Abstract: Salmonella enterica subsp. enterica serotype Enteritidis is not readily subtyped beyond the level of phage type (PT). Pulsed field gel electrophoresis (PFGE) is generally acknowledged to be the most discriminating typing method for Salmonella, but only a restricted variety of PFGE types has been described for S. enterica serotype Enteritidis. In the present study, a modification of the SE-AFLP typing method was used to investigate both outbreak and apparently sporadic isolates of S. enterica serotype Enteritidis belonging to different PTs and/or PFGE types. The method proved to be as discriminatory as PFGE when combined with phage typing, and provided subtyping data consistent with epidemiological information. Although the modified SE-AFLP typing method did not prove to achieve a superior discriminatory ability in resolving clusters, it has a high enough throughput for use in outbreak investigations. This method can be used in combination with other typing methods to obtain epidemiologically relevant subtyping data on S. enterica serotype Enteritidis.

Abstract: BACKGROUND: In November 2005, a large outbreak due to Salmonella enterica serotype Enteritidis (S. Enteritidis) was observed within children who had eaten their meals at 53 school cafeterias in Florence and the surrounding area. A total of 154 isolates of S. Enteritidis were recovered from human cases between November 2005 and January 2006. All strains were assigned phage type 8 (PT8) and a common XbaI pulsotype. This paper reports the findings of a molecular epidemiological investigation performed on 124 strains of S. Enteritidis isolated in the years 2005 and 2006 in Florence and the surrounding area, including the epidemic isolates. METHODS: One hundred twenty-four human isolates of S. Enteritidis identified in the period January 2005 - December 2006 were submitted to molecular typing by single enzyme - amplified fragment length polymorphism (SE-AFLP). RESULTS: Molecular subtyping by SE-AFLP yielded five different profiles. In the pre-epidemic phase, type A included 78.4% of isolates, whereas only three (8.1%) belonged to type C. All isolates, but one, of the epidemic phase were indistinguishable and attributed to type C. In the post-epidemic period, a polymorphic pattern of SE-AFLP types was again recognized but type C accounted for 73.3% of the isolates during the first six months of 2006, whereas during the remaining six months type A regained the first place, including 52.0% of the isolates. CONCLUSION: The epidemic event was attributed to the emergence and clonal expansion of a strain of S. Enteritidis PT8-SE-AFLP type C. Circulation of the epidemic clone was much more extensive than the surveillance and traditional laboratory data demonstrated.

Abstract: BACKGROUND: Food hygiene in hospital poses peculiar problems, particularly given the presence of patients who could be more vulnerable than healthy subjects to microbiological and nutritional risks. Moreover, in nosocomial outbreaks of infectious intestinal disease, the mortality risk has been proved to be significantly higher than the community outbreaks and highest for foodborne outbreaks. On the other hand, the common involvement in the role of food handlers of nurses or domestic staff, not specifically trained about food hygiene and HACCP, may represent a further cause of concern.The purpose of this study was to evaluate knowledge, attitudes, and practices concerning food safety of the nursing staff of two hospitals in Palermo, Italy. Association with some demographic and work-related determinants was also investigated. METHODS: The survey was conducted, by using a semi-structured questionnaire, in March-November 2005 in an acute general hospital and a paediatric hospital, where nursing staff is routinely involved in food service functions. RESULTS: Overall, 401 nurses (279, 37.1%, of the General Hospital and 122, 53.5%, of the Paediatric Hospital, respectively) answered. Among the respondents there was a generalized lack of knowledge about etiologic agents and food vehicles associated to foodborne diseases and proper temperatures of storage of hot and cold ready to eat foods. A general positive attitude towards temperature control and using clothing and gloves, when handling food, was shared by the respondents nurses, but questions about cross-contamination, refreezing and handling unwrapped food with cuts or abrasions on hands were frequently answered incorrectly. The practice section performed better, though sharing of utensils for raw and uncooked foods and thawing of frozen foods at room temperatures proved to be widely frequent among the respondents. Age, gender, educational level and length of service were inconsistently associated with the answer pattern.More than 80% of the respondent nurses did not attend any educational course on food hygiene. Those who attended at least one training course fared significantly better about some knowledge issues, but no difference was detected in both the attitude and practice sections. CONCLUSION: Results strongly emphasize the need for a safer management of catering in the hospitals, where non professional food handlers, like nursing or domestic staff, are involved in food service functions.

Abstract: BACKGROUND: Multidrug-resistant gram-negative bacilli (MDRGN) are an important cause of nosocomial infections in neonatal intensive care units (NICUs). We conducted a 1-year prospective surveillance study in an NICU to assess the epidemiology of MDRGN among newborns and the relative importance of acquisition routes. METHODS: Neonates admitted at the NICU of the Dipartimento Materno-Infantile, University Hospital, Palermo, Italy, from January 7, 2003, to January 6, 2004, were included in the study. Colonization of patients with MDRGN was assessed by cultures of rectal swabs sampled twice a week. Pulsed-field gel electrophoresis was used to determine relatedness among MDRGN isolates. Extended-spectrum beta-lactamases (ESBL) and metallo-beta-lactamases (MBL) production was investigated. The association between risk factors at admission and during the NICU stay was analyzed by multivariate logistic regression analysis. RESULTS: During the 12-month period January 7, 2003, through January 6, 2004, 1021 rectal swabs were cultured from 210 infants. One hundred sixteen infants (55.2%) were colonized by MDRGN. The monthly incidence of acquisition of MDRGN ranged between 12 and 53 cases per 1000 patient-days. Eighty-four (72.4%) of the 116 patients were cross colonized. Exclusive feeding by formula was significantly associated with cross transmission (RR=1.8, P=.02). Fifty-seven (49.1%) of the 116 infants were colonized by ESBL-producing Enterobacteriaceae. Feeding by formula was significantly associated with colonization by ESBL-producing Enterobacteriaceae (RR=1.6, P=.007), whereas breastfeeding proved to be protective (RR=0.5, P=.001). Ninety-two (43.8%) of the 210 infants received antibiotics during the NICU stay, but exposure to those most frequently administered, ampicillin-sulbactam and gentamicin, was not significantly associated with MDRGN colonization. CONCLUSION: The emerging picture of this study is that spread of MDRGN in an NICU may be the result of diffuse cross transmission and, consequently, of poor infection control procedures.

