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An Outbreak of Salmonella Serotype Saintpaul in a Children's Hospital

Published online by Cambridge University Press:  02 January 2015

Rena Bornemann ,
Danielle M. Zerr ,
Joan Heath ,
Jane Koehler ,
Marcus Grandjean ,
Ravi Pallipamu  and
Jeff Duchin
Rena Bornemann
Affiliation:
Children's Hospitaland Regional Medical Center, Seattle, Washington
Danielle M. Zerr*
Affiliation:
Children's Hospitaland Regional Medical Center, Seattle, Washington Department of Pediatrics, University of Washington, Seattle, Washington
Joan Heath
Affiliation:
Children's Hospitaland Regional Medical Center, Seattle, Washington
Jane Koehler
Affiliation:
Public Health-Seattle and King County, Seattle, Washington
Marcus Grandjean
Affiliation:
Public Health-Seattle and King County, Seattle, Washington
Ravi Pallipamu
Affiliation:
Washington State Department of Health, Public Health Laboratories, Seattle, Washington
Jeff Duchin
Affiliation:
Department of Internal Medicine, University of Washington, Seattle, Washington Public Health-Seattle and King County, Seattle, Washington
*
Children's Hospital, CH-32, 4800 Sand Point Way, NE, Seattle, WA 98105
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Abstract

Objectives:

To describe a nosocomial outbreak of Salmonella serotype Saintpaul gastroenteritis and to explore risk factors for infection.

Design:

Case-control study.

Setting:

A 208-bed, university-affiliated children's hospital.

Participants:

Patients hospitalized at Children's Hospital and Regional Medical Center, Seattle, Washington, during February 2001 who had stool specimens obtained for culture at least 24 hours after admission. Case-patients (n = 11) were patients with an indistinguishable strain of Salmonella Saintpaul cultured from their stool. Control-patients (n = 41) were patients hospitalized for problems other than gastroenteritis whose stool cultures were negative for Salmonella.

Methods:

Risk factors were evaluated using the chisquare test or Fisher's exact test. Continuous variables were compared using the Mann–Whitney U test. A multivariable analysis was performed using logistic regression. The predictor of interest was the receipt of enteral feeding formula mixed by the hospital.

Results:

Case-patients were more likely than control-patients to have received formula mixed by the hospital (OR, 4.2; 95% confidence interval, 1.04 to 17.16). Other variables evaluated were not significant predictors of Salmonella Saintpaul infection.

Conclusions:

Formula mixed by the hospital appears to have been the source of this Salmonella outbreak. Strict sanitation measures must be ensured in formula preparation and delivery, and bacterial pathogens should be included in the differential diagnosis for nosocomial gastroenteritis.

Type
Original Articles
Information
Infection Control & Hospital Epidemiology , Volume 23 , Issue 11 , November 2002 , pp. 671 - 676
Copyright
Copyright © The Society for Healthcare Epidemiology of America 2002

