Highly Resistant Salmonella Newport‐MDRAmpC Transmitted through the Domestic US Food Supply: A FoodNet Case‐Control Study of Sporadic Salmonella Newport Infections, 2002–2003
1Epidemic Intelligence Service and 2Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, Centers for Disease Control and Prevention, and 3Georgia Department of Health and 4Atlanta Research and Education Foundation, Atlanta; 5Connecticut Emerging Infections Program, New Haven; 6Minnesota Department of Health, Minneapolis; 7Tennessee Department of Health, Nashville; 8California Emerging Infections Program, Oakland; 9New York Department of Health, Albany; 10Oregon Department of Human Services, Portland; 11Colorado Department of Public Health and Environment, Denver
Background.
A new multidrug‐resistant (MDR) strain of Salmonella serotype Newport, Newport‐MDRAmpC, has recently emerged. We sought to identify the medical, behavioral, and dietary risk factors for laboratory‐confirmed Salmonella Newport infection, including that with Newport‐MDRAmpC.
Methods.A 12‐month population‐based case‐control study was conducted during 2002–2003 in 8 sites of the Foodborne Diseases Active Surveillance Network (FoodNet), with 215 case patients with Salmonella Newport infection and 1154 healthy community control subjects.
Results.Case patients with Newport‐MDRAmpC infection were more likely than control subjects to have taken an antimicrobial agent to which Newport‐MDRAmpC is resistant during the 28 days before the onset of diarrheal illness (odds ratio [OR], 5.0 [95% confidence interval {CI}, 1.6–16]). Case patients with Newport‐MDRAmpC infection were also more likely to have eaten uncooked ground beef (OR, 7.8 [95% CI, 1.4–44]) or runny scrambled eggs or omelets prepared in the home (OR, 4.9 [95% CI, 1.3–19]) during the 5 days before the onset of illness. International travel was not a risk factor for Newport‐MDRAmpC infection but was a strong risk factor for pansusceptible Salmonella Newport infection (OR, 7.1 [95% CI, 2.0–24]). Case patients with pansusceptible infection were also more likely to have a frog or lizard in their household (OR, 2.9 [95% CI, 1.1–7.7]).
Conclusions.Newport‐MDRAmpC infection is acquired through the US food supply, most likely from bovine and, perhaps, poultry sources, particularly among persons already taking antimicrobial agents.
Received 25 January 2006; accepted 24 February 2006; electronically published 14 June 2006.
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Presented in part: International Conference on Emerging Infectious Diseases, Atlanta, March 2004.
Potential conflicts of interest: none reported.
Financial support: Centers for Disease Control and Prevention, US Department of Health and Human Services.