Abstract: BACKGROUND: Shigella spp. are major cause of diarrhoeal disease in both developing and developed countries. Shigella sonnei is the serogroup of Shigella most frequently responsible for sporadic and epidemic enteritis in developed countries. In recent years the emergence and spread of S. sonnei biotype g carrying class 2 integron have been frequently reported in many countries. Recently, S. sonnei has been reported as the prevalent serogroup of Shigella in Iran.The present study was carried out to investigate phenotypic and genetic characteristics of Shigella sonnei isolates identified in the years 2002 and 2003 in Tehran, Iran. METHODS: Biotyping, drug susceptibility testing, pulsed field gel electrophoresis (PFGE) and analysis of class 2 integrons have been carried out on 60 S. sonnei isolates, including 57 sporadic isolates from paediatric cases of shigellosis occurring in 2002 and 2003, two sporadic isolates recovered in 1984 and the ATCC 9290 strain. RESULTS: Biotype g and resistance to streptomycin, sulfamethoxazole-trimethoprim and tetracycline were exhibited by 54 of the 57 recent isolates. Of the 54 biotype g isolates, 28 exhibited a class 2 integron of 2161 bp, and 24 a class 2 integron of 1371 bp, respectively. Class 2 integrons were not detected in four isolates only, including the two endemic isolates recovered in 1984 and two strains from recent sporadic cases. PFGE divided the strains into eight pulsotypes labeled A to H, three major pulsotypes - A to C - including the large majority of the recent sporadic S. sonnei isolates. Pulsotypes A and C were the most prevalent groups, accounting for 41.6% and 35.0%, respectively, of the isolates under study. CONCLUSION: The results suggest that biotype g, class 2 integron carrying S. sonnei are prevalent in our geographic area. S. sonnei isolated in the years 2002 and 2003 could be attributed to a few predominant clusters including, respectively, strains with pulsotypes B and C carrying a 2161 bp class 2 integron, and those having pulsotype A and a 1371 bp class 2 integron. A few epidemic clones are responsible for the apparently endemic occurrence of shigellosis in Tehran, Iran.

Abstract: The aim of our study was to evaluate the role of Salmonella spp in children hospitalised for acute gastroenteritis, and to study clinical and microbiological features of paediatric salmonellosis in our geographical area. In all, 540 patients admitted from March to September 2003 with symptoms of acute enteritis to the Infectious Diseases department of the "G. Di Cristina" hospital in Palermo were enrolled. Stool samples were collected within 48 hours of admission and tested for intestinal pathogens (bacterial, viral, parasites). Salmonella spp was detected in 18.5% of samples. The median age of infected children was 4.5 years. Salmonella enteritidis (49%) and Salmonella typhimurium (37%) were the most commonly identified genotypes. S. enteritidis infection was more frequently characterized by vomiting (65.3%) and dehydration (61.2%). Bloody diarrhoea was more common in S. typhimurium infection (40.5%). All strains were susceptible to ceftriaxone, while 40% of strains were resistant to tetracyclines and 37% to ampicillin.

Abstract: PURPOSE: To evaluate the adequacy of common disinfection regimens for disposable tonometer tips and assess if disinfection of reusable prisms or the use of disposable tips is preferable. METHODS: We used disposable tonometer tips, using the same material and tip diameter of standard Goldmann tonometer prism. Strains of Pseudomonas aeruginosa, Staphylococcus aureus, Bacillus subtilisand Candida albicanswere tested according to the European standard guidelines for disinfectants test. Antimicrobial effectiveness of the following disinfection practices has been assessed: dry wipe, Minuten wipes (Alpro), soaking in 3% hydrogen peroxide, 0.5% benzalkonium chloride, and 0.5% Pantasept for 1, 5, and 15 min. All tests have been performed three times and all conditions tested in duplicate. RESULTS: Dry wiping and 1 min soak in 3% hydrogen peroxide were ineffective on all microrganisms. Minuten wipes, 1 min soak in 0.5% benzalkonium chloride or 3% hydrogen peroxide were ineffective on B. subtilis. 0.5% Pantasept soak was effective in 1 min for all microrganisms tested, whereas 3% hydrogen peroxide and 0.5% benzalkonium chloride soaks were effective when performed for at least 5 min. B. subtiliswas the most resistant organism to disinfectant regimes at 1 min time. CONCLUSIONS: Results of our study demonstrate a relative disinfection efficacy for the different evaluated regimens, provided that correct exposure times are adopted for the chosen disinfectants, a condition difficult to ensure in a busy clinic setting. We conclude that disposable prism tonometry provides a safe alternative to Goldmann tonometry.

Abstract: BACKGROUND: Emergence and global dissemination of multiresistant strains of enteric pathogens is a very concerning problem from both epidemiological and Public Health points of view. Shigella sonnei is the serogroup of Shigella most frequently responsible for sporadic and epidemic enteritis in developed countries. The dissemination is associated most often to human to human transmission, but foodborne episodes have also been described. In recent years the circulation of multiresistant strains of S. sonnei biotype g carrying a class 2 integron has been reported in many countries worldwide. In southern Italy a strain with similar properties has been responsible for a large community outbreak occurred in 2003 in Palermo, Sicily.The objective of this study was to date the emergence of the biotype g strain carrying the class 2 integron in southern Italy and to evaluate the genetic heterogeneity of biotype g S. sonnei isolated throughout an extended interval of time. METHODS: A total of 31 clinical isolates of S. sonnei biotype g identified in southern Italy during the years 1971-2000 were studied. The strains were identified at the serogroup level, characterized by biochemical tests and submitted to antimicrobial susceptibility testing. Molecular typing was performed by pulsed field gel electrophoresis (PFGE) after digestion of DNA by XbaI. Carriage of class 2 integrons was investigated by polymerase chain reaction (PCR) with specific primers and confirmed by restriction endonuclease analysis of amplicons. RESULTS: The 15 isolates of S. sonnei biotype g identified in the decade 1971-1980 showed highly heterogeneous drug resistance profiles and pulsotypes. None of the isolates was simultaneous resistant to streptomycin and trimethoprim and none was class 2 integron positive. On the contrary, this resistance phenotype and class 2 integron carriage were very common among the 16 strains of biotype g identified in the following two decades. Moreover, all the more recent isolates, but one, showed closely related pulsotypes. CONCLUSION: Although our findings refer to a limited geographic area, they provide a snapshot of integron acquisition by an enteric pathogen responsible for several outbreaks in the years 2001-2003 in Italy. Molecular typing, indeed, suggests that the emergence of biotype g class 2 integron carrying S. sonnei in southern Italy should be backdated to at least the late 1980s. In the following decades, the circulation of biotype g appears to be sustained by multiresistant highly related strains. Similar trend are described in several countries, but the questions about mechanism of emergence and worldwide spread of this pathogen remain open.

