TY - JOUR
T1 - Extended-spectrum β-lactamase-producing enterobacteriaceae in hospital food
T2 - A risk assessment
AU - Stewardson, Andrew J.
AU - Renzi, Gesuele
AU - Maury, Nathalie
AU - Vaudaux, Celia
AU - Brossier, Caroline
AU - Fritsch, Emmanuel
AU - Pittet, Didier
AU - Heck, Max
AU - van der Zwaluw, Kim
AU - Ascelijn Reuland, E.
AU - van de Laar, Thijs
AU - Snelders, Eveline
AU - Vandenbroucke-Grauls, Christina M J E
AU - Kluytmans, Jan
AU - Edder, Patrick
AU - Schrenzel, Jacques
AU - Harbarth, Stephan
PY - 2014
Y1 - 2014
N2 - Objective. Determine the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) contamination of food and colonization of food handlers in a hospital kitchen and compare retrieved ESBL-PE strains with patient isolates. Design. Cross-sectional study. Setting. A 2,200-bed tertiary care university hospital in Switzerland. Participants.Food handlers. Methods. Raw and prepared food samples were obtained from the hospital kitchen, with a comparator group from local supermarkets. Fecal samples collected from food handlers and selectively pre-enriched homogenized food samples were inoculated onto selective chromogenic media. Phenotypic confirmation of ESBL production was performed using the double disk method. Representative ESBL-PE were characterized using polymerase chain reaction (PCR) and sequencing for blaCTX-M, blaSHV, and blaTEM genes, and Escherichia coli strains were typed using phylotyping, repetitive element palindromic PCR, and multilocus sequence typing. Meat samples were screened for antibiotic residues using liquid chromatography time-of-flight mass spectrometry. Results. Sixty (92%) of the raw chicken samples were ESBL-PE positive, including 30 (86%) of the hospital samples and all supermarket samples. No egg, beef, rabbit, or cooked chicken samples were ESBL-PE positive. No antibiotic residues were detected. Six (6.5%) of 93 food handlers were ESBL-PE carriers. ESBL-PE strains from chicken meat more commonly possessed blaCTX-M-1 and blaCTX-M-2, whereas blaCTX-M-14 and blaCTX-M-15 were predominant among strains of human origin. There was partial overlap in the sequence type of E. coli strains of chicken and human origin. No E. coli ST131 strains or blaCTX-M-15 genes were isolated from meat. Conclusions. Although there is significant ESBL-PE contamination of delivered chicken meat, current preventive strategies minimize risks to food handlers, hospital staff, and patients.
AB - Objective. Determine the prevalence of extended-spectrum β-lactamase (ESBL)-producing Enterobacteriaceae (ESBL-PE) contamination of food and colonization of food handlers in a hospital kitchen and compare retrieved ESBL-PE strains with patient isolates. Design. Cross-sectional study. Setting. A 2,200-bed tertiary care university hospital in Switzerland. Participants.Food handlers. Methods. Raw and prepared food samples were obtained from the hospital kitchen, with a comparator group from local supermarkets. Fecal samples collected from food handlers and selectively pre-enriched homogenized food samples were inoculated onto selective chromogenic media. Phenotypic confirmation of ESBL production was performed using the double disk method. Representative ESBL-PE were characterized using polymerase chain reaction (PCR) and sequencing for blaCTX-M, blaSHV, and blaTEM genes, and Escherichia coli strains were typed using phylotyping, repetitive element palindromic PCR, and multilocus sequence typing. Meat samples were screened for antibiotic residues using liquid chromatography time-of-flight mass spectrometry. Results. Sixty (92%) of the raw chicken samples were ESBL-PE positive, including 30 (86%) of the hospital samples and all supermarket samples. No egg, beef, rabbit, or cooked chicken samples were ESBL-PE positive. No antibiotic residues were detected. Six (6.5%) of 93 food handlers were ESBL-PE carriers. ESBL-PE strains from chicken meat more commonly possessed blaCTX-M-1 and blaCTX-M-2, whereas blaCTX-M-14 and blaCTX-M-15 were predominant among strains of human origin. There was partial overlap in the sequence type of E. coli strains of chicken and human origin. No E. coli ST131 strains or blaCTX-M-15 genes were isolated from meat. Conclusions. Although there is significant ESBL-PE contamination of delivered chicken meat, current preventive strategies minimize risks to food handlers, hospital staff, and patients.
UR - http://www.scopus.com/inward/record.url?scp=84895814201&partnerID=8YFLogxK
U2 - 10.1086/675609
DO - 10.1086/675609
M3 - Article
C2 - 24602942
AN - SCOPUS:84895814201
VL - 35
SP - 375
EP - 383
JO - Infection Control & Hospital Epidemiology
JF - Infection Control & Hospital Epidemiology
SN - 0899-823X
IS - 4
ER -