EHEC outbreak among staff at a children's hospital – use of PCR for verocytotoxin detection and PFGE for epidemiological investigation

• Published in: Epidemiology and infection Vol. 132; no. 1; pp. 43 - 49
• Main Authors: WELINDER-OLSSON, C., STENQVIST, K., BADENFORS, M., BRANDBERG, Å., FLORÉN, K., HOLM, M., HOLMBERG, L., KJELLIN, E., MÅRILD, S., STUDAHL, A., KAIJSER, B.
• Format: Journal Article
• Language: English
• Published: Cambridge, UK Cambridge University Press 01.01.2004
• Subjects: analysis; Bacterial; Bacteriology; Biological and medical sciences; Carrots; Children; classification; diagnosis; Diarrhea; Disease control; Disease Outbreaks; Disease Outbreaks - prevention & control; Disease Outbreaks - statistics & numerical data; DNA; DNA, Bacterial - analysis; DNA, Bacterial - genetics; E coli; Electrophoresis; Electrophoresis, Gel, Pulsed-Field - methods; Electrophoresis, Gel, Pulsed-Field - standards; Employees; Epidemics; Epidemiologic Methods; epidemiology; Escherichia coli; Escherichia coli Infections; Escherichia coli Infections - diagnosis; Escherichia coli Infections - epidemiology; Escherichia coli Infections - microbiology; Escherichia coli Infections - prevention & control; Escherichia coli Infections - transmission; Escherichia coli O157; Escherichia coli O157 - classification; Escherichia coli O157 - genetics; Feces; Feces - microbiology; Food contamination & poisoning; Food Microbiology; Foodborne Diseases; Foodborne Diseases - diagnosis; Foodborne Diseases - epidemiology; Foodborne Diseases - microbiology; Fundamental and applied biological sciences. Psychology; Gel; genetics; Hospital; Hospital units; Hospitals; Hospitals, Pediatric; Humans; Infection Control; Infection Control - methods; Infections; Infectious diseases; Laboratories; Lactuca - microbiology; Lettuce; Mass Screening; Mass Screening - methods; methods; Microbiology; Microbiology in the medical area; Mikrobiologi inom det medicinska området; Nurses; Nursing; Occupational Diseases; Occupational Diseases - diagnosis; Occupational Diseases - epidemiology; Occupational Diseases - microbiology; Occupational Diseases - prevention & control; Occupational Health; Pediatric; Personnel; Personnel, Hospital - statistics & numerical data; Polymerase Chain Reaction; Polymerase Chain Reaction - methods; Polymerase Chain Reaction - standards; prevention & control; Product category rules; Pulsed-Field; Sensitivity and Specificity; Serotyping; Shiga Toxin 1; Shiga Toxin 1 - genetics; Shiga Toxin 2; Shiga Toxin 2 - genetics; Specimens; statistics & numerical data; Sweden; Sweden - epidemiology; Symptoms; Time Factors; transmission; Virulence; Sweden; Human; Polymerase chain reaction; Microbiology; Detection; Child; Epidemiology
• ISSN: 0950-2688; 1469-4409
• DOI: 10.1017/S0950268803001444

This is the first report of a major foodborne outbreak of enterohaemorrhagic Escherichia coli (EHEC) in Sweden. It occurred among the nursing staff at a children's hospital with approximately 1600 employees. Contaminated lettuce was the most likely source of infection. Nine persons were culture-positive for Escherichia coli (E. coli) O157 and verocytotoxin-positive by PCR and a further two were verocytotoxin-positive by PCR only. All 11 EHEC-positive individuals had attended a party for approximately 250 staff members, which was held at the hospital. In a questionnaire 37 persons stated that they had symptoms consistent with EHEC infection during the weeks after the party. There was no evidence of secondary transmission from staff to patients. The value of PCR as a sensitive and fast method for diagnosis is discussed in this paper. Pulsed-field gel electrophoresis (PFGE) was used to ascertain that staff members were infected by the same clone, and that two patients with E. coli O157 infection were not.