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Agricultural, socioeconomic and environmental variables as risks for human verotoxigenic Escherichia coli (VTEC) infection in Finland.

https://arctichealth.org/en/permalink/ahliterature130372
Source
BMC Infect Dis. 2011;11:275
Publication Type
Article
Date
2011
Author
Katri Jalava
Jukka Ollgren
Marjut Eklund
Anja Siitonen
Markku Kuusi
Author Affiliation
Department of Infectious Disease Surveillance and Control, National Institute for Health and Welfare, Helsinki, Finland. katri.jalava@thl.fi
Source
BMC Infect Dis. 2011;11:275
Date
2011
Language
English
Publication Type
Article
Keywords
Adult
Aged
Aged, 80 and over
Child
Child, Preschool
Electrophoresis, Gel, Pulsed-Field
Environmental Exposure
Escherichia coli Infections - epidemiology - microbiology
Female
Finland - epidemiology
Humans
Incidence
Infant
Male
Middle Aged
Models, Statistical
Molecular Typing
Risk factors
Shiga-Toxigenic Escherichia coli - classification - genetics - isolation & purification
Socioeconomic Factors
Virulence Factors - genetics
Abstract
Verotoxigenic E. coli (VTEC) is the cause of severe gastrointestinal infection especially among infants. Between 10 and 20 cases are reported annually to the National Infectious Disease Register (NIDR) in Finland. The aim of this study was to identify explanatory variables for VTEC infections reported to the NIDR in Finland between 1997 and 2006. We applied a hurdle model, applicable for a dataset with an excess of zeros.
We enrolled 131 domestically acquired primary cases of VTEC between 1997 and 2006 from routine surveillance data. The isolated strains were characterized by virulence type, serogroup, phage type and pulsed-field gel electrophoresis. By applying a two-part Bayesian hurdle model to infectious disease surveillance data, we were able to create a model in which the covariates were associated with the probability for occurrence of the cases in the logistic regression part and the magnitude of covariate changes in the Poisson regression part if cases do occur. The model also included spatial correlations between neighbouring municipalities.
The average annual incidence rate was 4.8 cases per million inhabitants based on the cases as reported to the NIDR. Of the 131 cases, 74 VTEC O157 and 58 non-O157 strains were isolated (one person had dual infections). The number of bulls per human population and the proportion of the population with a higher education were associated with an increased occurrence and incidence of human VTEC infections in 70 (17%) of 416 of Finnish municipalities. In addition, the proportion of fresh water per area, the proportion of cultivated land per area and the proportion of low income households with children were associated with increased incidence of VTEC infections.
With hurdle models we were able to distinguish between risk factors for the occurrence of the disease and the incidence of the disease for data characterised by an excess of zeros. The density of bulls and the proportion of the population with higher education were significant both for occurrence and incidence, while the proportion of fresh water, cultivated land, and the proportion of low income households with children were significant for the incidence of the disease.
Notes
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PubMed ID
22008456 View in PubMed
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An outbreak of gastrointestinal illness and erythema nodosum from grated carrots contaminated with Yersinia pseudotuberculosis.

