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 Original Articles |
| A Molecular Epidemiological Study of Nationwide Foodborne Outbreaks due to
Salmonella enterica Serotype Enteritidis During the Early 1999 in South Korea |
| Cheol-Hyun Kim, M.D., Jang-Wook Sohn, M.D., Sung Han Kim*, Mi Sun Park, MSc.*
Youn Ho Kang, Ph.D.*, Bok Kwon Lee, MSc.*, Ho Hoon Kim, M.D., Ph.D*
Jung Sik Yoo, MSc.†, Young Hack Shin, Ph.D and Min-Ja Kim, M.D. |
| Division of Infectious Diseases, Department of Internal Medicine, Korea
University College of Medicine, Laboratory of Enteric Infections, Department of Microbiology*,
Department of Division of Epidemiology, Department of Infectious Diseases†,
National Institute of Health, South Korea |
Vol.32 Num.6 (p423~432)
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Background:Nationwide foodborne outbreaksdue to Salmonella enteritidis occurred during 1999 March～June in South Korea, which affected approximately 1,874 persons and caused 4 deaths. A case-control study found no single food item implicated. We investigated the epidemiological link of the outbreaks by phage typing and pulsed-field gel electrophoresis (PFGE) of the isolates.
Methods:We studied epidemiological characteristics of 24 outbreaks due to S. enteritidis reported in the 1999 March～June and determined phage types and PFGE subtypes of 139 isolates randomly selected from 20 outbreaks. The epidemiologic type linked to each outbreak was analyzed by region and month. Antimicrobial susceptibility was determined for 15 antimicrobials using the microbroth dilution method.
Results:Among 24 outbreaks, an outbreak was initially recognized in March at Kangwon province, followed by 12 in April (3 cities and 3 provinces), 7 in May (2 cities and 4 provinces) and 4 in June (a city and 2 provinces), respectively. Most outbreaks were related to food served at wedding receptions, restaurants, or schools. Six PT were identified among the 139 isolates tested; PT 4 was involved in 9 outbreaks, PT 6 in 5 and PT 1, 5a, 6b or 21 in one each. Two PFGE subtypes were identified among the 139 isolates tested; A0 was involved in 17 outbreaks and A9 in 3 outbreaks. The epidemiologic types recognized 2 discrete clusters; PT 4-PFGE A0 was involved in an outbreak in March, 7 in April and 2 in May and PT 6- PFGE A0 in an outbreak in April and 4 in May. Fifty- three percent of the 134 isolates tested were resistant to one or more antimicrobials. Resistance rates to tetracycline and nalidixic acid were 38% and 13.4%, respectively.
Conclusion:The results indicate that the nationwide outbreaks caused by S. enteritidis in the early 1999 might be due to rapid spread of common sources of infection contaminated with each of 2 epidemiologic types. |
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Keywords : Salmonella enteritidis, Foodborne outbreaks, Pulsed-field gel electrophoresis (PFGE), Phage typing |
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