Authors: Elshafie Sittana Shamseldin, Abraham Joji, Al-Bakir Wasan.
Background: Salmonella spp reach food in many different ways; directly from slaughter animals to food, and from human excreta transferred to food through hands, utensils, equipment, flies etc. Foods commonly involved are animal derived foods such as poultry, meat and meat products, milk and milk products, eggs and eggs products.
We investigated a hospital outbreak of Salmonella enteritidis food poisoning due to contaminated chicken and compared the strains isolated from the patient’s samples and contaminated chicken with those isolated from the community outbreaks. Through PulseNet International our strains were compared with the strains of the country of origin of the chicken.
Methods: An increased number of Salmonella Group D was noted in the community during January, June, September, November, and December 2006. The December 2006 cluster was mainly due to infection of the Asian Games Drivers (24 out of 28 reported cases). A surge of infections were also noticed during March, April, and June 2007 in the community as well as in the hospital. Nine inpatients from Hamad Medical Corporation (HMC) developed infection with Salmonella Group D eight of them had food poisoning symptoms following therapeutic feeds (Pureed, diabetic and gastric diets) prepared from chicken breast from the same supplier. Patient number 9 had no symptoms of food poisoning and Salmonella Group D was isolated from his blood only. All isolated Salmonella strains were preserved in CryoBank by the Microbiology laboratory and notified to the Public Health Department (PHD), Supreme Council of Health (SCH).
As part of the investigation samples were collected from catering staff, therapeutic feeds, environment of Catering Department, and raw chicken from Catering Department, and Material Management Department Store (same batch).
Results: Salmonella Group D was isolated from Chicken breast and chicken legs samples collected from the Catering Department and Material Management Store. To confirm their genetic relatedness, Salmonella Group D isolated from Asian Games Drivers, from the community, from HMC patients and from the Chicken were sent to Naval Medical Research Unit # 3 (NAMRU-3) for full identification and genetic analysis by PFGE. All strains were found to be Salmonella enteritidis and they are all genetically related. With the help of PulseNet International the strains were found to be genetically identical to the isolates of the country of origin of the chicken.
Conclusion: Based on our investigation, the hospital outbreak may be due to the contamination of the chicken breast during processing /packing at the company’s premises. Prolonged stay of patients feed outside the refrigerator enabled multiplication of the organisms which escaped the cooking process. The source of infections in the Asian Games Drivers and other community outbreaks could not be identified since food samples were not available for testing.
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