Guth BEC, Perrella E, 1996. Prevalence of invasive ability and other virulence-associated characteristics in Providencia alcalifaciens strains isolated in Sao Paulo, Brazil. J Med Microbiol 45: 459–462.
Albert MJ, Faruque ASG, Mahalanabis D, 1998. Association of Providencia alcalifaciens with diarrhea in children. J Clin Microbiol 36: 1433–1435.
Haynes J, Hawkey PM, 1989. Providencia alcalifaciens and travellers' diarrhoea. BMJ 299: 94–95.
Yoh M, Matsuyama J, Ohnishi M, Takagi K, Miyagi H, Mori K, Park KS, Ono T, Honda T, 2005. Importance of Providencia species as a major cause of traveler's diarrhoea. J Med Microbiol 54: 1077–1082.
Albert MJ, Alam K, Ansaruzzaman M, Islam MM, Rahman ASMH, Haider K, Bhuiyan NA, Nahar S, Ryan N, Montanaro J, Mathan MM, 1992. Pathogenesis of Providencia alcalifaciens-induced diarrhea. Infect Immun 60: 5017–5024.
Mathan M, Mathan VI, Albert MJ, 1993. Electron microscopic study of the attachment and penetration of rabbit intestinal epithelium by Providencia alcalifaciens. J Pathol 171: 67–71.
Albert MJ, Ansaruzzaman M, Bhuiyan NA, Neogi PKB, Faruque ASG, 1995. Characteristics of invasion of HEp-2 cells by Providencia alcalifaciens. J Med Microbiol 42: 186–190.
Janda JM, Abbott SL, Woodward D, Khashe S, 1998. Invasion of HEp-2 and other eukaryotic cell lines by Providenciae: further evidence supporting the role of Providencia alcalifaciens in bacterial gastroenteritis. Curr Microbiol 37: 159–165.
Murata T, Iida T, Shiomi Y, Tagomori K, Akeda Y, Yanagihara I, Mushiake S, Ishiguro F, Honda T, 2001. A large outbreak of food borne infection attributed to Providencia alcalifaciens. J Infect Dis 184: 1050–1055.
Chlibek R, Jirous J, Beran J, 2002. Diarrhea outbreak among Czech Army Field Hospital personnel caused by Providencia alcalifaciens. J Travel Med 9: 151–152.
Bean NH, Griffin PM, Goulding JS, Ivey CB, 1990. Foodborne disease outbreaks, 5-year summary, 1983–1987. MMWR CDC Surveill Summ 39: 15–57.
Ewing WH, 1986. Edwards and Ewing's Identification of Enterobactericeae, 4th edition. New York, NY: Elsevier Science Publishing Co. Inc., 443–459.
Pham HN, Ohkusu K, Mishima N, Noda M, Shah MM, Sun X, Hayashi M, Ezaki T, 2007. Phylogeny and species identification of the family Enterobacteriaceae based on dnaJ sequences. Diagn Microbiol Infect Dis 58: 153–161.
Clinical and Laboratory Standard Institute, 2007. Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement, Clinical and Laboratory Standard Institute (CLSI) document M100-S17. Wayne, PA: Clinical and Laboratory Standard Institute.
Libisch B, Watine J, Balogh B, Gacs M, Muzslay M, Szabó G, Füzi M, 2008. Molecular typing indicates an important role for two international clonal complexes in dissemination of VIM-producing Pseudomonas aeruginosa clinical isolates in Hungary. Res Microbiol 159: 162–168.
Lee VJ, Ong AE, Auw M, 2009. An outbreak of Salmonella gastrointestinal illness in a military camp. Ann Acad Med Singapore 38: 207–211.
Contzen M, Hailer M, Rau J, 2014. Isolation of Bacillus cytotoxicus from various commercial potato products. Int J Food Microbiol 174: 19–22.
Doan CH, Davidson PM, 2000. Microbiology of potatoes and potato products: a review. J Food Prot 63: 668–683.
Faruque ASG, Mahalanabis D, Islam A, Hoque SS, 1994. Severity of cholera during concurrent infections with other enteric pathogens. J Diarrhoeal Dis Res 12: 214–218.
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Providencia alcalifaciens is an emerging bacterial pathogen known to cause acute gastroenteritis in children and travelers. In July 2013, P. alcalifaciens was isolated from four children appearing for diarrhea at Kiambu District Hospital (KDH) in Kenya. This study describes the outbreak investigation, which aimed to identify the source and mechanisms of infection. We identified seven primary and four secondary cases. Among primary cases were four mothers who had children and experienced mild diarrhea after eating mashed potatoes. The mothers reported feeding children after visiting the toilet and washing their hands without soap. P. alcalifaciens was detected from all secondary cases, and the isolates were found to be clonal by random amplified polymorphic DNA (RAPD) fingerprinting. Our study suggests that the outbreak was caused by P. alcalifaciens, although no fluid accumulation was observed in rabbit ileal loops. The vehicle of the outbreak was believed to be the mashed potato dish, but the source of P. alcalifaciens could not be confirmed. We found that lack of hygiene, inadequate food storage, and improper hand washing before food preparation was the likely cause of the current outbreak. This is the first report of a foodborne infection caused by P. alcalifaciens in Kenya.
Financial support: This study was supported in part by Grant-in-Aid for Scientific Research, Japan (Research B: 15H05286) and the Program for Nurturing Global Leaders in TECD, Nagasaki University, Japan.
