Extended-Spectrum ß-Lactamase-Producing Enterobacteriaceae in Hospital Food: A Risk Assessment

Article Article scientifique Article Extended-Spectrum ß-Lactamase-Producing Enterobacteriaceae in Hospital Food: A Risk Assessment eng 2014 author Stewardson Andréw James 714373 author Renzi Gesuele 111073 author Maury Nathalie author Vaudaux Celia author Brossier Caroline author Fritsch Emmanuel 789549 author Pittet Didier 117792 author Heck Max author van der Zwaluw Kim author Reuland E Ascelijn author van de Laar Thijs author Snelders Eveline author Vandenbroucke-Grauls Christina author Kluytmans Jan author Edder Patrick 26675 author Schrenzel Jacques 29184 author Harbarth Stéphan Juergen 0000-0002-3551-1025 93885 375-383 10.1086/675609 24602942 0899-823X Objective. Determine the prevalence of extended-spectrum ß-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. Dewey 616 56 Département de médecine 221 false 338 Génomique et microbiote 604 526 Résistance aux antibiotiques 866 251 Staphylocoques dorés résistants à la méthicilline et hygiène hospitalière 330 Infection control and hospital epidemiology 35 4 e581394c-c233-4331-b157-40a8984a2b30 Article (Published version) Restricted 675609.pdf 459496 application/pdf restrictedAccess Faculté de médecine / Section de médecine clinique / Département de médecine

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Extended-Spectrum ß-Lactamase-Producing Enterobacteriaceae in Hospital Food: A Risk Assessment	Infection control and hospital epidemiology			2014	562	2

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Fritsch, Emmanuel