Severe <i>Streptococcus equi</i> Subspecies <i>zooepidemicus</i> Outbreak from Unpasteurized Dairy Product Consumption, Italy

Bosica, Serena; Chiaverini, Alexandra; Angelis, Maria Elisabetta De; Petrini, Antonio; Averaimo, Daniela; Martino, Michele Di; Rulli, Marco; Saletti, Maria Antonietta; Cantelmi, Maria Chiara; Ruggeri, Francesco R.; Lodi, Fabrizio; Calistri, Paolo; Cito, Francesca; Cammà, Cesare; Domenico, Marco Di; Rinaldi, Antonio Pio; Fazii, Paolo; Cedrone, Fabrizio; Martino, Giuseppe Di; Accorsi, Patrizia; Morelli, Daniela; Luca, Nicola De; Pomilio, Francesco; Parruti, Giustino; Savini, Giovanni

doi:10.3201/eid2905.221338

Cited by 8 publications

(11 citation statements)

References 15 publications

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“…In Italy, Streptococcus equi subspecies zooepidemicus caused a severe strong‐evidence outbreak involving a total 37 human cases with 23 hospitalisations and 5 deaths (Table 53 ). A fresh cheese made from unpasteurised milk was identified as the source of the outbreak (Bosica et al., 2023 ). This outbreak deserves particular attention for its severity and because S. equi subspecies zooepidemicus has never been reported to EFSA since the collection of FBO data began in 2004.…”

Section: Resultsmentioning

confidence: 99%

The European Union One Health 2022 Zoonoses Report

2023

EFS2

107

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This report by the European Food Safety Authority and the European Centre for Disease Prevention and Control presents the results of the zoonoses monitoring and surveillance activities carried out in 2022 in 27 Member States (MSs), the United Kingdom (Northern Ireland) and 11 non-MSs. Key statistics on zoonoses and zoonotic agents in humans, food, animals and feed are provided and interpreted historically. In 2022, the first and second most reported zoonoses in humans were campylobacteriosis and salmonellosis, respectively. The number of cases of campylobacteriosis and salmonellosis remained stable in comparison with 2021. Nineteen MSs and the United Kingdom (Northern Ireland) achieved all the established targets in poultry populations for the reduction of Salmonella prevalence for the relevant serovars. Salmonella samples from carcases of various animal species, and samples for Campylobacter quantification from broiler carcases, were more frequently positive when performed by the competent authorities than when own checks were conducted. Yersiniosis was the third most reported zoonosis in humans, followed by Shiga toxin-producing Escherichia coli (STEC) and Listeria monocytogenes infections. L. monocytogenes and West Nile virus infections were the most severe zoonotic diseases, with the most hospitalisations and highest case fatality rates. In 2022, reporting showed an increase of more than 600% compared with 2021 in locally acquired cases of human West Nile virus infection, which is a mosquito-borne disease. In the EU, the number of reported foodborne outbreaks and cases, hospitalisations and deaths was higher in 2022 than in 2021. The number of deaths from outbreaks was the highest ever reported in the EU in the last 10 years, mainly caused by L. monocytogenes and to a lesser degree by Salmonella. Salmonella and in particular S. Enteritidis remained the most frequently reported causative agent for foodborne outbreaks. Norovirus (and other calicivirus) was the agent associated with the highest number of outbreak human cases. This report also provides updates on brucellosis, Coxiella burnetii (Q fever), echinococcosis, rabies, toxoplasmosis, trichinellosis, infection with Mycobacterium tuberculosis complex (focusing on Mycobacterium bovis and Mycobacterium caprae) and tularaemia.

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Section: Resultsmentioning

confidence: 99%

The European Union One Health 2022 Zoonoses Report

2023

EFS2

107

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“…As a significant pathogen, SEZ has the potential to infect various mammals, including humans. Outbreaks in numerous animal species have been documented, and sporadic infections in humans have also been reported ( Kuusi et al., 2006 ; Hau et al., 2022 ; Bosica et al., 2023 ; Chen et al., 2023 ). The exploration of immune proteins and infection mechanisms has long been a focal point of SEZ research, aiming to discover novel therapeutic approaches ( Wei et al., 2013 ; Xie et al., 2018 ; Li et al., 2022 ; Xu et al., 2022 ).…”

Section: Discussionmentioning

confidence: 99%

Characterization of AI-2/LuxS quorum sensing system in biofilm formation, pathogenesis of Streptococcus equi subsp. zooepidemicus

Xie,

Zhang,

Guo

et al. 2024

Front. Cell. Infect. Microbiol.

