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Fica C A, Illanes R V, Sakurada Z A, Vidal C M, Valenzuela M ME.
Source
Sección Infectología, Hospital Clínico, Universidad de Chile, Chile. afica@redclinicauchile.cl
Abstract
We report a case of bacteraemia by Campylobacter fetus subsp. fetus in a 77 year-old woman with immunosuppression secondary to steroid use. Diagnosis was suspected by finding Gram negative curved rods in blood cultures taken after 4 days of a febrile illness without local findings. Diarrhea was not present. There was no consumption of undercooked meat or non-pasteurized milk and no contact with pets. The patient was treated with sulbactam-cefoperazone due to the coexistence of urinary tract infection by multiresistant E. coli. The outcome was favorable and albeit susceptibility was not assessed, quinolone resistance was presumed because illness appeared during ciprofloxacin prophylaxis for urinary tract infection. In contrast to C. jejuni infections, C. fetus infections are associated to debilitated or immunosuppressed patients, bacteraemia is predominant, diarrhea is rarely observed and disease is not self-limited.
PMID:
17186081
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4.
Epidemiol Infect. 2002 Dec;129(3):451-7.
E. coli O157 phage type 21/28 outbreak in North Cumbria associated with pasteurized milk.
Goh S, Newman C, Knowles M, Bolton FJ, Hollyoak V, Richards S, Daley P, Counter D, Smith HR, Keppie N.
Source
North Cumbria Health Authority, Wavell Drive, Rosehill, Carlisle, Cumbria CAI 2SE.
Abstract
In March 1999, a large community outbreak of Escherichia coli O157 infection occurred in North Cumbria. A total of 114 individuals were reported to the Outbreak Control Team (OCT); 88 had laboratory confirmed E. coli O157. Twenty-eight (32%) of the confirmed cases were admitted to hospital, including three children (3.4%) with haemolytic uraemic syndrome. There were no deaths. A case-control study found that illness was strongly associated with drinking pasteurized milk from a local farm (P = <0.0001) on single variable analysis. Microbiological investigations at the farm revealed E. coli O157 phage type (PT) 21/28 VT 2 which was indistinguishable from the human isolates by pulsed field gel electrophoresis. At the time of occurrence this was the largest E. coli O157 outbreak in England and Wales and the first E. coli O157 PT 21/28 VT 2 outbreak associated with pasteurized milk. This outbreak highlights lessons to be learnt regarding on-farm pasteurization.
PMID:
12558327
PMCID: PMC2869906
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5.
J Infect Dis. 2000 May;181(5):1834-7. Epub 2000 May 15.
An outbreak of Yersinia enterocolitica O:8 infections associated with pasteurized milk.
Ackers ML, Schoenfeld S, Markman J, Smith MG, Nicholson MA, DeWitt W, Cameron DN, Griffin PM, Slutsker L.
Source
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia, USA.
Abstract
In October 1995, an outbreak of Yersinia enterocolitica O:8 infections occurred in the Upper Valley of Vermont and New Hampshire. Ten patients were identified, median age 9 years (range, 6 months-44 years). Three patients were hospitalized; 1 underwent an appendectomy. Consumption of bottled pasteurized milk from a local dairy was associated with illness (matched odds ratio undefined; lower 95% confidence interval, 1.9). No deficiencies in pasteurization procedures or equipment were detected. Y. enterocolitica O:8 was isolated from 1 raw-milk sample and from a fecal sample from 1 dairy pig. The route of contamination was not determined; this outbreak likely resulted from postpasteurization contamination of milk. Dairy pigs were the most likely source of contamination. Milk bottles were likely contaminated by rinsing with untreated well water prior to filling or by other environmental routes. Educating dairy owners about Y. enterocolitica and postpasteurization contamination is necessary to prevent further outbreaks.
PMID:
10823796
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6.
JAMA. 1987 Dec 11;258(22):3269-74.
Massive outbreak of antimicrobial-resistant salmonellosis traced to pasteurized milk.
Ryan CA, Nickels MK, Hargrett-Bean NT, Potter ME, Endo T, Mayer L, Langkop CW, Gibson C, McDonald RC, Kenney RT, et al.
Source
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, GA 30333.