Authors' addresses: Mohammad Monir Shah, Peter S. Larson, and Yoshio Ichinose, Centre for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine Nagasaki University, Nagasaki, Japan, and Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya, E-mails: shah@nagasaki-u.ac.jp, pslarson2@gmail.com, and ichinose@nagasaki-u.ac.jp. Erick Odoyo, Cyrus Kathiiko, and Gabriel Miringu, Nagasaki University Institute of Tropical Medicine-Kenya Medical Research Institute Project, Nairobi, Kenya, E-mails: e.odoyo@gmail.com, ckathiiko@gmail.com, and gbm900@yahoo.com. Ernest Apondi, Centre for Infectious Disease Research in Asia and Africa, Institute of Tropical Medicine Nagasaki University, Nagasaki, Japan, E-mail: wandesh2000@yahoo.com. Masahiro Nakashima, Department of Tumor and Diagnostic Pathology, Nagasaki University Graduate School of Biomedical Sciences, Nagasaki, Japan, E-mail: moemoe@nagasaki-u.ac.jp.
Guth BEC, Perrella E, 1996. Prevalence of invasive ability and other virulence-associated characteristics in Providencia alcalifaciens strains isolated in Sao Paulo, Brazil. J Med Microbiol 45: 459–462.
Albert MJ, Faruque ASG, Mahalanabis D, 1998. Association of Providencia alcalifaciens with diarrhea in children. J Clin Microbiol 36: 1433–1435.
Haynes J, Hawkey PM, 1989. Providencia alcalifaciens and travellers' diarrhoea. BMJ 299: 94–95.
Yoh M, Matsuyama J, Ohnishi M, Takagi K, Miyagi H, Mori K, Park KS, Ono T, Honda T, 2005. Importance of Providencia species as a major cause of traveler's diarrhoea. J Med Microbiol 54: 1077–1082.
Albert MJ, Alam K, Ansaruzzaman M, Islam MM, Rahman ASMH, Haider K, Bhuiyan NA, Nahar S, Ryan N, Montanaro J, Mathan MM, 1992. Pathogenesis of Providencia alcalifaciens-induced diarrhea. Infect Immun 60: 5017–5024.
Mathan M, Mathan VI, Albert MJ, 1993. Electron microscopic study of the attachment and penetration of rabbit intestinal epithelium by Providencia alcalifaciens. J Pathol 171: 67–71.
Albert MJ, Ansaruzzaman M, Bhuiyan NA, Neogi PKB, Faruque ASG, 1995. Characteristics of invasion of HEp-2 cells by Providencia alcalifaciens. J Med Microbiol 42: 186–190.
Janda JM, Abbott SL, Woodward D, Khashe S, 1998. Invasion of HEp-2 and other eukaryotic cell lines by Providenciae: further evidence supporting the role of Providencia alcalifaciens in bacterial gastroenteritis. Curr Microbiol 37: 159–165.
Murata T, Iida T, Shiomi Y, Tagomori K, Akeda Y, Yanagihara I, Mushiake S, Ishiguro F, Honda T, 2001. A large outbreak of food borne infection attributed to Providencia alcalifaciens. J Infect Dis 184: 1050–1055.
Chlibek R, Jirous J, Beran J, 2002. Diarrhea outbreak among Czech Army Field Hospital personnel caused by Providencia alcalifaciens. J Travel Med 9: 151–152.
Bean NH, Griffin PM, Goulding JS, Ivey CB, 1990. Foodborne disease outbreaks, 5-year summary, 1983–1987. MMWR CDC Surveill Summ 39: 15–57.
Ewing WH, 1986. Edwards and Ewing's Identification of Enterobactericeae, 4th edition. New York, NY: Elsevier Science Publishing Co. Inc., 443–459.
Pham HN, Ohkusu K, Mishima N, Noda M, Shah MM, Sun X, Hayashi M, Ezaki T, 2007. Phylogeny and species identification of the family Enterobacteriaceae based on dnaJ sequences. Diagn Microbiol Infect Dis 58: 153–161.
Clinical and Laboratory Standard Institute, 2007. Performance Standards for Antimicrobial Susceptibility Testing; Seventeenth Informational Supplement, Clinical and Laboratory Standard Institute (CLSI) document M100-S17. Wayne, PA: Clinical and Laboratory Standard Institute.
Libisch B, Watine J, Balogh B, Gacs M, Muzslay M, Szabó G, Füzi M, 2008. Molecular typing indicates an important role for two international clonal complexes in dissemination of VIM-producing Pseudomonas aeruginosa clinical isolates in Hungary. Res Microbiol 159: 162–168.
Lee VJ, Ong AE, Auw M, 2009. An outbreak of Salmonella gastrointestinal illness in a military camp. Ann Acad Med Singapore 38: 207–211.
Contzen M, Hailer M, Rau J, 2014. Isolation of Bacillus cytotoxicus from various commercial potato products. Int J Food Microbiol 174: 19–22.
Doan CH, Davidson PM, 2000. Microbiology of potatoes and potato products: a review. J Food Prot 63: 668–683.
Faruque ASG, Mahalanabis D, Islam A, Hoque SS, 1994. Severity of cholera during concurrent infections with other enteric pathogens. J Diarrhoeal Dis Res 12: 214–218.
Past two years | Past Year | Past 30 Days | |
---|---|---|---|
Abstract Views | 816 | 657 | 212 |
Full Text Views | 482 | 7 | 0 |
PDF Downloads | 165 | 7 | 0 |