Abstract: Comparison of pulsed-field gel electrophoresis patterns (generated with XbaI and BlnI) of Shigella sonnei isolates from Ireland and Italy suggests that two possibly distantly related lineages are present in both countries. Smaller, more closely related groups, including isolates from Ireland and Italy, were also noted. These groups raise the possibility that the dissemination of clonal groups of S. sonnei may have occurred in recent years.

Abstract: In this study, a total of 204 Mycobacterium tuberculosis DNAs from Sicily (n = 144) and Sardinia (n = 60) were studied by three genotyping methods. Results were analyzed both within and across islands, to define the phylogeographical specificities of the genotypes, look for their diversity and infer a molecular evolutionary scenario. A strong link between geography and tuberculosis genotypes was observed in Sardinia. The results were also matched against a world-wide genetic diversity database to compare the population structure of the tubercle bacilli in the islands. Eight common genotypes between Sicily, Sardinia and continental Italy were found which underlines the influences of the Italian mainland on the population structure on the islands and vice versa. A unified evolutionary scenario of M. tuberculosis evolution was built using numerical taxonomy and maximum parsimony (MP) methods. The finding of multiple families of M. tuberculosis strains (S, T, LAM, Haarlem), their presumed links with the major genetic groups (MGG) of M. tuberculosis complex, supports the view of independent introduction of several ancestral genotypes in Sicily and in Sardinia. We conclude that the two PCR-based genotyping combination (spoligotyping-VNTR) is an excellent tool to reconstruct M. tuberculosis phylogeny, that may be used to construct global and local evolutionary scenarios of the M. tuberculosis complex. The results obtained are paradigmatic of the complex interplay that exists between epidemic dynamics and evolutionary genetics of M. tuberculosis.

Abstract: A group of subgingival isolates of C. albicans recovered from Italian HIV-positive (HIV+) subjects were characterized both phenotypically and genotypically. Phenotyping of the isolates was carried out by a biotyping method based on the enzyme profiles, carbohydrate assimilation patterns and boric acid resistance of the yeasts. Genotyping was performed through randomly amplified polymorphic DNA (RAPD) analysis. Five biotypes were found among the 29 subgingival C. albicans strains examined. The predominant biotypes were A1R (55.17%), A1S (24.14%), and A2R (13.79%), while the biotypes A11R and A13R were represented by a single isolate each. RAPD profiles identified 15 genotypes among the 29 isolates. Almost every individual harboured his/her own specific isolate and in three out of the six subjects with multiple isolates (two to six each) more than one genotype (two to six) was found. The biotype distribution we found is consistent with previous reports on C. albicans isolates from other oral sources, whereas the resistance to boric acid was highly frequent in subgingival strains. RAPD analysis showed high genetic heterogeneity within subgingival isolates, also when isolates were phenotypically identical. These findings, obtained from HIV+ subjects living in Southern Italy, may be useful as baseline information on subgingival C. albicans colonization in the Mediterranean area.

Abstract: Phenotyping and genotyping have been carried out on 64 epidemic and sporadic isolates of Shigella sonnei identified in Italy in the years 2001 to 2003. Class 2 integron carriage has been also investigated. Isolates from four of the five outbreaks and four of six sporadic cases were biotype g, pulsed-field gel electrophoresis type B, and class 2 integron positive, suggesting emergence and spread of an epidemic clone in Italy.

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Abstract: Relevance of latent infection in the epidemiology of tuberculosis (TB) is expected to increase in many developed countries. Indeed, many demographic, social and public health changes could contribute to the expansion of groups or communities at significantly higher risk than the general population for infection to Mycobacterium tuberculosis or progression from latent to active disease. Tuberculin skin testing (TB), the gold standard for diagnosis of M. tuberculosis infection, is imperfect and prone to false positive and negative results, unless strictly targeted and carefully standardized for reliable performance and interpretation. This paper proposes a pre-test risk assessment questionnaire and standardized criteria for evaluation of TB test according to international guidelines.

Abstract: After an upward trend paralleling that occurring in most European countries, including Italy, since October 2002 Salmonella enterica serotype Enteritidis (S. Enteritidis) has again gained the first position among outbreak and sporadic human isolates of Salmonella in Sicily. Because phage typing of S. Enteritidis has many technical and epidemiological limitations and molecular methods have proved to be poorly discriminative for this organism, multiple typing, using phage typing together with pulsed field gel electrophoresis (PFGE) and plasmid profiling on a sample of fifty human and poultry isolates identified during the period October 2002 to May 2003 in Sicily, was chosen as the most valuable strategy to explore key features of this new epidemic wave. Although the limited number of strains imposes a cautious interpretation of the results, an apparently increasing phage type heterogeneity has emerged with rise in PT6 as the more striking event. While PFGE has confirmed the findings by other authors about the close genetic homogeneity between PT4 and PT6, plasmid profiling has provided discriminative patterns for PT6 strains. Combined phenotypic and genotypic profiles are necessary for epidemiological studies and public health investigations on S. enteritidis.

Abstract: The present update on the global distribution of Mycobacterium tuberculosis complex spoligotypes provides both the octal and binary descriptions of the spoligotypes for M. tuberculosis complex, including Mycobacterium bovis, from >90 countries (13,008 patterns grouped into 813 shared types containing 11,708 isolates and 1,300 orphan patterns). A number of potential indices were developed to summarize the information on the biogeographical specificity of a given shared type, as well as its geographical spreading (matching code and spreading index, respectively). To facilitate the analysis of hundreds of spoligotypes each made up of a binary succession of 43 bits of information, a number of major and minor visual rules were also defined. A total of six major rules (A to F) with the precise description of the extra missing spacers (minor rules) were used to define 36 major clades (or families) of M. tuberculosis. Some major clades identified were the East African-Indian (EAI) clade, the Beijing clade, the Haarlem clade, the Latin American and Mediterranean (LAM) clade, the Central Asian (CAS) clade, a European clade of IS6110 low banders (X; highly prevalent in the United States and United Kingdom), and a widespread yet poorly defined clade (T). When the visual rules defined above were used for an automated labeling of the 813 shared types to define nine superfamilies of strains (Mycobacterium africanum, Beijing, M. bovis, EAI, CAS, T, Haarlem, X, and LAM), 96.9% of the shared types received a label, showing the potential for automated labeling of M. tuberculosis families in well-defined phylogeographical families. Intercontinental matches of shared types among eight continents and subcontinents (Africa, North America, Central America, South America, Europe, the Middle East and Central Asia, and the Far East) are analyzed and discussed.