Abstract
Two waves of antimicrobial-resistant Salmonella typhimurium infections in Illinois totaling over 16 000 culture-confirmed cases were traced to two brands of pasteurized 2% milk produced by a single dairy plant. Salmonellosis was associated with taking antimicrobials before onset of illness. Two surveys to determine the number of persons who were actually affected yielded estimates of 168 791 and 197 581 persons, making this the largest outbreak of salmonellosis ever identified in the United States. The epidemic strain was easily identified because it had a rare antimicrobial resistance pattern and a highly unusual plasmid profile; study of stored isolates showed it had caused clusters of salmonellosis during the previous ten months that may have been related to the same plant, suggesting that the strain had persisted in the plant and repeatedly contaminated milk after pasteurization.
PMID:
3316720
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7.
N Engl J Med. 1985 Feb 14;312(7):404-7.
Pasteurized milk as a vehicle of infection in an outbreak of listeriosis.
Fleming DW, Cochi SL, MacDonald KL, Brondum J, Hayes PS, Plikaytis BD, Holmes MB, Audurier A, Broome CV, Reingold AL.
Abstract
Between June 30th and August 30th, 1983, 49 patients in Massachusetts acquired listeriosis. Seven cases occurred in fetuses or infants and 42 in immunosuppressed adults; 14 patients (29 per cent) died. Of 40 Listeria monocytogenes isolates available for testing, 32 were serotype 4b. Two case-control studies, one matching for neighborhood of residence and the other for underlying disease, revealed that the illness was strongly associated with drinking a specific brand of pasteurized whole or 2 per cent milk (odds ratio = 9, P less than 0.01 for the neighborhood-matched study; odds ratio = 11.5, P less than 0.001 for the illness-matched study). The association with milk was further substantiated by four additional analyses that suggested the presence of a dose-response effect, demonstrated a protective effect of skim milk, associated cases with the same product in an independent study in another state, and linked a specific phage type with the disease associated with milk. The milk associated with disease came from a group of farms on which listeriosis in dairy cows was known to have occurred at the time of the outbreak. Multiple serotypes of L. monocytogenes were isolated from raw milk obtained from these farms after the outbreak. At the plant where the milk was processed, inspections revealed no evidence of improper pasteurization. These results support the hypothesis that human listeriosis can be a foodborne disease and raise questions about the ability of pasteurization to eradicate a large inoculum of L. monocytogenes from contaminated raw milk.
PMID:
3918263
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8.
JAMA. 1984 Jan 27;251(4):483-6.
A multistate outbreak of infections caused by Yersinia enterocolitica transmitted by pasteurized milk.
Tacket CO, Narain JP, Sattin R, Lofgren JP, Konigsberg C Jr, Rendtorff RC, Rausa A, Davis BR, Cohen ML.
Abstract
In June and July 1982, a large interstate outbreak of Yersinia enterocolitica infections caused by an unusual serotype occurred in Tennessee, Arkansas, and Mississippi. Eighty-six percent of cases had enteritis characterized by fever, abdominal pain, and diarrhea. In three separate case-control studies, drinking milk pasteurized by plant A was statistically associated with illness. In a survey of randomly chosen households, 8.3% of persons who recalled having drunk milk from plant A during the suspect period experienced a yersiniosislike illness. Inspection of the plant and cultures of the available raw and pasteurized milk did not reveal the source or mechanism of contamination or a breach in normal pasteurizing technique. Although outbreaks of enteric disease caused by pasteurized milk are rare in the United States, the ability of Y enterocolitica to grow in milk at refrigeration temperatures makes pasteurized milk a possible vehicle for virulent Y enterocolitica. The extent to which milk is responsible for sporadic cases of yersiniosis is unknown.
PMID:
6546313
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9.
N Engl J Med. 1978 Jan 12;298(2):76-9.
Epidemic Yersinia enterocolitica infection due to contaminated chocolate milk.
Black RE, Jackson RJ, Tsai T, Medvesky M, Shayegani M, Feeley JC, MacLeod KI, Wakelee AM.
Abstract
In September and October, 1976, an outbreak of illness due to chocolate milk contaminated with Yersinia enterocolitica resulted in hospitalization of 36 children, 16 of whom had appendectomies. Infection with Y. enterocolitica serotype 0:8 was demonstrated in 38 ill persons. Sixty-one per cent of the persons who were infected had a titer greater than 1:160 OH agglutinins to serotype 8 yersinia, whereas 48 per cent of the hospitalized children had a fourfold change in agglutinin titer. An epidemiologic investigation demonstrated that illness was associated with drinking of chocolate milk purchased in school cafeterias, and Y. enterocolitica 0:8 was subsequently isolated from the milk. The investigation suggested that the bacterium was introduced at the dairy during the mixing by hand of chocolate syrup with previously pasteurized milk.
PMID:
579433
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