https://arctichealth.org/en/permalink/ahliterature167019
Source
J Infect Dis. 2006 Nov 1;194(9):1209-16
Publication Type
Article
Date
Nov-1-2006
Author
Katri Jalava
Marjaana Hakkinen
Miia Valkonen
Ulla-Maija Nakari
Taito Palo
Saija Hallanvuo
Jukka Ollgren
Anja Siitonen
J Pekka Nuorti
Author Affiliation
Department of Infectious Diseases Epidemiology, National Public Health Institute, FIN-00300 Helsinki, Finland.
Source
J Infect Dis. 2006 Nov 1;194(9):1209-16
Date
Nov-1-2006
Language
English
Publication Type
Article
Keywords
Adolescent
Arthritis, Reactive - epidemiology - microbiology
Case-Control Studies
Child
Child, Preschool
Daucus carota - microbiology
Disease Outbreaks
Erythema Nodosum - epidemiology - microbiology
Female
Finland - epidemiology
Food Microbiology
Gastroenteritis - epidemiology - microbiology
Humans
Infant
Infant, Newborn
Male
Time Factors
Yersinia pseudotuberculosis - isolation & purification
Yersinia pseudotuberculosis Infections - epidemiology
Abstract
Outbreaks of Yersinia pseudotuberculosis infection have been epidemiologically linked to fresh produce, but the bacterium has not been recovered from the food items implicated. In May 2003, a cluster of gastrointestinal illness and erythema nodosum was detected among schoolchildren who had eaten lunches prepared by the same institutional kitchen.
We conducted a case-control study and trace-back, environmental, and laboratory investigations. Case patients had culture-confirmed Y. pseudotuberculosis O:1 infection, erythema nodosum, or reactive arthritis. Bacterial isolates from clinical and environmental samples were compared using pulsed-field gel electrophoresis (PFGE).
Of 7392 persons at risk, 111 (1.5%) met the case definition; 76 case patients and 172 healthy control subjects were enrolled in the case-control study. Only raw grated carrots were significantly associated with illness in a logistic-regression model (multivariable odds ratio, 5.7 [95% confidence interval, 1.7-19.5]); a dose response was found for increasing amount of consumption. Y. pseudotuberculosis O:1 isolates from 39 stool specimens and from 5 (42%) of 12 soil samples that contained carrot residue and were obtained from peeling and washing equipment at the production farm were indistinguishable by PFGE.
Carrots contaminated early in the production process caused a large point-source outbreak. Our findings enable the development of evidence-based strategies to prevent outbreaks of this emerging foodborne pathogen.
Notes
Comment In: J Infect Dis. 2006 Nov 1;194(9):1191-317041842
PubMed ID
17041846 View in PubMed
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Application of molecular genetic methods in diagnostics and epidemiology of food-borne bacterial pathogens.

https://arctichealth.org/en/permalink/ahliterature176690
Source
APMIS. 2004 Nov-Dec;112(11-12):908-29
Publication Type
Article
Author
Susanna Lukinmaa
Ulla-Maija Nakari
Marjut Eklund
Anja Siitonen
Author Affiliation
Laboratory of Enteric Pathogens, National Public Health Institute (KTL), Helsinki, Finland.
Source
APMIS. 2004 Nov-Dec;112(11-12):908-29
Language
English
Publication Type
Article
Keywords
Bacteria - classification - genetics - isolation & purification - pathogenicity
Bacterial Typing Techniques - methods
Campylobacter jejuni - genetics - isolation & purification - pathogenicity
Clostridium perfringens - genetics - isolation & purification - pathogenicity
Databases, Genetic
Electrophoresis, Gel, Pulsed-Field - methods
Enterobacteriaceae - genetics - isolation & purification - pathogenicity
Finland - epidemiology
Food Microbiology
Foodborne Diseases - diagnosis - epidemiology - microbiology
Genotype
Humans
Listeria monocytogenes - genetics - isolation & purification - pathogenicity
Molecular Biology - methods
Molecular Epidemiology - methods
Phenotype
Polymerase Chain Reaction - methods
Salmonella enterica - genetics - isolation & purification - pathogenicity
Yersinia - genetics - isolation & purification - pathogenicity
Abstract
Salmonella enterica, Campylobacter and Yersinia species, Shiga toxin-producing Escherichia coli (STEC), Listeria monocytogenes and Clostridium perfringens are the bacterial pathogens constituting the greatest burden of food-borne disease in Finland. Several molecular genetic methods have been applied to diagnose, discriminate and survey these bacteria. PCR, PCR-RFLP and PFGE are the most widely and successfully used. However, these methods are unable to replace conventional and internationally standardised phenotyping. Electronic database libraries of the different genomic profiles will enable continuous surveillance of infections and detection of possible infection clusters at an early stage. Furthermore, whole-genome sequence data have opened up new insights into epidemiological surveillance. Laboratory-based surveillance performed in a timely manner and exploiting adequate methods, and co-operation at local, national and international levels are among the key elements in preventing food-borne diseases. This paper reviews different applications of molecular genetic methods for investigating enteric bacterial pathogens and gives examples of the methods successfully used in diagnostics and epidemiological studies in Finland.
PubMed ID
15638843 View in PubMed
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Cefotaxime-resistant Salmonella enterica in travelers returning from Thailand to Finland.

