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Volume 29, Number 2—February 2023
Research

Increased Multidrug-Resistant Salmonella enterica I Serotype 4,[5],12:i:- Infections Associated with Pork, United States, 2009–2018

Ian D. PlumbComments to Author , Allison C. Brown, Erin K. Stokes, Jessica C. Chen, Heather Carleton, Beth Tolar, Preethi Sundararaman, Amy Saupe, Daniel C. Payne, Hazel J. Shah, Jason P. Folster, and Cindy R. Friedman
Author affiliations: Centers for Disease Control and Prevention, Atlanta, Georgia, USA (I.D. Plumb, A.C. Brown, E.K. Stokes, J.C. Chen, H. Carleton, B. Tolar, P. Sundararaman, D.C. Payne, H.J. Shah, J.P. Folster, C.R. Friedman); Minnesota Department of Health, St. Paul, Minnesota, USA (A. Saupe)

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Table 3

Characteristics of outbreaks caused by multidrug-resistant Salmonella enterica 4,[5],12:i:- compared with other nontyphoidal Salmonella, United States, 2009–2018*

Outbreak type and transmission mode Salmonella 4,[5],12:i:-, n = 123 Other Salmonella, n = 1,829 PFGE link to MDR clade
Linked, n = 4 Not linked, n = 45
Multistate outbreak
13 (10.6)
284 (15.5)
3 (4.1)
10 (22.2)
Mode of transmission
Foodborne, no single food category† 52 (42.3) 792 (43.3) 25 (33.8) 26 (57.8)
Foodborne, single food category 23 (18.7) 414 (22.6) 17 (23) 5 (11.1)
Animal contact, no single animal type 6 (4.9) 15 (0.8) 4 (5.4) 2 (4.4)
Animal contact, single animal type 12 (9.8) 138 (7.5) 8 (10.8) 4 (8.9)
Person-to-person 7 (5.7) 126 (6.9) 6 (8.1) 1 (2.2)
Environmental 0 15 (0.8) 0 0
Waterborne 0 2 (0.1) 0 0
Unknown transmission
23 (18.7)
327 (17.9)
14 (18.9)
7 (15.6)
Food source, single food category N = 23 N = 406 N = 17 N = 5
Chicken 4 (17.4) 77 (19) 3 (17.6) 1 (20)
Pork 13 (56.5) 47 (11.6) 11 (64.7) 1 (20)
Turkey 2 (8.7) 27 (6.7) 2 (11.8) 0
Other food category
4 (17.4)‡
255 (62.8), n = 406
1 (5.9), n = 17
3 (60)
Animal contact, single animal type N = 12 N = 138 N = 8 N = 4
Live poultry 3 (25.0)§ 77 (55.8) 2 (25.0) 1 (25)
Swine 5 (41.7) 0 5 (62.5) 0
Other animal 4 (33.3)¶ 61 (44.2) 1 (12.5) 3 (75)

*Values are no. (%) except as indicated. PFGE used as a marker for the MDR clade as defined by core genome multilocus sequence typing in PulseNet. Among sequenced clinical PulseNet isolates collected during 2015–2018 that also had PFGE information, 2,070/3,007 (69%) belonged to a clade associated with ASSuT resistance that contained 275 PFGE patterns; these patterns were identified in 7/937 (0.8%) isolates outside the clade. Excludes 4 outbreaks without PFGE information. ASSuT, ampicillin, streptomycin, sulphamethoxazole, and tetracycline; MDR, multidrug resistant; PFGE, pulsed-field gel electrophoresis. †Includes confirmed 4,[5],12:i:- outbreaks classified as foodborne transmission for which no specific food was reported. ‡Includes dairy (n = 1), nuts or seeds (n = 1), seeded vegetables (n = 1), and sprouts (n = 1). §Linked to contact with chicken (n = 1), turkey (n = 1), or baby chick or duckling (n = 1). ¶Linked to contact with rodents (n = 2), turtles (n = 1), or cattle (n = 1).

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Page created: December 15, 2022
Page updated: January 24, 2023
Page reviewed: January 24, 2023
The conclusions, findings, and opinions expressed by authors contributing to this journal do not necessarily reflect the official position of the U.S. Department of Health and Human Services, the Public Health Service, the Centers for Disease Control and Prevention, or the authors' affiliated institutions. Use of trade names is for identification only and does not imply endorsement by any of the groups named above.
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