Abstract: Phenotypic and genetic characteristics of 21 strains of Salmonella serotype Heidelberg isolated in the years 1999-2003 from different sources in Italy were studied. Susceptibility patterns, plasmid analysis, and PFGE were used as epidemiological markers. Although non-homogeneous drug resistance patterns and plasmid profiles had been detected, PFGE patterns suggest the hypothesis of a nationwide clonal spread of this serotype associated with poultry.

Abstract: Methicillin resistant Staphylococcus aureus (MRSA) is a pathogen of special concern in intensive care units (ICUs). The burn units are a very susceptible habitat to colonization and infection events by this organism. In this paper isolation of MRSA from a sepsis case and from samples of the care unit air is described, along with simultaneous circulation of two clones of MRSA. Some peculiar epidemiological features of MRSA in burn intensive care wards are confirmed.

Abstract: From 1984 to 1999, we collected 31 isolates of the rare serovar Salmonella bongori 48:z(35):- in southern Italy. Twenty-four of the isolates were from cases of acute enteritis in humans. Pulsed-field gel electrophoresis analysis showed that all but one of our isolates were at least 80% similar. Our findings suggest that genetically related S. bongori 48:z(35):- strains are endemically circulating in southern Italy.

Abstract: We have identified Salmonella genomic island I (SGI1) in an isolate of Salmonella enterica serotype Paratyphi B. This antibiotic-resistance gene cluster, which confers multidrug resistance, has been previously identified in S. enterica serotype Typhimurium phage types DT 104 and DT 120 and in S. enterica serotype Agona.

Abstract: We investigated the distribution of serotypes and patterns of drug resistance of 206 strains of salmonella isolated in southern Italy in the years 1998-2000 from raw food of animal origin, faeces of food animals and animal feed. To improve knowledge of mobile genetic elements carrying the resistance genes, some molecular features were also investigated within isolates resistant to three or more antibiotics. A high proportion of isolates, 52.2% and 37.7%, respectively, belonging to both Typhimurium and other serotypes of animal origin, proved to be multidrug resistant. The DT104 complex specific multidrug pattern of resistance was quite infrequent among isolates other than Typhimurium, but resistances to nalidixic acid and kanamycin were more frequent within these last ones (36.9% vs. 11.4% and 56.5% vs. 2.2%, respectively). Class I integrons were detected in isolates of Typhimurium and seven different serotypes. The relevance of food animal environment as a drug resistance reservoir and animal food as a potential resistance gene vehicle between the farm and human ecological niches is confirmed by our findings.

Abstract: From 1992 to 1997, only six sporadic isolates of Salmonella enterica serotype Enteritidis from patients with cases of gastroenteritis in southern Italy exhibited resistance to broad-spectrum cephalosporins. Five isolates produced SHV-12, and one isolate encoded a class C beta-lactamase. The bla(SHV-12) gene was located in at least two different self-transferable plasmids, one of which also carried a novel class 1 integron.

Abstract: We present a short summary of recent observations on the global distribution of the major clades of the Mycobacterium tuberculosis complex, the causative agent of tuberculosis. This global distribution was defined by data-mining of an international spoligotyping database, SpolDB3. This database contains 11708 patterns from as many clinical isolates originating from more than 90 countries. The 11708 spoligotypes were clustered into 813 shared types. A total of 1300 orphan patterns (clinical isolates showing a unique spoligotype) were also detected.

Abstract: In a previous study, we proposed to associate spoligotyping and typing with the variable number of tandem DNA repeats (VNTR) as an alternative strategy to IS6110-restriction fragment length polymorphism (RFLP) for molecular epidemiological studies on tuberculosis. The aim of the present study was to further evaluate this PCR-based typing strategy and to describe the population structure of Mycobacterium tuberculosis in another insular setting, Sicily. A collection of 106 DNA samples from M. tuberculosis patient isolates was characterized by spoligotyping and VNTR typing. All isolates were independently genotyped by the standard IS6110-RFLP method, and clustering results between the three methods were compared. The totals for the clustered isolates were, respectively, 15, 60, and 82% by IS6110-RFLP, spoligotyping, and VNTR typing. The most frequent spoligotype included type 42 that missed spacers 21 to 24 and spacers 33 to 36 and derived types 33, 213, and 273 that, together represented as much as 26% of all isolates, whereas the Haarlem clade of strains (types 47 and 50, VNTR allele 32333) accounted for 9% of the total strains. The combination of spoligotyping and VNTR typing results reduced the number of clusters to 43% but remained superior to the level of IS6110-RFLP clustering (ca. 15%). All but one IS6110-defined cluster were identified by the combination of spoligotyping and VNTR clustering results, whereas 9 of 15 spoligotyping-defined clusters could be further subdivided by IS6110-RFLP. Reinterpretation of previous IS6110-RFLP results in the light of spoligotyping-VNTR typing results allowed us to detect an additional cluster that was previously missed. Although less discriminative than IS6110-RFLP, our results suggest that the use of the combination of spoligotyping and VNTR typing is a good screening strategy for detecting epidemiological links for the study of tuberculosis epidemiology at the molecular level.

Abstract: In 1997 to 1999, we detected class I integrons in multidrug-resistant isolates of Salmonella enterica serovars Anatum, Blockley, Brandenburg, Bredeney, Derby, Heidelberg, Livingstone, Newport, Ohio, Panama, Paratyphi B, Saintpaul, Sandiego, and Stanley.

Abstract: AIMS: This paper compares the faecal streptococci count on 25 samples of polluted waters obtained with three techniques: most probable number (MPN), membrane filtration (MF) and pour plate (PP) methods. Although the PP method is a simple technique, familiar to water bacteriologists, it is not recommended in the international methods. METHODS AND RESULTS: For the MPN method, azide dextrose broth and ethyl violet azide broth were employed. For the MF technique, Millipore filters were placed onto azide maltose agar (KF agar), while for the PP method, 1 ml of a decimal water dilution was added to (Kennel Faecal) KF medium. Regression analysis and Friedman's ANOVA were performed to determine the relationship between faecal streptococci counts obtained with the three techniques. Statistical analysis of the results showed that the MPN, MF and PP techniques were equally valid with respect to faecal streptococci enumeration in polluted waters. CONCLUSION: Since the PP method was found to be as good as the other techniques, it may be preferred in polluted waters. It is more economical in terms of both time and materials than the MPN count, and it is as accurate as the MF count. SIGNIFICANCE AND IMPACT OF THE STUDY: This study indicates that the PP method, although not recommended internationally, is a reliable alternative to MF and MPN.

