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PFGE typing showed the isolates to be the outbreak strain (9 of 10) or a closely related strain.
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Importantly, four isolates collected directly from the non-disinfected and disinfected bronchofiberscope were also identified as being the outbreak strain, suggesting that serious failure of the bronchofiberscope reprocessing procedure and that the outbreak strain of MDR-Ab might have been transmitted through direct contact with the bronchofiberscope.
Food handler C, who was carrying the outbreak strain of MRSA, performed various tasks at the store, including preparing foods and handling barbecued pork and coleslaw.
While its genes for cellulose synthase are intact, the outbreak strain carries a frameshift mutation in bcsE, which encodes an accessory protein required for cellulose production.
Fifty-three of the 54 virulent, serogroup A isolates are likely to represent the outbreak strain or subtypes of this.
Although we were unable to sample mice from facility C, it is likely that the outbreak strain was the same as in facility A and was introduced during the wild mouse infestation that had occurred.
Thirteen of the 15 residents and staff that were positive for the outbreak strain were eventually treated with doxycycline.
The bacterial isolate obtained from the staff member was determined by PFGE to be unrelated to the outbreak strain.
Salmonella spp. were not recovered from raw soybeans or black-eyed peas, black beans were unavailable for sampling, and vinegar was not tested, but the outbreak strain was identified in opened and unopened bags of Rhizopus spp. starter culture.
Additional cases could be attributed to the outbreak strain on the basis of whole-genome data.
These strains appear to be related to the outbreak strain but with loss of the mec-A determinant.
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