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Outbreak of Healthcare-Associated Infection and Colonization With Multidrug-Resistant Salmonella enterica Serovar Senftenberg in Florida

Published online by Cambridge University Press:  02 January 2015

Robyn S. Kay ,
Alexander G. Vandevelde ,
Paul D. Fiorella ,
Rebecca Crouse ,
Carina Blackmore ,
Roger Sanderson ,
Christina L. Bailey  and
Michael L. Sands
Robyn S. Kay*
Affiliation:
Bureau of Epidemiology, Jacksonville, Florida
Alexander G. Vandevelde
Affiliation:
Florida Department of Health, the Division of Infectious and Communicable Diseases, University of Florida Health Science Center Jacksonville, Jacksonville, Florida Duval County Health Department, Jacksonville, Florida
Paul D. Fiorella
Affiliation:
Bureau of Laboratories, Section of Molecular Diagnostics and Epidemiology, Jacksonville, Florida
Rebecca Crouse
Affiliation:
Florida Department of Health, the Division of Infectious and Communicable Diseases, University of Florida Health Science Center Jacksonville, Jacksonville, Florida Duval County Health Department, Jacksonville, Florida
Carina Blackmore
Affiliation:
Bureau of Environmental Health, Jacksonville, Florida
Roger Sanderson
Affiliation:
Bureau of Epidemiology, Jacksonville, Florida
Christina L. Bailey
Affiliation:
Florida Department of Health, the Division of Infectious and Communicable Diseases, University of Florida Health Science Center Jacksonville, Jacksonville, Florida Duval County Health Department, Jacksonville, Florida
Michael L. Sands
Affiliation:
Florida Department of Health, the Division of Infectious and Communicable Diseases, University of Florida Health Science Center Jacksonville, Jacksonville, Florida Duval County Health Department, Jacksonville, Florida
*
Florida Department of Health, 1217 N. Pearl Street, Hardy Building 215, Jacksonville, FL 32202 (Robyn_Kay@doh.state.fl.us)
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Abstract

Background.

In July 1999, a rare strain of multidrug-resistant Salmonella enterica serovar Senftenberg was isolated from the sputum of a trauma patient. Over a 6-year period (1999-2005) in northeast Florida, this Salmonella serovar spread to 66 other patients in 16 different healthcare facilities as a result of frequent transfers of patients among institutions. To our knowledge, this is the first outbreak of healthcare-associated infection and colonization with a fluoroquinolone-resistant strain of S. Senftenberg in the United States.

Objectives.

To investigate an outbreak of infection and colonization with an unusual strain of S. Senftenberg and assist with infection control measures.

Design.

A case series, outbreak investigation, and microbiological study of all samples positive for S. Senftenberg on culture.

Setting.

Cases of S. Senftenberg infection and colonization occurred in hospitals and long-term care facilities in 2 counties in northeast Florida.

Results.

The affected patients were mostly elderly persons with multiple medical conditions. They were frequently transferred between healthcare facilities. This Salmonella serovar was capable of long-term colonization of chronically ill patients. All S. Senftenberg isolates tested shared a similar pulsed-field gel electrophoresis (PFGE) pattern.

Conclusion.

A prolonged outbreak of infection and colonization with multidrug-resistant S. Senftenberg was identified in several healthcare facilities throughout the Jacksonville, Florida, area and became established when infection control measures failed. The bacterial agent was capable of long-term colonization in chronically ill patients. Because the dispersal pattern of this strain suggested a breakdown of infection control practices, a multipronged intervention approach was undertaken that included intense education of personnel in the different institutions, interinstitutional cooperation, and transfer paperwork notification.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 28 , Issue 7 , July 2007 , pp. 805 - 811
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2007

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