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

Published online by Cambridge University Press:  27 January 2004

C. WELINDER-OLSSON
Affiliation:
Department of Clinical Bacteriology, University of Göteborg, Sweden
K. STENQVIST
Affiliation:
Department of Communicable Disease Control, Göteborg, Sweden
M. BADENFORS
Affiliation:
Bacteriology Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden
Å. BRANDBERG
Affiliation:
Bacteriology Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden
K. FLORÉN
Affiliation:
Bacteriology Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden
M. HOLM
Affiliation:
Environment Administration, City of Göteborg, Sweden
L. HOLMBERG
Affiliation:
Department of Communicable Disease Control, Göteborg, Sweden
E. KJELLIN
Affiliation:
Bacteriology Laboratory, Sahlgrenska University Hospital, Göteborg, Sweden
S. MÅRILD
Affiliation:
The Queen Silvia Children's Hospital, Sahlgrenska University Hospital, Göteborg, Sweden
A. STUDAHL
Affiliation:
Health and Medical Care Committee, Borås, Sweden
B. KAIJSER
Affiliation:
Department of Clinical Bacteriology, University of Göteborg, Sweden
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Abstract

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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.

Type
Research Article
Copyright
© 2004 Cambridge University Press