Abstract: Spread of multidrug-resistant strains of Salmonella enterica serotype Typhimurium (S. typhimurium) is increasingly reported worldwide. The presence of a pattern of resistance to ampicillin, chloramphenicol, streptomycin, sulfonamides and tetracycline (ACSSuT), in some cases associated to trimethoprim and infrequently to quinolones, is of particular concern. This resistance pattern appears to be chromosomally encoded and, in most epidemiological studies, closely related to definitive type 104 (DT104). In southern Italy multidrug-resistant isolates of S. typhimurium had been identified since 1980, but only during 1992 S. typhimurium strains with chromosomally encoded drug resistance were first isolated from domestic animals. One hundred fifty-five isolates--52.5% of the multidrug-resistant strains identified in the years 1992-1997--were submitted to phage typing and plasmid profile analysis. Ribotyping was also performed in comparison with a random sample of 150 strains susceptible or resistant to three or less antibiotics identified in the same interval of time. Four ribotypes (RTs)--1, 5, 8, and 48--included approximately 90% of the multiresistant strains, RT8 accounting for 61.2%. Phage type (PT) 193 is the most prevalent phage type. Phage typing and ribotyping suggest that few bacterial clones are involved in spread of multidrug-resistant S. typhimurium strains in southern Italy.

Abstract: During 1990 to 1998, we identified multidrug-resistant isolates of Salmonella Enteritidis in southern Italy. Plasmids containing class I integrons and codifying for synthesis of extended- spectrum beta-lactamases were detected. Active surveillance for resistance to antimicrobial agents is needed to guard against the possible spread of resistant clones.

Abstract: Molecular typing of salmonella strains isolated between 1997 and 1999 in southern Italy and carried out by the Southern Italy Centre for Enteric Pathogens, has shown a high frequency of Salmonella enterica serotype Cerro. This serotype is extremely rare i

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Abstract: A rapid and sensitive PCR-hybridization procedure for detection of Salmonella serovars in food samples was developed. This method is based on three subsequent steps: (1) extraction of nucleic acids from a 2 ml aliquot of the pre-enrichment medium used for the conventional culture method after 6 h of incubation at 37 degrees C; (2) amplification with primers selected from the sequences of invE and invA genes; (3) Southern blot and hybridization with a biotin labeled oligonucleotide probe. The entire procedure requires 30 h. The PCR-hybridization assay was able to detect as little as 50 fg of purified chromosomal DNA of S. typhimurium and 0.2 cfu g-1 of an artificially contaminated food sample. Of 245 food samples analyzed by culture and PCR-hybridization, 20 were positive by both methods and 16 were positive by PCR-hybridization only. None of the 209 PCR-negative samples tested positive by culture. The sensitivity, specificity, alpha and beta error values of the results of the PCR-hybridization procedure, compared with those of culture, were 100, 92.9, 0 and 7.1%, respectively. These results indicate that a short pre-enrichment and PCR-hybridization could be used as a screening test for the detection of Salmonella in food samples.

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Abstract: Salmonella bongori 48:z 35 :- was first isolated from a lizard in Chad in 1966 and was classified as a biochemically atypical strain of the subgenus I of Kauffmann. Successively, some additional strains with different antigenic formulas but similar bioche

Abstract: In some industrialized countries reemergence of tuberculosis has been recorded. Most cases are thought to be caused by reactivation of infections that had been acquired many years before, but in some geographical areas up to 40% of diagnosed infections have been estimated to be newly acquired, based on the results of molecular epidemiological methods. Restriction fragment length polymorphism of the insertion sequence IS6110 of Mycobacterium tuberculosis has been widely used to evaluate epidemiological patterns of transmission in various communities. We have used IS6110 fingerprinting to analyze 101 strains which were isolated between June 1994 and June 1998 from 95 inhabitants of the province of Palermo, Italy, an area with an endemic rate for tuberculosis ranging between 5.1 and 8.0 per 100,000 persons in the last 5 years. 89 different patterns have been obtained, 87.4% of the patients were infected by presumably unrelated isolates. Six microepidemics were also recognized. These data suggest that reactivation largely exceeds recent infection.

Abstract: A foodborne outbreak of Salmonella enteritidis PT4 is described. This microrganism was detected in a home-made dessert, in the duck and hen eggs used for its preparation and in faecal samples of six persons involved in the outbreak. PCR ribotyping revealed that all the strains shared a profile of S. enteritidis never previously identified in southern Italy and quite different from that of the strains simultaneously isolated in the same geographic area. The possible identification of a clonal variant of S. enteritidis PT4 host-adapted to duck is hypothesized.

Abstract: An outbreak of Salmonella enterica serotype Typhimurium belonging to phage type (PT) 193 occurred in autumn 1995 and involved 83 individuals in a large area of Northern Italy (Lombardy Region). Epidemiological and microbiological investigations of strains isolated from clinical and food specimens revealed that the vehicle was a batch of salami, produced on 4 September 1995 by a local firm. The outbreak was contained when the batch was withdrawn from sale. Insufficient ripening of the salami had allowed the salmonella to survive, emphasizing the need to define criteria for the ripening process of foods such as salami.

Abstract: Polymerase chain reaction (PCR-) ribotyping was performed on 243 strains of Salmonella enterica serotype Enteritidis isolated during the years 1980-1994 from 58 foodborne outbreaks occurring in different regions of Italy. The majority (37) of the outbreaks were attributed to phage type (PT) 4, followed by PT1 (seven outbreaks); the latter was identified in 1993 in Italy in epidemic strains of Enteritidis. In eight cases more than one phage type was recognised from a single event. Nine PCR-ribotypes (PCR-RTs) were detected, with a strong prevalence of PCR-RTs f7 and e5 (23 and 21 outbreaks, respectively). In two instances two distinct PCR-RTs were identified within strains from a single outbreak. All but one of the PT1 outbreaks were caused by PCR-RT f7, whereas PT4 outbreaks could be subdivided into six subsets. Clustering of isolates was consistent with data obtained from epidemiological investigations. PCR-ribotyping proved to be an effective and reliable tool for subtyping isolates of Enteritidis belonging to the most frequent phage types. Nevertheless, in terms of laboratory expertise and lack of inter-laboratory standardisation, this typing technique is best suited for reference laboratories.