https://arctichealth.org/en/permalink/ahliterature261089
Source
Emerg Infect Dis. 2014 Jul;20(7):1214-7
Publication Type
Article
Date
Jul-2014
Author
Marianne Gunell
Laura Aulu
Jari Jalava
Susanna Lukinmaa-Åberg
Monica Osterblad
Jukka Ollgren
Pentti Huovinen
Anja Siitonen
Antti J Hakanen
Source
Emerg Infect Dis. 2014 Jul;20(7):1214-7
Date
Jul-2014
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - therapeutic use
Cefotaxime - therapeutic use
Drug Resistance, Bacterial
Finland
Humans
Salmonella Infections - drug therapy - microbiology
Salmonella enterica - drug effects - isolation & purification
Thailand
Travel
Abstract
During 1993-2011, cefotaxime resistance among Salmonella enterica isolates from patients in Finland increased substantially. Most of these infections originated in Thailand; many were qnr positive and belonged to S. enterica serovar Typhimurium and S. enterica monophasic serovar 4,[5],12:i:-. Although cefotaxime-resistant salmonellae mainly originate in discrete geographic areas, they represent a global threat.
Notes
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PubMed ID
24960266 View in PubMed
Less detail

Characterization of Salmonella Typhimurium isolates from domestically acquired infections in Finland by phage typing, antimicrobial susceptibility testing, PFGE and MLVA.

https://arctichealth.org/en/permalink/ahliterature270445
Source
BMC Microbiol. 2015;15:131
Publication Type
Article
Date
2015
Author
Taru Lienemann
Aino Kyyhkynen
Jani Halkilahti
Kaisa Haukka
Anja Siitonen
Source
BMC Microbiol. 2015;15:131
Date
2015
Language
English
Publication Type
Article
Keywords
Anti-Bacterial Agents - pharmacology
Bacterial Typing Techniques - methods
Bacteriophage Typing
DNA, Bacterial - analysis
Finland
Humans
Microbial Sensitivity Tests
Minisatellite Repeats
Multilocus Sequence Typing
Phylogeny
Salmonella Infections - microbiology
Salmonella typhimurium - classification - drug effects - isolation & purification
Abstract
Salmonella enterica spp. enterica serotype Typhimurium (STM) is the most common agent of domestically acquired salmonellosis in Finland. Subtyping methods which allow the characterization of STM are essential for effective laboratory-based STM surveillance and for recognition of outbreaks. This study describes the diversity of Finnish STM isolates using phage typing, antimicrobial susceptible testing, pulsed-field gel electrophoresis (PFGE) and multilocus variable-number tandem repeat analysis (MLVA), and compares the discriminatory power and the concordance of these methods.
A total of 375 sporadic STM isolates were analysed. The isolates were divided into 31 definite phage (DT) types, dominated by DT1 (47 % of the isolates), U277 (9 % of the isolates) and DT104 (8 % of the isolates). Of all the isolates, 62 % were susceptible to all the 12 antimicrobials tested and 11 % were multidrug resistant. Subtyping resulted in 83 different XbaI-PFGE profiles and 111 MLVA types. The three most common XbaI-PFGE profiles (STYM1, STYM7 and STYM8) and one MLVA profile with three single locus variants accounted for 56 % and 49 % of the STM isolates, respectively. The studied isolates showed a genetic similarity of more than 70 % by XbaI-PFGE. In MLVA, 71 % of the isolates lacked STTR6 and 77 % missed STTR10p loci. Nevertheless, the calculated Simpson's diversity index for XbaI-PFGE was 0.829 (95 % CI 0.792-0.865) and for MLVA 0.867 (95 % CI 0.835-0.898). However, the discriminatory power of the 5-loci MLVA varied among the phage types. The highest concordance of the results was found between XbaI-PFGE and phage typing (adjusted Wallace coefficient was 0.833 and adjusted Rand coefficient was 0.627).
In general, the calculated discriminatory power was higher for genotyping methods (MLVA and XbaI-PFGE) than for phenotyping methods (phage typing). Overall, comparable diversity indices were calculated for PFGE and MLVA (both DI?>?0.8). However, MLVA was phage type dependent providing better discrimination of the most common phage types. Furthermore, 5-loci MLVA was a less laborious method and easier to interpret than XbaI-PFGE. Thus, the laboratory-based surveillance of the Finnish human STM infections has been conducted with a combination of phage typing, antimicrobial susceptibility testing and 5-loci MLVA since January 2014.
Notes
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PubMed ID
26129826 View in PubMed
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Characterization of Shigella sonnei Isolate Carrying Shiga Toxin 2-Producing Gene.

