|MARZEL, A. - TEL AVIV UNIVERSITY|
|DESAI, P - UNIVERSITY OF CALIFORNIA|
|NISSAN, I - STATE OF ISRAEL, MINISTRY OF HEALTH|
|SCHORR, Y - STATE OF ISRAEL, MINISTRY OF HEALTH|
|SUEZ, J - THE SHEBA MEDICAL CENTER AT TEL HASHOMER|
|VALINSKY, L - STATE OF ISRAEL, MINISTRY OF HEALTH|
|RESIFELD, A - STATE OF ISRAEL, MINISTRY OF HEALTH|
|AGMON, V - STATE OF ISRAEL, MINISTRY OF HEALTH|
|MCCLELLAND, M - UNIVERSITY OF CALIFORNIA|
|RAHAV, G - THE SHEBA MEDICAL CENTER AT TEL HASHOMER|
|GAL-MOR, O - THE SHEBA MEDICAL CENTER AT TEL HASHOMER|
Submitted to: Journal of Clinical Microbiology
Publication Type: Peer Reviewed Journal
Publication Acceptance Date: 3/29/2014
Publication Date: 4/9/2014
Citation: Marzel, A., Desai, P.T., Nissan, I., Schorr, Y.I., Suez, J., Valinsky, L., Resifeld, A., Agmon, V., Guard, J.Y., Mcclelland, M., Rahav, G., Gal-Mor, O. 2014. Integrative analysis of Salmonellosis in Israel revelas association of Salmonella enterica Serovar-with extraintestinal infrections, dissemination of endemic S. enterica Serovar Typhimurium Dt104 biotypes, severe underreporti. Journal of Clinical Microbiology. 52(6):p2078-2088.2014.
Interpretive Summary: An epidemiological study of 48,345 Salmonellosis illnesses occurring in Israel was made to study the association of nontyphoidal Salmonella serovars with invasive infections in people. A new serotype of invasive Salmonella enterica, namely S. enterica serovar 9,12:l,v:- and a new strain of S. Typhimurium DT104 were identified and sequenced. Accumulatively, these findings indicate a severe underreporting of Salmonella outbreaks in Israel and provide insights into the epidemiology and genomics of prevalent serovars, responsible for recurring illness.
Technical Abstract: Salmonella enterica is the leading etiologic agent of bacterial food-borne outbreaks worldwide. This ubiquitous species contains more than 2,600 serovars that may differ in their host specificity, clinical manifestations, and epidemiology. To characterize salmonellosis epidemiology in Israel and to study the association of nontyphoidal Salmonella (NTS) serovars with invasive infections, 48,345 Salmonella cases reported and serotyped at the National Salmonella Reference Center between 1995 and 2012 were analyzed. A quasi-Poisson regression was used to identify irregular clusters of illness, and pulsed-field gel electrophoresis in conjunction with whole-genome sequencing was applied to molecularly characterize strains of interest. Three hundred twenty-nine human salmonellosis clusters were identified, representing an annual average of 23 (95% confidence interval [CI], 20 to 26) potential outbreaks. We show that the previously unsequenced S. enterica serovar 9,12:l,v: belongs to the B clade of Salmonella enterica subspecies enterica, and we show its frequent association with extraintestinal infections, compared to other NTS serovars. Furthermore, we identified the dissemination of two prevalent Salmonella enterica serovar Typhimurium DT104 clones in Israel, which are genetically distinct from other global DT104 isolates. Accumulatively, these findings indicate a severe underreporting of Salmonella outbreaks in Israel and provide insights into the epidemiology and genomics of prevalent serovars, responsible for recurring illness.