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References

1.Centers for Disease Control and Prevention. Outbreak of Salmonella serotype Muenchen infections associated with unpasteurized orange juice: United States and Canada, June 1999. MMWR 1999;48:582–585.Google Scholar
2.Meehan, PJ, Atkeson, T, Kepner, D, Melton, M. A foodborne outbreak of gastroenteritis involving two different pathogens. Am J Epidemiol 1992;136:611–616.Google Scholar
3.Gallay, A, Vaillant, V, Bouvet, P, Grimont, P, Desenclos, JC. How many food-borne outbreaks of Salmonella infection occurred in France in 1995? Application of the capture-recapture method to three surveillance systems. Am J Epidemiol 2000;152:171–177.CrossRefGoogle Scholar
4.Telzak, EE, Budnick, LD, Greenberg, MS, et al. A nosocomial outbreak of Salmonella enteritidis infection due to the consumption of raw eggs. N Engl J Med 1990;323:394–397.Google Scholar
5.McAllister, TA, Roud, JA, Marshall, A, Holland, BM, Turner, TL. Outbreak of Salmonella eimsbuettel in newborn infants spread by rectal thermometers. Lancet 1986;1:1262–1264.CrossRefGoogle ScholarPubMed
6.Khan, AGallo, R, Hameed, R, et al. Salmonella senftenberg outbreak. Infect Control Hosp Epidemiol 1998;19:296–298.Google Scholar
7.Spearing, NM, Jensen, A, McCall, BJ, Neill, AS, McCormack, JG. Direct costs associated with a nosocomial outbreak of Salmonella infection: an ounce of prevention is worth a pound of cure. Am J Infect Control 2000;28:54–57.Google Scholar
8.L'Ecuyer, PB, Diego, J, Murphy, D, et al. Nosocomial outbreak of gastroenteritis due to Salmonella senftenberg. Clin Infect Dis 1996;23:734–742.CrossRefGoogle ScholarPubMed
9.Boase, J, Lipsky, S, Simani, P, et al. Outbreak of Salmonella Muenchen infections associated with unpasteurized orange juice: United States and Canada, June 1999. JAMA 2000;282:726–728.Google Scholar
10.Hammami, AArlet, G, Ben Redjeb, S, et al. Nosocomial outbreak of acute gastroenteritis in a neonatal intensive care unit in Tunisia caused by multiply drug resistant Salmonella wien producing SHV-2 beta-lactamase. Eur J Clin Microbiol Infect Dis 1991;10:641–646.Google Scholar
11.Joseph, CA, Palmer, SR. Outbreaks of Salmonella infection in hospitals in England and Wales 1978-87. BMJ 1989;298:1161–1164.Google Scholar
12.Shimoni, Z, Pitlik, S, Leibovici, L, et al. Nontyphoid Salmonella bacteremia: age-related differences in clinical presentation, bacteriology, and outcome. Clin Infect Dis 1999;28:822–827.Google Scholar
13.Schutze, GE, Kirby, RS, Flick, EL, Stefanova, R, Eisenach, KD, Cave, MD. Epidemiology and molecular identification of Salmonella infections in children. Arch Pediatr Adolesc Med 1998;152:659–664.Google Scholar
14.Gautom, RK. Rapid pulsed-field gel electrophoresis protocol for typing of Escherichia coli O157:H7 and other gram-negative organisms in 1 day. J Clin Microbiol 1997;35:2977–2980.Google Scholar
15.Baggesen, DL, Wegener, HC, Christensen, JP. Typing of Salmonella enterica serovar Saintpaul: an outbreak investigation. APMIS 1996;104:411–418.Google Scholar
16.O'Mahony, M, Cowden, J, Smyth, B, et al. An outbreak of Salmonella saint-paul infection associated with beansprouts. Epidemiol Infect 1990;104:229–235.Google Scholar
17.Pagon, S, Krapf, W, Geel, O. Salmonella saint-paul infections occurring after consumption of grilled chickens. Schweizerische Rundschau fur Medizin Praxis 1976;65:538–542.Google Scholar
18.Taylor, R, Sloan, D, Cooper, T, Morton, B, Hunter, I. A waterborne outbreak of Salmonella Saintpaul. Commun Dis Intell 2000;24:336–340.Google Scholar
19.Hird, DW, Pappaioanou, M, Smith, BP. Case-control study of risk factors associated with isolation of Salmonella Saintpaul in hospitalized horses. Am J Epidemiol 1984;120:852–864.CrossRefGoogle ScholarPubMed
20.Gotoff, SP, Boring, JR, Lepper, MH. An epidemic of Salmonella saint-paul infection in a convalescent home. Am J Med Sci 1966;251:16–21.Google Scholar
21.Centers for Disease Control and Prevention. Salmonella serotype Tennessee in powered milk products and infant formula: Canada and United States, 1993. MMWR 1993;42:516–517.Google Scholar
22.Centers for Disease Control and Prevention. Enterobacter sakazakii infections associated with the use of powdered infant formula: Tennessee, 2001. MMWR 2002;51:297–300.Google Scholar
23.Freedland, CP, Roller, RD, Wolfe, MB, Flynn, NM. Microbial contamination of continuous drip feedings. JPEN J Parenter Enteral Nutr 1989;13:18–22.Google Scholar
24.Anderson, KR, Norris, DJ, Godfrey, LB, Avent, CK, Butterworth, CE. Bacterial contamination of tube-feeding formulas. JPEN J Parenetr Enteral Nutr 1984;8:673–678.Google Scholar