title: Multidrug-Resistant Salmonella Heidelberg Associated with Mechanically Separated Chicken at a Correctional Facility.
abstract: We describe multidrug-resistant (MDR) Salmonella Heidelberg infections associated with mechanically separated chicken (MSC) served at a county correctional facility. Twenty-three inmates met the case definition. All reported diarrhea, 19 (83%) reported fever, 16 (70%) reported vomiting, 4 (17%) had fever ≥103°F, and 3 (13%) were hospitalized. A case-control study found no single food item significantly associated with illness. Salmonella Heidelberg with an indistinguishable pulsed-field gel electrophoresis pattern was isolated from nine stool specimens; two isolates displayed resistance to a total of five drug classes, including the third-generation cephalosporin, ceftriaxone. MDR Salmonella Heidelberg might have contributed to the severity of illness. Salmonella Heidelberg indistinguishable from the outbreak subtype was isolated from unopened MSC. The environmental health assessment identified cross-contamination through poor food-handling practices as a possible contributing factor. Proper hand-washing techniques and safe food-handling practices were reviewed with the kitchen supervisor.
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Amanda L
authors.initials: AL
authors.lastname: Taylor
authors.affiliation: 2 Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Rendi
authors.initials: R
authors.lastname: Murphree
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: L Amanda
authors.initials: LA
authors.lastname: Ingram
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Katie
authors.initials: K
authors.lastname: Garman
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Deborah
authors.initials: D
authors.lastname: Solomon
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Eric
authors.initials: E
authors.lastname: Coffey
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Deborah
authors.initials: D
authors.lastname: Walker
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Marsha
authors.initials: M
authors.lastname: Rogers
authors.affiliation: 2 Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Ellyn
authors.initials: E
authors.lastname: Marder
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Marie
authors.initials: M
authors.lastname: Bottomley
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Amy
authors.initials: A
authors.lastname: Woron
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Linda
authors.initials: L
authors.lastname: Thomas
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Sheri
authors.initials: S
authors.lastname: Roberts
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Henrietta
authors.initials: H
authors.lastname: Hardin
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: Parvin
authors.initials: P
authors.lastname: Arjmandi
authors.affiliation: 4 Food Safety and Inspection Service, United States Department of Agriculture , Minneapolis, Minnesota.
authors.forename: Alice
authors.initials: A
authors.lastname: Green
authors.affiliation: 2 Centers for Disease Control and Prevention , Atlanta, Georgia .
authors.forename: Latoya
authors.initials: L
authors.lastname: Simmons
authors.affiliation: 1 Tennessee Department of Health, Chattanooga, Tennessee.
authors.forename: Allyson
authors.initials: A
authors.lastname: Cornell
authors.affiliation: 3 Tennessee Department of Health, Nashville, Tennessee.
authors.forename: John
authors.initials: J
authors.lastname: Dunn
mesh_terms: D000328:Adult; D000818:Animals; D016022:Case-Control Studies; D002645:Chickens / Q000382:microbiology*; D003035:Cobalt; D004196:Disease Outbreaks; D024881:Drug Resistance, Bacterial; D018432:Drug Resistance, Multiple; D005243:Feces / Q000382:microbiology; D005260:Female; D005506:Food Contamination; D005511:Food Handling / Q000379:methods*; D005516:Food Microbiology; D006235:Hand Disinfection; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012475:Salmonella / Q000187:drug effects* / Q000302:isolation & purification; D012478:Salmonella Food Poisoning / Q000382:microbiology / Q000517:prevention & control / Q000635:transmission
chemical_list: D003035:Cobalt; C027875:cobaltous sulfide