https://arctichealth.org/en/permalink/ahliterature269260
Source
Emerg Infect Dis. 2015 May;21(5):891-2
Publication Type
Article
Date
May-2015
Author
Outi Nyholm
Taru Lienemann
Jani Halkilahti
Sointu Mero
Ruska Rimhanen-Finne
Ville Lehtinen
Saara Salmenlinna
Anja Siitonen
Source
Emerg Infect Dis. 2015 May;21(5):891-2
Date
May-2015
Language
English
Publication Type
Article
Keywords
DNA, Bacterial
Dysentery, Bacillary - diagnosis - drug therapy - microbiology
Electrophoresis, Gel, Pulsed-Field
Female
Finland
Genotyping Techniques
Humans
Middle Aged
Shiga Toxin 2 - biosynthesis - genetics
Shigella sonnei - classification - genetics - isolation & purification
Notes
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PubMed ID
25897522 View in PubMed
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Chickens and cattle as sources of sporadic domestically acquired Campylobacter jejuni infections in Finland.

https://arctichealth.org/en/permalink/ahliterature150166
Source
Appl Environ Microbiol. 2009 Aug;75(16):5244-9
Publication Type
Article
Date
Aug-2009
Author
Marjaana Hakkinen
Ulla-Maija Nakari
Anja Siitonen
Author Affiliation
Research Department, Finnish Food Safety Authority Evira, Mustialankatu 3, Helsinki FI-00790, Finland. marjaana.hakkinen@evira.fi
Source
Appl Environ Microbiol. 2009 Aug;75(16):5244-9
Date
Aug-2009
Language
English
Publication Type
Article
Keywords
Animals
Animals, Domestic - microbiology
Bacterial Typing Techniques
Campylobacter Infections - epidemiology - microbiology
Campylobacter jejuni - classification - genetics - isolation & purification
Cattle - microbiology
Chickens - microbiology
Deoxyribonucleases, Type II Site-Specific
Electrophoresis, Gel, Pulsed-Field
Finland - epidemiology
Food Microbiology
Genotype
Humans
Meat - microbiology
Poultry Diseases - microbiology
Seasons
Abstract
A substantial sampling among domestic human campylobacter cases, chicken process lots, and cattle at slaughter was performed during the seasonal peak of human infections. Campylobacter jejuni isolates (n = 419) were subtyped using pulsed-field gel electrophoresis with SmaI, and isolates representing overlapping types (n = 212) were further subtyped using KpnI for restriction. The SmaI/KpnI profiles of 55.4% (97/175) of the human isolates were indistinguishable from those of the chicken or cattle isolates. The overlapping SmaI/KpnI subtypes accounted for 69.8% (30/43) and 15.9% (32/201) of the chicken and cattle isolates, respectively. The occurrence of identical SmaI/KpnI subtypes with human C. jejuni isolates was significantly associated with animal host species (P
Notes
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PubMed ID
19542336 View in PubMed
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Domestically acquired Campylobacter infections in Finland.

https://arctichealth.org/en/permalink/ahliterature180613
Source
Emerg Infect Dis. 2004 Jan;10(1):127-30
Publication Type
Article
Date
Jan-2004
Author
Antti Vierikko
Marja-Liisa Hänninen
Anja Siitonen
Petri Ruutu
Hilpi Rautelin
Author Affiliation
University of Helsinki Haartman Institute, Department of Bacteriology and Immunology, Helsinki, Finland.
Source
Emerg Infect Dis. 2004 Jan;10(1):127-30
Date
Jan-2004
Language
English
Publication Type
Article
Keywords
Adolescent
Adult
Age Distribution
Aged
Aged, 80 and over
Campylobacter Infections - epidemiology
Campylobacter jejuni - classification - isolation & purification - pathogenicity
Child
Female
Finland - epidemiology
Humans
Male
Middle Aged
Serotyping
Sex Distribution
Abstract
Campylobacter jejuni isolates (n = 533) from domestic cases diagnosed in Finland during a 3-month peak period were studied. The highest rate was observed among those 70-74 years of age. Domestic C. jejuni isolates were especially frequent in the eastern districts. Six serotypes covered 61% of all C. jejuni isolates.
Notes
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PubMed ID
15078608 View in PubMed
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Faecal contamination of a municipal drinking water distribution system in association with Campylobacter jejuni infections.

