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Salmonella Typhimurium DT104, Italy
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     Istituto Superiore di Sanita, Rome, Italy

    According to the Colindale scheme for phage typing (4 and L.R. Ward, pers. comm.), numerous distinguishable DT104 subtypes can be identified as DT104 A, B, C, H, and L. Most (90%) S. Typhimurium DT104 strains isolated during the last 2 years belonged to subtype DT104L.

    Emergence of phage subtype DT104A was identified in June 2004 during an outbreak of salmonellosis in Rome. This subtype had never been previously identified in Italy. All DT104A isolates were susceptible to the Enter-net panel of antimicrobial drugs (2), a feature unusual for S. Typhimurium (5). A total of 63 cases were confirmed; 61 were from Rome, and 2 were from a neighboring region. All isolates had similar pulsed-field gel electrophoretic profiles when analyzed with the Salm-gene protocol (6). Since the outbreak, 1 additional human isolate of DT104A was identified from a resident of the same neighboring region. This isolate was also susceptible to the panel of antimicrobial drugs. A fermented pork salami was epidemiologically implicated as the vehicle of infection. No microbiologic evidence was found because no food samples were available when the outbreak was recognized.

    The incidence of DT104 in Italy has remained stable from 2002 through 2004. However, emergence of subtype DT104A during a recent outbreak highlights the need for subtyping in identifying communitywide outbreaks and in monitoring changing subtype patterns.

    References

    Helms M, Ethelberg S, Mlbak K, DT104 Study Group. International Salmonella Typhimurium DT104 infections, 1992–2001. Emerg Infect Dis. 2005;11:859–67.

    Enter-net. International surveillance network for the enteric infections Salmonella and VTEC O157. [cited 2006 May 12]. Available from http://www.hpa.org.uk/hpa/inter/enter-net_menu.htm

    Busani L, Graziani C, Battisti A, Franco A, Ricci A, Vio D, et al. Antibotic resistance in Salmonella enterica serotypes Typhimurium, Enteritidis and Infantis from human infections foodstuffs and farm animals in Italy. Epidemiol Infect. 2004;132:245–51.

    Anderson ES, Ward LR, De Saxe MJ, Old DC, Barker R, Duguid JP. Bacteriophage-typing designations of Salmonella Typhimurium. J Hyg (Lond). 1977;78:297–300.

    Malorny B, Schroeter A, Bunge C, Helmuth R. Prevalence of Escherichia coli O157:H7 prophage-like sequences among German Salmonella enterica serotype Typhimurium phage types and their use in detection of phage type DT104 by polymerase chain reaction. Vet Microbiol. 2002;87:253–65.

    Peters TM, Maguire C, Threlfall EJ, Fisher IST, Gill N, Gatto AJ. on behalf of the Salm-gene project participants. The Salm-gene project–a European collaboration for DNA fingerprinting for food-related salmonellosis. Euro Surveill. 2003;8:46–50.(Amy Cawthorne, Pasquale G)