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Abstract: Differently from other European countries, Southern Italy was affected by a considerable increase in human infections due to Salmonella enterica subsp. enterica serovar Enteritidis (S. Enteritidis) only after 1990. On the present investigation, two groups of S. Enteritidis strains isolated during the low-incidence period 1980-1984 and the epidemic period 1990-1993, respectively, have been submitted to phage-typing and ribotyping in order to ascertain whether the epidemic increase was determined by the spread of a foreign bacterial clone or not. Among the 150 isolates relative to the aforesaid two periods, 12 different phage types (PTs) were observed. PT4 was the most common phage type among the strains isolated in 1980-1984 (61%) as well as in those of the epidemic period 1990-1993 (72%). PT8 was the second most frequent (33%) phage type in 1980-1984. It was substituted by PT1 (19%) in the 1990-1993 period. Analysis of rDNA patterns obtained after Hinc II digestions and Escherichia coli rRNA hybridizations showed 8 different patterns, A to H. The great majority of the strains studied (140 isolates, 93%) belonged to the ribotype A, showing a similar frequency both in 1980-1984 (36 of 39, 92%) and in 19901993 (104 of 111, 94%). The predominance of PT4 and ribotype A among both preepidemic and epidemic strains is in agreement with the hypothesis that host genetic diversity decline and modern farming practices in the poultry industry have facilitated a widespread dissemination of preexisting endemic strains. This hypothesis urges to plan new strategies in preventing S. Enteritidis infections.

Abstract: Increased frequency of identification of Salmonella enterica serotype Enteritidis as a causative agent of sporadic and epidemic cases of infection in humans, along with isolation in many parts of the world of strains belonging in a large proportion to a few phage types, has made phage typing alone inadequate for epidemiological investigations. In southern Italy the epidemic increase in isolation of S. enterica serotype Enteritidis that has been observed since 1990 has been associated in approximately 80% of isolates with phage type 4 (PT-4), in agreement with the epidemiological observations from other European countries. We have applied polymerase chain reaction (PCR) ribotyping in association with phage typing to a sample of non-outbreak strains and to all the outbreak strains sent for identification and typing to the Southern Italy Centre for Enterobacterial Pathogens between 1980 and 1994 from hospital and public health laboratories. This technique identified 15 distinct profiles among the 405 strains examined. Whereas a single profile (PCR ribotype a1) appeared to be closely related to PT-8, and to characterize a high percentage of the strains circulating during the early non-epidemic years (1980-1985), 11 patterns were recognizable within PT-4, and 5 within PT-1. Some of these apparently emerged after 1990. This subdivision enabled attribution of the epidemic circulation of PT-4 to multiple clones of S. enterica serotype Enteritidis.

Abstract: Salmonella enterica serotype Typhimurium has a very large diffusion worldwide within human and non-human hosts. The simultaneous circulation in the same geographical areas of many bacterial clones requires the use of reliable, reproducible and highly discriminatory typing techniques for epidemiological studies. Molecular biological methods, such as plasmid profile analysis, restriction endonuclease digestion of plasmid and chromosomal DNA and hybridization-based procedures have proven to be useful tools for strain differentiation. More recently, detection of polymorphisms in the intergenic spacer regions of rRNA genes by polymerase chain reaction (PCR ribotyping) has been successfully applied to characterize bacterial strains. In this study, PCR ribotyping was performed on 45 epidemiologically related and unrelated strains of S. enterica serotype Typhimurium isolated in northern and southern Italy during 1992. Isolates were simultaneously characterized by traditional ribotyping. Results suggest that PCR ribotyping is a rapid, easy-to-perform and reproducible typing method able to determine relatedness among isolates of this serotype.

Abstract: Epidemic strains of Salmonella enterica subsp. enterica serovar Bovismorbificans isolated in southern Italy during the years 1989-1991 were submitted to a molecular epidemiological study in comparison with isolates identified in the years 1980-1988 in the same geographic area. Genomic DNA fragments obtained by digestion with BglI or Eco RI hybridized with Escherichia coli rRNA to produce three distinct, but highly related patterns. Ribotype 1, which had never been identified before 1989, was found to characterize most of the strains identified between 1989 and 1991. Such a finding supports the hypothesis of emergence and spread of a new bacterial clone associated with the increased number of human infections reported in the same years in southern Italy.

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Abstract: Shigella sonnei is a major agent of diarrhoeal disease in developed as well as in developing countries. Several phenotypic methods to define strain differences have been applied to this species of Shigella including, more recently, analysis of extrachromosomal and chromosomal DNA. In this study, 432 endemic and epidemic strains isolated between 1975 and 1991 in Italy, France and Switzerland were submitted to rRNA gene restriction pattern analysis, after digestion of whole-cell DNA by Hinc II, and to concomitant biotyping. Thirteen ribotypes, H1 to H13, and five biotypes, a, d, e, f, g, were detected. Ninety-five percent of the sporadic strains were assigned to ribotypes H1 to H4, which could be subtyped, except for H4, in different biotypes. Strains from each of seven different outbreaks had indistinguishable ribotype-biotype patterns. In contrast, 65 strains, isolated in Sicily in 1980 over an extended period of apparently epidemic increase of isolations and which had previously been considered to be a single bacterial clone on the basis of resistance pattern and phage type, were found to belong to two different and scarcely related ribotypes. Ribotyping and biochemical subtyping appear to be a useful epidemiological tool in studies on the circulation and distribution of strains of S. sonnei.

Abstract: Salmonella typhimurium is the most frequently identified serovar of Salmonella in Italy. This serovar is characterized by the widespread dissemination among human and non-human sources of phenotypically and genetically well-differentiated clones. In this study 457 strains of S. typhimurium isolated in Italy in the years 1982-91 from human and animal sources were submitted to characterization by the rDNA fingerprinting technique. Application of this typing method, after digestion of chromosomal DNA with HincII endonuclease, confirmed the greatest genetic differentiation of clones of S. typhimurium, allowing reliable identification of 45 rDNA patterns linked into 9 major clusters. rDNA pattern clusters or ribotypes specific to man were not recognized, whereas some rDNA patterns were characteristically related to ducks, pigeons and pet birds. The ribotyping results for isolates from animal hosts suggest that pig and cattle are the main source of human infection.

