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International reference laboratory based surveillance of multiple drug resistance (MDR) Salmonella and Vero cytotoxin producing Escherichiacoli (VTEC)

Objective

To collect standardised data on the anti-microbial resistance patterns of salmonellas isolated from humans.
To facilitate the study of resistance mechanisms and their genetic control by arranging the collection of representative strains of MDR-salmonellas and co-ordinating the required research work between specialised centres, and where available compare the resistances' of animal isolates.
To extend the typing of VTEC O157 for surveillance purposes.
To pilot an international quality assessment scheme for laboratory methods used in the identification/typing of VTEC.
To establish a core set of data items to accompany, where possible, each laboratory typed human VTEC isolate.
To create an international database of human VTEC isolates which is updated regularly and is readily available to each participating team.
To detect clusters of human VTEC isolate types in time, place and person and to bring such clusters to the attention of collaborators rapidly.

The general increase in the incidence of multiple drug resistant (MDR) salmonella brings with it the threat of greater morbidity especially in those vulnerable to the effects of salmonella septicaemia. Because of the international trade in human food and food animals, the problems associated with MDR-salmonellas in one country may influence the situation in others. Europe wide surveillance of salmonella resistance will allow the formulation and implementation of appropriate control measures on an international scale.
The incidence of Vero cytotoxin-producing Escherichia coli (VTEC) O157 in individual countries of the EU is small when compared to salmonella, however it is an important public health problem because of the associated high mortality and the serious complications of haemorrhagic colitis and HUS. During the past ten years reported cases of VTEC O157 infection have risen steeply in some European countries. An outbreak across Europe attributable to international distribution of a contaminated foodstuff is likely to occur in the future. Creation of an international shared database of human VTEC isolates, including data on strain types, is an essential step towards strengthening prevention within the EU.
The Enter-net project aims to establish an international surveillance system for MDR-salmonella, and to develop a monitoring system to determine the epidemiology of VTEC O157. These aims will be achieved through i) collecting standardised data on salmonella anti-microbial resistance, ii) extending the typing of VTEC O157 for surveillance purposes, iii) creating an international database which is updated regularly and iv) detecting clusters and initiating collaborative investigations.

Coordinator

PUBLIC HEALTH LABORATORY SERVICE
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United Kingdom