D001426:Bacterial Proteins; C048795:AmpC beta-lactamases; D001618:beta-Lactamases