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Abstract: A cross-sectional seroepidemiologic study was carried out between 1985 and 1990 in 1,567 heterosexual intravenous drug users who had been seen at the AIDS Regional Reference Center in Palermo, Italy, to evaluate the rate of human immunodeficiency virus type 1 (HIV-1) seroprevalence in this group and its long-term trend. Sixty serum samples collected from drug users in 1980 and 1983, before the founding of the Center (1985), were tested as well. Some demographic and behavioral risk factors were studied in a subgroup of intravenous drug users enrolled in 1985, 1987, and 1990 for their possible association with HIV-1. These factors were also studied in relation to hepatitis B virus infection, since both viruses share the same modes of spread. These drug users had a higher prevalence of markers for hepatitis B virus than of HIV-1 antibodies, and the prevalence rates in sera collected declined over time for both infections. The presence of both antibodies to HIV-1 and markers for hepatitis B virus was independently associated with the age of the drug user, the duration of drug use, and the year of serum collection. Antibodies to HIV-1 were observed more frequently in females than in males. No relation was found between education or employment status and the presence of HIV-1 antibodies or hepatitis B virus markers. Although new HIV-1 infections still occur, the decline in seroprevalence observed at the end of the 1980s might be related to modifications in social behavior among newer drug users, partial exhaustion of the susceptible population, and increasing risk awareness in more experienced users.

Abstract: Salmonella enterica subsp. enterica serovar Abortusovis is a major agent of abortion of the sheep and is firmly established, although at low prevalence, in Sicily. This paper describes the application rDNA gene restriction pattern fingerprinting to investigate relatedness among 7 serovar Abortusovis strains isolated at the "Istituto Zooprofilattico Sperimentale" of Sicily and 29 isolates identified at the Southern Italy Centre of Enterobacteriaceae between 1981 and 1989. Although Abortusovis serovar has exhibited a remarkable degree of homogeneity, genomic DNA polymorphisms, that have emerged, suggest possible importation of bacterial clones from different geographic areas.

Abstract: A strain of HIV 1 (PA 40), isolated from a patient with AIDS, showed a size variation of its external glycoprotein. This glycoprotein had an estimated molecular weight of 105 Kd and differed from that of both HIV 1 IIIb and HIV 2 Rod strains. The protein was derived from a bigger (140 Kd) precursor, detectable only in the infected cells and could incorporate labeled glucose in its prosthetic portion. The change in size of the external glycoprotein may be the result of envelope sequence variations since the unglycosylated form of the envelope precursor of PA 40 strain, detected in tunicamycin treated cells, was smaller than that of the HIV 1 IIIb strain. The different size of the external glycoprotein is a further aspect of the variability of the biological characteristic of HIV 1 strains and might be correlated with the emergence of more virulent variants which arose during the progression of the clinical disease.

Abstract: Characterization of 169 strains of Salmonella typhi of phage types C1, C4, D1 and D9 isolated in 1975-88 was carried out by rDNA gene restriction pattern analysis. Twenty-four isolates had been recovered during four large waterbone outbreaks in the last 20 years in Sicily; 145 strains, isolated from apparently sporadic cases of infection in Southern Italy in the same period of time, were also examined. Application of rRNA-DNA hybridization technique after digestion of chromosomal DNA with Cla I showed the identity of patterns of the epidemic strains of phage types C1 and D1, confirming attribution of the outbreaks to single bacterial clones. Patterns of the two available strains of lysotype D9 were slightly different, whilst the 12 epidemic strains of phage type C4 could be assigned to two distinct patterns scarcely related to each other and, consequently, to two different clones. A considerable heterogeneity was detected among all apparently sporadic isolates of the four phage types under study. This fingerprinting method appears a reliable tool to complement phage typing in characterizing isolates of S. typhi. In particular, epidemiological features of spread of this salmonella serovar in areas, where simultaneous circulation of indigenous and imported strains occurs, can be elucidated.

Abstract: Three strains of Shigella dysenteriae type 2 were isolated from a small household outbreak which occurred in Palermo, Sicily, during summer 1990. Two isolates were recovered from hospitalized patients and one from an asymptomatic carrier. The infection could not be associated with travel to foreign countries or contact with travellers returned from abroad. Since 1953 S. dysenteriae has been never isolated in Southern Italy. The isolates from dysentery cases were susceptible to antibiotics and carried a plasmid of 120 MDa associated with a small cryptic plasmid; in contrast, the strain isolated from the healthy carrier contained an additional plasmid of approximately 40 MDa, which codified for resistance to ampicillin, streptomycin, sulfamethoxazole and trimethoprim. All strains showed some atypical biochemical properties, but their rRNA-DNA patterns of hybridization were closely similar to that of the reference strains of type 2 and easily distinguishable from those of the other types of non-Shiga bacillus reference strains. Epidemiological isolation features of these strains suggest a possible circulation of this Shigella species in Sicily. Genetic characterization of these strains may be useful for surveillance of infections by this organism.

Abstract: Salmonellosis is become an increasing public health problem in many countries. Serotyping and assessment of antibiotic resistance are useful tools, which assist in understanding the epidemiology of Salmonella infections. In this respect, the Centre of Enterobacteriaceae of Southern Italy provides helpful information on the changing pattern of Salmonella serovars in this geographic area. This paper reports the distribution of serovars and their antibiotic susceptibility in the years 1983-1987. In particular, because of their peculiar trends during this 5-year period, epidemiological features of Mbandaka, Corvallis, Dublin, Infantis and Wien serovars are described.

Abstract: In the years 1987-1988, 110 strains of Wien serovar were isolated from a gastroenteritis outbreak in a neonatal unit in Palermo (Sicily). These strains showed different drug resistance patterns and plasmid profiles. Analysis of endonuclease restriction fragments of chromosomal DNA by hybridization with E. coli rRNA has demonstrated that a single bacterial clone or its derivatives were responsible for the outbreak. Furthermore, the study of 139 strains, isolated since 1970 from different geographic locations of the Mediterranean area, has confirmed a notable degree of homogeneity within Wien serovar, even though the detection of genetic polymorphisms in some isolates suggests that a number of distinct bacterial strains contributes to maintain the circulation of Wien serovar.

Abstract: In the years 1981-1988, Shigella boydii played a very limited role in the aetiology of diarrhoeal disease in Italy. However, between September and November, 1985, 19 isolates of serotype 2 were recovered in northern Italy from a dysentery outbreak which occurred in a geriatrics hospital in Abbiategrasso (Milan, Lombardy) and seven were identified in southern Italy during the period January-July, 1986 from apparently unrelated infection cases occurring in Brindisi (Apulia). These isolates were compared by molecular methods to seven strains of S. boydii of serotype 2 isolated since 1981 from the same geographic areas. Plasmid DNA analysis showed a large variety of patterns, whereas hybridization of chromosomal DNA with E. coli rRNA identified only two different profiles, one of which was exclusively found in all isolates from the hospital outbreak. No differences were detected among rDNA patterns of the remaining strains of S. boydii, irrespective of their geographic origin. These findings are consistent with the hypothesis that the infrequent cases of infection from S. boydii of serotype 2 which occurred during the years under study could probably be attributed to two different bacterial clones. Hybridization procedure and detection of hybrids were simplified by replacement of radioactive labelling of rRNA by the use of photobiotin.

