A Predominant Multidrug-Resistant Salmonella enterica Serovar Saintpaul Clonal Line in German Turkey and Related Food Products

Recently, Salmonella enterica subsp. enterica serovar Saintpaul has increasingly been observed in several countries, including Germany. However, the pathogenic potential and epidemiology of this serovar are not very well known. This study describes biological attributes of S. Saintpaul isolates obtained from turkeys in Germany based on characterization of their pheno- and genotypic properties. Fifty-five S. Saintpaul isolates from German turkeys and turkey-derived food products isolated from 2000 to 2007 were analyzed by using antimicrobial agent, organic solvent, and disinfectant susceptibility tests, isoelectric focusing, detection of resistance determinants, plasmid profiling, pulsed-field gel electrophoresis (PFGE), and hybridization experiments. These isolates were compared to an outgroup consisting of 24 S. Saintpaul isolates obtained from humans and chickens in Germany and from poultry and poultry products (including turkeys) in Netherlands. A common core resistance pattern was detected for 27 German turkey and turkey product isolates. This pattern included resistance (full or intermediate) to ampicillin, amoxicillin-clavulanic acid, gentamicin, kanamycin, nalidixic acid, streptomycin, spectinomycin, and sulfamethoxazole and intermediate resistance or decreased susceptibility to ciprofloxacin (MIC, 2 or 1 μg/ml, respectively) and several third-generation cephalosporins (including ceftiofur and cefoxitin MIC, 4 to 2 and 16 to 2 μg/ml, respectively]). These isolates had the same core resistance genotype, with bla_TEM-1, aadB, aadA2, sul1, a Ser83→Glu83 mutation in the gyrA gene, and a chromosomal class 1 integron carrying the aadB-aadA2 gene cassette. Their XbaI, BlnI, and combined XbaI-BlnI PFGE patterns revealed levels of genetic similarity of 93, 75, and 90%, respectively. This study revealed that a multiresistant S. Saintpaul clonal line is widespread in turkeys and turkey products in Germany and was also detected among German human fecal and Dutch poultry isolates.Over the last few decades, the emergence and spread of antimicrobial agent-resistant zoonotic bacteria has become a serious public health concern (2, 23). The widespread use of antimicrobial agents for disease control, including at the farm level, has increased selection of antimicrobial agent-resistant Salmonella isolates (1, 23, 44). Food animals are considered an important reservoir for resistant bacteria. These animals and food products derived from them are traded worldwide, which contributes to the global spread of zoonotic agents and antimicrobial resistance. In the last few years, several monitoring activities were initiated in order to generate baseline data on antimicrobial resistance in bacteria isolated from livestock and food derived from animals that could be used in future assessments of the risk of antimicrobial resistance (10).According to European Union (EU) Zoonoses Regulation (EC) no. 2160/2003 on the control of Salmonella and other specified food-borne zoonotic agents, a European Community target for reducing the prevalence of Salmonella in turkey flocks had to be established. Consequently, EU Commission decision 2006/662/EC was released, and a baseline survey of the prevalence of Salmonella in turkey flocks was carried out in all European countries, including Germany, over a 1-year period starting on 1 October 2006 (http://www.efsa.europa.eu/EFSA/efsa_locale-1178620753812_1178706574172.htm). The main objective of this study was to estimate the prevalence of Salmonella in commercial flocks of turkeys. The data showed that at the EU level Salmonella enterica serovar Bredeney was the serovar reported most frequently for fattening turkey flocks and occurred in 17.2% of the samples from Salmonella-positive flocks (1,084 of 3,702 flocks were positive), followed by S. enterica serovar Hadar, S. enterica serovar Derby, and then S. enterica serovar Saintpaul (14.0%, 11.3%, and 10.4% of the samples from positive flocks, respectively). In this study, S. Saintpaul was detected in fattening turkeys in 12 countries, reflecting the wide spread of this serovar. Recently, S. Saintpaul has been increasingly observed in several countries, including Germany. According to Enter-Net reports (data on Salmonella human isolates identified by European national reference centers), for the last quarter of the year 2006 S. Saintpaul was the fourth most common serovar (1.6%) and, in contrast to the data for previous years, was one of the most frequent causes of human salmonellosis in Europe. After this, its prevalence was 1.2% and 0.6% in the first quarters of 2007 and 2008, respectively, among the Salmonella serotypes implicated in human disease (http://ecdc.europa.eu/en/publications/Pages/Surveillance_Reports.aspx). During the period from 2001 to 2009 in Germany, 463 cases of human salmonellosis related to S. Saintpaul (0.09% of all cases; the maximum prevalence was 0.15% in 2008, the prevalence was 0.1% in 2002, 2005, 2006, and 2009 and 0.06% in 2004, and the minimum prevalence was 0.05% in 2007) were reported to the Robert Koch Institute (Berlin, Germany) (www3.rki.de/SurvStat). In Germany, S. Saintpaul attracted public attention particularly in 1993, when it caused a nationwide food-borne outbreak (27). This serotype has often been related to outbreaks in other countries, and in 2008 it was implicated in a large multistate human outbreak associated with various vegetables in the United States (4).Previous studies showed that isolates of S. Saintpaul are often multidrug resistant (33, 35), but little is known about the mechanisms underlying antimicrobial resistance or about the pathogenic potential and epidemiology of isolates belonging to this serotype. The goals of this study were to obtain information about the resistance characteristics of isolates collected between 2000 and 2007 in Germany and to assess possible clonal relationships. The isolates used originated from turkey feces collected during the German Salmonella baseline study (in 2006 and 2007) or from diagnostic samples, including samples of turkey feces and turkey-related food products. These isolates were compared with German strains isolated from humans and chickens and with poultry strains isolated in Netherlands.