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Previous Volume 337:589-594 August 28, 1997 Number 9 Next

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ABSTRACT

Background Streptococcus iniae is a pathogen in fish, capable of causing invasive disease and outbreaks in aquaculture farms. During the winter of 1995–1996 in the greater Toronto area there was a cluster of four cases of invasive S. iniae infection in people who had recently handled fresh, whole fish from such farms.

Methods We conducted a prospective and retrospective community-based surveillance for cases of S. iniae infection in humans. To obtain a large sample of isolates, we studied cultures obtained from the surface of fish from aquaculture farms. Additional isolates were obtained from the brains of infected tilapia (oreochromis species). All the isolates were characterized by pulsed-field gel electrophoresis (PFGE).

Results During one year, our surveillance identified a total of nine patients with invasive S. iniae infection (cellulitis of the hand in eight and endocarditis in one). All the patients had handled live or freshly killed fish, and eight had percutaneous injuries. Six of the nine fish were tilapia, which are commonly used in Asian cooking. Thirteen additional S. iniae isolates (2 from humans and 11 from infected tilapia) were obtained from normally sterile sites. The isolates from the nine patients were indistinguishable by PFGE and were highly related to the other clinical isolates. There was substantial genetic diversity among the 42 surveillance isolates from the surface of fish, but in 10 isolates the PFGE patterns were identical to those from the patients with S. iniae infection.

Conclusions S. iniae can produce invasive infection after skin injuries during the handling of fresh fish grown by aquaculture. We identified a clone of S. iniae that causes invasive disease in both humans and fish.

Source Information

From the Department of Medicine, University of Toronto, Toronto (M.R.W., A.M., D.E.L.); the Laboratory Centre for Disease Control, Ottawa, Ont. (M.L., D.A.K.); the Scarborough Grace Hospital, Scarborough, Ont. (P.W., D.R., M.C.); the Department of Microbiology, Mount Sinai and Princess Margaret Hospitals, Toronto (A.M., B.M.W., D.E.L.); the City of Scarborough Public Health Department, Scarborough, Ont. (C.O.); and the Public Health Laboratory of Ontario, Toronto (A.B.) — all in Canada; and the Centers for Disease Control and Prevention, Atlanta (R.F.).

Address reprint requests to Dr. Low at the Department of Microbiology, Mount Sinai Hospital, 600 University Ave., Toronto, ON M5G 1X5, Canada.

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