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Streptococcus equi subsp. zooepidemicus (SEZ) is an opportunistic pathogen of both humans and animals. Quorum sensing (QS) plays an important role in the regulation of bacterial group behaviors. The aim of this study was to characterize the LuxS in SEZ and evaluate its impact on biofilm formation, pathogenesis and gene expression. The wild-type SEZ and its LuxS mutant (ΔluxS) were examined for growth, biofilm formation, virulence factors, and transcriptomic profiles. Our results showed that LuxS deficiency did not affect SEZ hemolytic activity, adhesion or capsule production. For biofilm assay demonstrated that mutation in the luxS gene significantly enhances biofilm formation, produced a denser biofilm and attached to a glass surface. RAW264.7 cell infection indicated that ΔluxS promoted macrophage apoptosis and pro-inflammatory responses. In mice infection, there was no significant difference in mortality between SEZ and ΔluxS. However, the bacterial load in the spleen of mice infected with ΔluxS was significantly higher than in those infected with SEZ. And the pathological analysis further indicated that spleen damage was more severe in the ΔluxS group. Moreover, transcriptomics analysis revealed significant alterations in carbon metabolism, RNA binding and stress response genes in ΔluxS. In summary, this study provides the first evidence of AI-2/LuxS QS system in SEZ and reveals its regulatory effects on biofilm formation, pathogenicity and gene expression.

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“…The reports described in this review are summarized in Table S1 [ 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 , 29 , 30 , 31 , 32 , 33 , 34 , 35 , 36 , 37 , 38 , 39 , 40 , 41 , 42 , 43 , 44 , 45 , 46 , 47 , 48 , 49 , 50 , 51 , 52 , 53 ], where the bacterial groups involved in the illnesses are reported in alphabetical order along where the type of ...…”

Section: Recent Cases Of Opportunistic Infections Transmitted By Food...mentioning

confidence: 99%

“…A recent large outbreak, with 37 cases, occurred in Central Italy in the period of November 2021 to May 2022 and was traced back to the consumption of cheese made from unpasteurized milk from a single manufacturer [ 45 ]. The patients manifested different infective states, including septicemia, pharyngitis, arthritis, uveitis, endocarditis, and meningitis.…”

Section: Recent Cases Of Opportunistic Infections Transmitted By Food...mentioning

confidence: 99%

“…The isolates from the producer clustered with the clinical ones and with an isolate from cow mastitis were obtained in November 2021 and originated from the same farm. The reported outbreak indicated that SEZ is an important emerging pathogen with a high virulence and that the use of WGS coupled with epidemiological investigation can prevent further infection cases [ 45 ].…”

Section: Recent Cases Of Opportunistic Infections Transmitted By Food...mentioning

confidence: 99%

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Recent Records on Bacterial Opportunistic Infections via the Dietary Route

Rossi,

Santonicola,

Amadoro

et al. 2023

Microorganisms

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This narrative review was aimed at identifying the opportunistic bacterial pathogens that can be transmitted by contaminated food and represent a current threat for patients particularly susceptible to infections because of underlying conditions or predisposing factors. The analysis was focused on recent case or outbreak reports and systematic reviews published in the years 2019 to 2023 and resulted in sorting 24 bacterial groups comprising the genera or species able to cause a variety of systemic or invasive infections if ingested with food or drinking water. These included both bacteria known to cause mild infections in immunocompetent persons and bacteria considered to be innocuous, which are used in food fermentation or as probiotics. No recent cases of infections transmitted through dietary routes were reported for the critical nosocomial pathogens widely found in food products, primarily Acinetobacter baumannii and Klebsiella pneumoniae. However, the very first sources of their introduction into the clinical environment still need to be established. In many instances, risky dietary habits, such as eating raw fish, seafood, raw meat, unpasteurized milk, and their derived products or the lack of control in fermentation processes, has led to the reported illnesses, pointing out the necessity to improve the hygiene of production and consumer awareness of the risks.

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Severe Streptococcus equi Subspecies zooepidemicus Outbreak from Unpasteurized Dairy Product Consumption, Italy

Cited by 8 publications

References 15 publications

The European Union One Health 2022 Zoonoses Report

The European Union One Health 2022 Zoonoses Report

Characterization of AI-2/LuxS quorum sensing system in biofilm formation, pathogenesis of Streptococcus equi subsp. zooepidemicus

Recent Records on Bacterial Opportunistic Infections via the Dietary Route

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