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Nontyphoidal Salmonella causes approximately 1.2 million illnesses, 23,000 hospitalizations, and 450 deaths each year in the United States. Direct medical costs are estimated to be $365 million annually. Of concern, surveillance data reveal that an increasing proportion of nontyphoidal Salmonella are resistant to ceftriaxone or ciprofloxacin, drugs representing classes of antibiotics commonly used to treat severe salmonellosis. Currently, CDC is seeing resistance to ceftriaxone in about 3% of nontyphoidal Salmonella tested, and some level of resistance to ciprofloxacin in about 3%. Taking into account all of the classes of antibiotics for which testing is done at CDC, about 5% of nontyphoidal Salmonella tested by CDC are resistant to antibiotics in 5 or more classes.

Multiple outbreaks of foodborne salmonellosis have occurred in which the Salmonella organisms were multidrug resistant. For example, in 2011 an outbreak due to Salmonella Typhimurium linked to ground beef involved 20 people primarily in northeast states; this pathogen was resistant to antibiotics in multiple classes, including aminoglycosides, tetracyclines, sulfonamides, and beta lactams, and cephalosporins and beta lactams in combination with beta-lactamase inhibitors. This pattern of resistance is often associated with co-located resistance genes on a bacterial plasmid, which is a mobile genetic element able to transfer to other types of bacteria.

In practice.... The Foppen Salmon Case - Salmonella taking a deathly toll

Dutch company Foppen issued a smoked salmon recall on September 28, 2012 after health officials in the Netherlands determined that the company’s smoked salmon was the source of a Salmonella outbreak that had sickened at least 200 Dutch and 100 Americans.  By October 18, Dutch public health authorities had announced that 950 residents of the Netherlands had become ill with Salmonella infections after eating the smoked salmon and at least 3 deaths had been attributed to the Salmonella outbreak.

According to media reports, Foppen distributed the Salmonella-contaminated smoked salmon to major Dutch supermarket chains.  Costco recalled all its Foppen smoked salmon products in the U.S.