Outbreak of Multidrug-Resistant Salmonella Heidelberg Infections Linked to Dairy Calf Exposure, United States, 2015–2018

Details

• Alternative Title:
  Foodborne Pathog Dis
• Personal Author:
  Nichols, Megin ; Gollarza, Lauren ; Sockett, Donald ; Aulik, Nicole ; Patton, Elisabeth ; Watkins, Louise K. Francois ; Gambino-Shirley, Kelly J. ; Folster, Jason P. ; Chen, Jessica C. ; Tagg, Kaitlin A. ; Stapleton, Gregory Sean ; Trees, Eija ; Ellison, Zachary ; Lombard, Jason ; Morningstar-Shaw, Brenda ; Schlater, Linda ; Elbadawi, Lina ; Klos, Rachel
• Description:
  In August 2016, the Wisconsin Department of Health Services notified the U.S. Centers for Disease Control and Prevention of multidrug-resistant (MDR) | serovar Heidelberg infections in people who reported contact with dairy calves. Federal and state partners investigated this to identify the source and scope of the outbreak and to prevent further illnesses. Cases were defined as human | Heidelberg infection caused by a strain that had one of seven pulsed-field gel electrophoresis (PFGE) patterns or was related by whole genome sequencing (WGS), with illness onset from January 1, 2015, through July 2, 2018. Patient exposure and calf purchase information was collected and analyzed; calves were traced back from the point of purchase. Isolates obtained from animal and environmental samples collected on-farm were supplied by veterinary diagnostic laboratories and compared with patient isolates using PFGE and WGS. Antimicrobial susceptibility testing by standardized broth microdilution was performed. Sixty-eight patients from 17 states were identified. Forty (63%) of 64 patients noted cattle contact before illness. Thirteen (33%) of 40 patients with exposure to calves reported that calves were sick or had died. Seven individuals purchased calves from a single Wisconsin livestock market. One hundred forty cattle from 14 states were infected with the outbreak strain. WGS indicated that human, cattle, and environmental isolates from the livestock market were genetically closely related. Most isolates (88%) had resistance or reduced susceptibility to antibiotics of ≥5 antibiotic classes. This resistance profile included first-line antibiotic treatments for patients with severe salmonellosis, including ampicillin, ceftriaxone, and ciprofloxacin. In this outbreak, MDR | Heidelberg likely spread from sick calves to humans, emphasizing the importance of illness surveillance in animal populations to prevent future spillover of this zoonotic disease.
• Subjects:
  Animals Anti-Bacterial Agents Cattle Disease Outbreaks Drug Resistance, Multiple, Bacterial Electrophoresis, Gel, Pulsed-Field Humans Microbial Sensitivity Tests One Health Salmonella Enterica
• Source:
  Foodborne Pathog Dis. 19(3):199-208
• Pubmed ID:
  34989634
• Pubmed Central ID:
  PMC9524362
• Document Type:
  Journal Article
• Funding:
  CC999999/ImCDC/Intramural CDC HHSUnited States/
• Place as Subject:
  United States
• Volume:
  19
• Issue:
  3
• Collection(s):
  CDC Public Access
• Main Document Checksum:
  urn:sha256:8bf6612e3ace55969cd0fd645882e790affa549258592608f794ceb1e1617cb0
• Download URL:
  https://stacks.cdc.gov/view/cdc/121657/cdc_121657_DS1.pdf
• File Type:
  [PDF - 621.57 KB ]