https://arctichealth.org/en/permalink/ahliterature153491
Source
J Water Health. 2008 Sep;6(3):365-76
Publication Type
Article
Date
Sep-2008
Author
Tarja Pitkänen
Ilkka T Miettinen
Ulla-Maija Nakari
Johanna Takkinen
Kalle Nieminen
Anja Siitonen
Markku Kuusi
Arja Holopainen
Marja-Liisa Hänninen
Author Affiliation
Department of Environmental Health, National Public Health Institute (KTL), Laboratory of Environmental Microbiology, P.O. Box 95, FI-70701 Kuopio, Finland. Tarja.Pitkanen@ktl.fi
Source
J Water Health. 2008 Sep;6(3):365-76
Date
Sep-2008
Language
English
Publication Type
Article
Keywords
Campylobacter Infections - epidemiology
Campylobacter jejuni - isolation & purification
Cities - epidemiology
Drinking
Feces - microbiology
Finland - epidemiology
Fresh Water - microbiology
Humans
Interviews as Topic
Water Microbiology
Abstract
After heavy rains Campylobacter jejuni together with high counts of Escherichia coli, other coliforms and intestinal enterococci were detected from drinking water of a municipal distribution system in eastern Finland in August 2004. Three patients with a positive C. jejuni finding, who had drunk the contaminated water, were identified and interviewed. The pulsed-field gel electrophoresis (PFGE) genotypes from the patient samples were identical to some of the genotypes isolated from the water of the suspected contamination source. In addition, repetitive DNA element analysis (rep-PCR) revealed identical patterns of E. coli and other coliform isolates along the distribution line. Further on-site technical investigations revealed that one of the two rainwater gutters on the roof of the water storage tower had been in an incorrect position and rainwater had flushed a large amount of faecal material from wild birds into the drinking water. The findings required close co-operation between civil authorities, and application of cultivation and genotyping techniques strongly suggested that the municipal drinking water was the source of the infections. The faecal contamination associated with failures in cleaning and technical management stress the importance of instructions for waterworks personnel to perform maintenance work properly.
PubMed ID
19108557 View in PubMed
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Heat Wave-Associated Vibriosis, Sweden and Finland, 2014.

https://arctichealth.org/en/permalink/ahliterature273966
Source
Emerg Infect Dis. 2016 Jul;22(7):1216-20
Publication Type
Article
Date
Jul-2016
Author
Craig Baker-Austin
Joaquin A Trinanes
Saara Salmenlinna
Margareta Löfdahl
Anja Siitonen
Nick G H Taylor
Jaime Martinez-Urtaza
Source
Emerg Infect Dis. 2016 Jul;22(7):1216-20
Date
Jul-2016
Language
English
Publication Type
Article
Abstract
During summer 2014, a total of 89 Vibrio infections were reported in Sweden and Finland, substantially more yearly infections than previously have been reported in northern Europe. Infections were spread across most coastal counties of Sweden and Finland, but unusually, numerous infections were reported in subarctic regions; cases were reported as far north as 65°N, ˜100 miles (160 km) from the Arctic Circle. Most infections were caused by non-O1/O139 V. cholerae (70 cases, corresponding to 77% of the total, all strains were negative for the cholera toxin gene). An extreme heat wave in northern Scandinavia during summer 2014 led to unprecedented high sea surface temperatures, which appear to have been responsible for the emergence of Vibrio bacteria at these latitudes. The emergence of vibriosis in high-latitude regions requires improved diagnostic detection and clinical awareness of these emerging pathogens.
PubMed ID
27314874 View in PubMed
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