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The most common source of serovar Worthington is turkey, turkey ceca, and its production environment. This serovar has been reported in milk powder contamination, vegetables, and seafood. However, serovar Worthington has been frequently reported to cause infection especially in neonatal cases and the pediatric ward. Serovar Worthington tends to cause infection in vulnerable groups such as newborns or elderly. Although the symptoms caused by serovar Worthington infection are likely non-typhoidal infection symptoms such as diarrhea or vomiting, in some cases, it can develop to meningitis leading to fatality. In 1955, there was a report on serovar Worthington suspected causing gastroenteritis including vomiting in several newborn babies in a small maternity ward at Indonesian hospital. The outbreak to newborn babies in the nursery of maternity ward also occurred in hospital in Hong Kong in August 1974 leading to 1 from 13 cases died due to meningitis but the outbreak cause was unable to identified. However, the second outbreak occurred in five weeks after with infected five newborns and this time revealed that the outbreak caused by the contamination in tubing system of a suction apparatus which was used for baby's oropharyngeal suction. The outbreak causing by the same contamination also happened in Pakistan in early 1990s. Salmonella Worthington was recovered from 18 babies who received suction. NowadaysRecently, serovar Worthington likely becomes multidrug-resistant bacteria challenging for treatment especially in neonates and elderly.
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Genetic characteristics: Serovar Worthington has been found to be polyphyletic with 1 lineage and 1 stand-alone singleton. Salmonella Worthington has been reported on its ability either acquire third-generation cephalosporin resistance plasmid (blaDHA-1-carrying IncFII plasmid) from Citrobacter amalonaticus or transfer its own resistance genes consisting of extended-spectrum cephalosporins, monobactam, and fluoroquinolone to Escherichia coli. A pan-susceptible Salmonella enterica serovar Worthington isolate was detected in the stool of a man returning from Sri Lanka. Under ceftriaxone treatment, a third-generation cephalosporin (3GC)-resistant Salmonella Worthington was isolated after 8 days. Molecular analyses indicated that the two isolates were identical. However, the latter strain acquired a blaDHA-1-carrying IncFII plasmid probably from a Citrobacter amalonaticus isolate colonizing the gut. This is the first report of in vivo acquisition of plasmid-mediated resistance to 3GCs in S. enterica.isolated from
phylogenetic groups identified
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2. https://academic.oup.com/trstmh/article/103/4/390/1918003?login=true
4. https://www.sciencedirect.com/science/article/pii/S0168160503003301?via%3Dihub#BIB20