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Possibly Reptile-Associated Hospital-Acquired Salmonella poona in Two Maryland Newborns

J Totaro, MPH, L Edwards, MHS, J Smith, D Shah, MPH, K Fujii, MHS, B Roup, PhD, RN, CIC, D Blythe, MD, MPH.
Office of Epidemiology and Disease Control Programs, Maryland Department of Health and Mental Hygiene

Abstract: Background: In December 2001, Salmonella poona was isolated from two unrelated newborns (A and B) at the same hospital. S. poona is rare in Maryland, accounting for <1% of reported Salmonella cases. The hospital along with state and local health departments investigated these cases.

Methods: The mothers of the newborns (Mothers A and B) were interviewed for key exposures during the week prior to symptom onset. Blood and stool were cultured from each newborn. Stool was cultured from each mother. Pulsed field gel electrophoresis (PFGE) analysis was performed on positive isolates. Employee records were reviewed to identify hospital staff involved with the care of both newborns. Staff were questioned about symptoms.

Results: S. poona was isolated from both newborns and Mother A. PFGE patterns were identical for all three isolates. The newborns were hospitalized for twelve and sixteen days, respectively. Mother A owned a pet iguana and was its primary caretaker. Health department requests to culture the iguana were refused. No ill hospital staff were identified.

Conclusions: It is likely that Newborn A was infected with S. poona during delivery by an S. poona-infected mother. Mother A may have contracted salmonellosis through contact with the iguana. Newborn B was likely infected either during delivery or shortly thereafter. As S. poona was not isolated from Mother B, it is theorized that this infant was infected by hospital staff. These cases highlight the importance of handwashing among health care workers and parents and illustrate the potential hazards of owning a pet reptile.

Submitted to Association for Professionals in Infection Control & Epidemiology (APIC) Annual Meeting 2002; accepted for poster presentation.

S. PoonaTransmission Route Diagram
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Maryland Department of Health & Mental Hygiene — Epidemiology & Disease Control Program