Abstract: Fifty-two strains of Salmonella enterica subsp. enterica serovar Kottbus, identified at the Centres of Enterobacteriaceae of Northern and Southern Italy, were investigated by molecular genetic methods. Thirteen isolates were recovered during two food-poisoning outbreaks that occurred in May 1987 in Lombardy. The rDNA gene restriction patterns, obtained by probing endonuclease cleaved chromosomal DNA with photobiotin labeled Escherichia coli rRNA, revealed some heterogeneity among strains isolated from Southern Italy, whereas Northern Italy isolates exhibited virtually identical banding patterns.

Abstract: A multiple typing analysis was carried out on 14 apparently heterogeneous Salmonella typhimurium strains recovered during a 3 week period from an enteritis case. Conjugational transfer of resistance determinants and restriction endonuclease fingerprinting of plasmids allowed the different isolates of S. typhimurium to be attributed to a single clone.

Abstract: Nosocomial Pseudomonas aeruginosa isolates were typed by DNA fingerprinting techniques. Chromosomal DNA banding patterns, after endonuclease digestion, of six isolates from a neonatal care unit confirmed the results of O-serotyping and antimicrobial susceptibility pattern analysis. In contrast, the characterization by chromosomal DNA fingerprinting of P. aeruginosa strains isolated from patients treated in a burn unit disagreed with the two classic typing methods: in fact, isolates that varied in serotype and antibiograms showed identical restriction endonuclease profiles, whereas two indistinguishable isolates cultured from individual patients were easily and reproducibly differentiated by molecular analysis.

Abstract: One hundred and thirteen S. wien strains, isolated in Palermo from August 1987 to May 1988 during an enteritis outbreak in a neonatal care unit, were investigated. Genetic and phenotypic characteristics of isolates suitable for epidemiological studies are reported.

Abstract: An epidemiological study was carried out on sixty-four Salmonella typhimurium strains isolated in Palermo during the period January-July 1987 and identified at the Southern Italy Center of Enterobacteriaceae. These included 5 isolates from a small food-poisoning outbreak, which resulted antibiotic susceptible, not colicinogenic and untypable by the phage-type scheme of Anderson. Plasmid profile analysis was not a reliable method to differentiate them from non epidemic strains. The 5 epidemic isolates, belonging to biotype 25a, were assigned into NT 2 phage-type by an accessory set of phages developed in this laboratory. Such biotype/phage-type association was never detected in the remaining Salmonella typhimurium strains isolated during the first 7 months of 1987. Chromosomal DNA analysis provided additional information on the relationships among Salmonella typhimurium isolates.

Abstract: A molecular epidemiological analysis was carried out on S. enteritidis isolates identified at the Central Italy Enterobacteriaceae Center during 1986. 26 of these were from a diarrhoeal disease outbreak, which occurred in the period April-June at the "S. Chiara" Hospital, Pisa. All S. enteritidis strains harboured a virulence-encoding 39 MDa plasmid. The nosocomial isolates made in June 1986 carried an additional non-conjugative plasmid of 75 MDa, associated with the streptomycin-resistance. In contrast, the nosocomial S. enteritidis strains isolated during the period April-May and 16 isolates from the same geographic area were susceptible to antibiotics and showed a different plasmid pattern. According to the plasmid profile and antibiotic resistance pattern analysis, it could be argued that the hospital cases of S. enteritidis infection occurring after May 1986 are attributable to a strain having different origin from the strain circulating in April-May 1986.

Abstract: In 1984-87, 10 isolates of Salmonella enterica subsp. bongori ser. 48:Z35:-, 9 of human source, were identified at the Southern Italy Centre of Enterobacteriaceae. This serotype had never been identified in Southern Italy before 1984. The combined use of different typing methods, with particular reference to restriction enzyme fingerprinting of plasmid and chromosomal DNA, supports the hypothesis that all Bongor serovars derive from a single strain.

Abstract: A longitudinal study to ascertain the most common therapeutic approach to diarrheal disease by general practitioners and pediatricians was carried out in Western Sicily. Data obtained showed that of 902 home-managed cases of diarrhea observed by 58 physicians during one year, 65.3% were treated with antibiotics, 8.0% with antimotility agents and 26.7% were not treated with any pharmacological agent (rehydration or diet). Although oral rehydration therapy was widely known by physicians in Western Sicily, only a few of them were willing to use it routinely as the principal and exclusive treatment.

Abstract: A molecular epidemiology study was carried out on Salmonella mbandaka and Salmonella corvallis strains identified from two food-poisoning outbreaks which occurred in August 1985 in Pistoia and in October 1985 in Sant'Ilario d'Enza (RE). All the Salmonella mbandaka strains were plasmid-free; all the epidemic Salmonella corvallis strains, in contrast to the non epidemic isolates, carried a small plasmid of approximately 2 MDa molecular weight. Restriction enzyme cleavage pattern analysis revealed that the plasmids of the epidemic strains were closely related.

Abstract: A molecular epidemiological study was carried out on 60 Salmonella dublin isolates identified at the Southern Italy Enterobacteriaceae Center between 1971 and 1985. These included 23 isolates from children with diarrhoea in Palermo obtained during 1984. All isolates from the outbreak of gastroenteritis in children were resistant to chloramphenicol and streptomycin and harboured two plasmids of 50 MDa and 3 MDa molecular weight, whereas the majority of the isolates identified before 1984 were susceptible to these antibiotics and carried only a 50 MDa molecular weight plasmid. Four S. dublin strains successively identified from cattle (Palermo, Foggia, Portici) and from a child (Palermo) were shown to possess similar antibiotic resistance patterns and plasmid profiles to S. dublin isolates from the outbreak of gastroenteritis in children. The 50 MDa plasmid was shown to be associated with virulence in mice, while it was not possible to assign any genetic function to the 3 MDa plasmid.

Abstract: Dog faeces and soil samples, collected for one year from public gardens in densely inhabited areas of Palermo (Italy), were investigated for the presence of Salmonella spp. and Ye.enterocolitica, to verify the hypothesis that mechanism of spread of Ye.enterocolitica may be comparable to that of Salmonella spp. Five Salmonella and one Ye.enterocolitica were isolated from 212 dog faeces; one Salmonella and four Ye.enterocolitica from 240 soil samples. O-serotypes of Ye.enterocolitica were not belonging to human pathogenic groups. The same Salmonella spp. were present both in humans and in the environment.