Listeria: The mystery organism Levison, Matthew E; Kaye, Donald
Infectious Disease News,
06/2017, Letnik:
30, Številka:
6
Trade Publication Article
...contamination can occur after pasteurization or cooking by contact with contaminated surfaces in food preparation areas. Because the organisms can multiply at refrigerator temperatures and survive ...in frozen food, it is not surprising that listeriosis is often associated with ingestion of packaged, ready-to-eat (RTE) products (eg, coleslaw; smoked fish; shellfish, such as shrimp; pâté; and deli meats), after having been stored at refrigeration temperatures, especially because its presence in food does not alter taste or smell. The genotypes of clinical isolates are then compared with data from state laboratories, the CDC, FDA and the U.S. Department of Agriculture's Food Safety and Inspection Service, which perform WGS on food and environmental L. monocytogenes isolates. With an incubation period (the time from exposure to onset of illness) of more than 2 months, it can be especially difficult to trace an illness back to the food responsible for it. ...health officials need to interview patients with laboratory-confirmed cases as quickly as possible after Listeria infection is diagnosed to maximize patients' recollection of the foods they consumed before they got sick. Common sources of Listeria RTE deli meats and hot dogs Refrigerated pâté or meat spreads Unpasteurized (raw) milk and dairy products Soft cheese made with unpasteurized milk, such as queso fresco, feta, Brie and Camembert Refrigerated smoked seafood Raw sprouts Source: Foodsaftey.gov The investigation of outbreaks often provides information about transmission of L. monocytogenes that can be used to improve food safety.
We evaluated the usefulness of the Duke criteria for diagnosing cases of active infective endocarditis (IE). Patients were identified prospectively over a 3-year period at 54 hospitals in the ...Philadelphia metropolitan area. Three of us independently reviewed abstracted hospital records and classified 410 patients as definite, probable, or possible cases of IE or as probable noncases. We then applied the Duke criteria to this sample to assess the degree of agreement between our diagnoses and the diagnoses based on these new criteria. Agreement was good to excellent, ranging from 72% to 90%, depending on the case definition used. The sensitivity of the Duke criteria was also good to excellent, varying from 71% to 99%, again depending on case definition used. Specificity was lower (0–89%). We conclude that use of the Duke criteria will result in little underdiagnosis of IE but that it may result in overdiagnosis of IE; therefore, these criteria should be applied prospectively to determine their clinical usefulness.
Few studies have addressed the occurrence of M. leprae in armadillos outside the U.S. Besides M. leprae-infected humans, the 9-banded armadillo is the only natural host of M. leprae and therefore may ...be a source of infection for some humans in the U.S. About 70% of cases in the country acquired their disease when they lived or worked in leprosy-endemic regions outside the U.S.; however, about 30% of cases in the U.S. report no foreign residence and therefore likely acquired leprosy inside the country. Most reside in states where M. leprae infection occurs naturally in free-ranging armadillos, and case-control studies have shown that contact with M. leprae-infected armadillos is a risk factor for acquisition of leprosy in the U.S. Human exposure to armadillos is quite common in the Gulf Coast region, where the animals are handled during the process of hunting, cleaning and preparing their meat for food, and eating.
According to the CDC, cases of Legionnaires' disease have been increasing dramatically in the United States, with 2,270 in the first 7 months of 2014 and 2,472 cases in the same period this year, ...whereas only 1,500 cases were being reported annually 15 years ago. Pontiac fever develops within 72 hours after exposure and attack rates are high; up to 95% of exposed persons become ill (unlike LD, which only develops during outbreaks in 5% of exposed individuals), and symptoms resolve in 2 to 5 days without antibiotic treatment. Because in the U.S. more than 99% of reported cases due to Legionella species are classified as LD, this article concentrates only on LD.
To describe an epidemic of vancomycin-resistant Enterococcus faecium causing bacteremia and bacteriuria, to identify the source of infection, to delineate risk factors associated with acquisition of ...the organism, and to determine antibiotic sensitivities for the organism.
Investigation of an epidemic, including a case-control study.
Medical-surgical intensive care unit and ward in a university medical center.
Nine patients infected or colonized with vancomycin-resistant Enterococcus faecium and 20 noninfected controls.
Clinical data, environmental surveillance cultures, and in-vitro microbiologic studies.
Colonization or infection by vancomycin-resistant E. faecium was associated with an increased duration of treatment with ceftazidime, 13.2 compared with 4.6 days, and a greater number of nonisolated days of hospitalization in the intensive care unit, 19.9 compared with 6.4 days for infected and noninfected patients, respectively (P less than 0.05). Environmental surveillance cultures recovered the organism repeatedly from the rectal probe handles of three electronic thermometers used exclusively on nonisolated patients in the intensive care unit. Restriction endonuclease analysis of plasmid DNA showed that all clinical and environmental isolates were identical. Infection control measures, including isolation of colonized or infected patients and removal of the rectal thermometer probes suspected to be responsible for transmission, resulted in termination of the outbreak. In-vitro, time-kill studies showed that the combination of ciprofloxacin, rifampin, and gentamicin resulted in bactericidal activity against the organism.
This nosocomial outbreak of infection due to a highly vancomycin-resistant strain of Enterococcus is the first epidemic in which an electronic thermometer has been implicated as the vehicle of transmission for an infectious agent.
Syphilis is currently epidemic among men who have sex with men in the United States and in many other parts of the world. Since 2000, rates of syphilis have been increasing in the U.S., as well as ...Canada, the United Kingdom, Australia and Europe, primarily among MSM. From 2000 to 2013, the rate of P&S syphilis among men rose almost fourfold from 2.6 per 100,000 in 2000 to 10.3 per 100,000 in 2013. Because many states do not routinely report information on sexual practices or the sex of sex partners, the CDC had not collected data by sex of sex partners until 2005.
This population-based study aimed to determine the incidence of native, prosthetic, and bioprosthetic valve nosocomial infective endocarditis (IE), and IE associated with the use of injected drugs. ...Patients with IE during 27 months over the years 1988 to 1990, and residing in any of 6 counties in the Philadelphia metropolitan area were identified. An expert panel reviewed all patients to verify the diagnosis. Incidence rates were estimated after adjustment for failure to recruit and underreporting. Of 853 potential patients, 670 (79%) met the inclusion criteria. The overall incidence rate of IE was 11.6 cases/100,000 person-years (95% confidence interval CI 10.8 to 12.4). The rates for specific types of IE were: 4.45 (95% CI 3.97 to 4.94) for community-acquired native valve, 0.94 (95% CI 0.72 to 1.12) for prosthetic valve, 0.94 (95% CI 0.71 to 1.16) for nosocomial, and 5.34 (95% CI 4.80 to 5.87) for IE associated with use of injected drugs. Previous population studies found overall incidence rates of 1.7 to 4 cases/100,000 person-years, similar to our rate for community-acquired native valve IE. Type-specific rates have not been previously reported. The higher overall rate in this study is partly related to the nigh prevalence of injection drug use in our area.
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