Salmonella Kingabwa Infections and Lizard Contact, United States, 2005

Molecular and phenotypic features for identification of the opportunistic pathogens Ochrobactrum spp. CLUSTAL W: improving the sensitivity of progressive multiple sequence alignment through sequence weighting, position specific gap penalties and weight matrix choice. A simple, fast, and accurate algorithm to estimate large phy-logenies by maximum likelihood. Distribution of repetitive DNA sequences in eubacteria and application to fingerprinting of bacterial genomes. Analysis of the bacterial community inhabiting an aero-bic thermophilic sequencing batch reactor (AT-SBR) treating swine waste. Clustering of bloodstream infections during maggot debride-ment therapy using contaminated larvae of Protophormia terraenovae. To the Editor: Nontyphoidal Salmonella infections cause an estimated 1.4 million illnesses and 400 deaths in the United States annually (1). Among the >2,500 Salmonella serotypes, Salmonella enterica serotype Kingabwa rarely causes human illness. This serotype was first reported in a patient in the Belgian Congo in 1953 (2). From 1995 through 2004, only 30 human illnesses caused by S. Kingabwa were reported to the National Salmonella Surveillance System (3). No common source for S. Kingabwa human illnesses has been previously identified. We recently investigated an outbreak of S. Kingabwa infections associated with 2 lizard species: the water dragon and the bearded dragon. Eighteen isolates of S. Kingabwa (antigenic formula: I 43:y:1,5) were received by PulseNet, the National Molecular Subtyping Network for Foodborne Disease Surveillance, from 2001 through 2005. When digested with restriction enzyme XbaI and subtyped by pulsed-field gel elec-trophoreisis (PFGE), 13 isolates produced a single, indistinguishable pattern (KINX01.0001). Of these, 1 (8%) was isolated in 2001, 4 (31%) were isolated in 2002, 2 (15%) were isolated in 2004, and 6 (46%) were isolated in 2005. We defined a case as illness during 2005 caused by S. Kingabwa that matched pattern KINX01.0001 by PFGE. Of the 9 S. Kingabwa isolates received by PulseNet in 2005, 6 matched KINX01.0001. Antimicro-bial drug susceptibility of 3 isolates was determined by the National Antimicrobial Resistance Monitoring System (NARMS) for Enteric Bacteria at the Centers for Disease Control and Prevention (CDC), and the isolates were susceptible to each of 15 antimicrobial agents tested. The 6 patients in the 2005 outbreak did not know each other and resided in 5 states: Maine ((67%) were <1 year old (range <1–53 years), 4 were male, 2 were hospitalized , and none died. Interviews with patients or their parents or guardians conducted during routine public health surveillance collected information on specific food items, water sources, restaurant venues , …