Escherichia coli O157:H7 Infections Associated With Consumption of Locally Grown Strawberries Contaminated by Deer
Escherichia coli O157:H7 Infections Associated With Consumption of Locally Grown Strawberries Contaminated by Deer
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DOI：
10.1093/cid/cit468
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发表时间：
2013-10-15
影响因子：
11.8
通讯作者：
Keene, William E.
中科院分区：
文献类型：
--
作者：
Laidler, Matthew R.;Tourdjman, Mathieu;Keene, William E.
背景。俄勒冈州爆发的大肠杆菌O157:H7是通过志贺毒素产生大肠杆菌病例的增加而发现的，这种病例具有难以区分的新型脉冲场凝胶电泳（PFGE）亚型模式。我们将确诊病例定义为2011年7月至8月期间培养出具有暴发PFGE模式的O157: H7大肠杆菌的人，将推定病例定义为与O157: H7大肠杆菌检测呈阳性并同时出现腹泻疾病的病例有家庭关系的人。我们进行了一项调查，包括结构化的假设生成访谈，匹配的病例对照研究，以及环境和追溯调查。我们确定了15例。6例住院，其中4例为溶血性尿毒症综合征。2例溶血性尿毒综合征患者死亡。疾病与路边摊或农贸市场的草莓消费显著相关（匹配优势比为19.6；95%置信区间为2.9-无穷大）。一个农场被确定为受污染草莓的来源。A农场的111个初始环境样本中有10个（9%）对大肠杆菌O157: H7呈阳性。所有O157: H7大肠杆菌检测呈阳性的样本均含有鹿粪，5个被检测农场有>= 1个样本呈暴发PFGE模式阳性。调查发现新鲜草莓是大肠杆菌O157: H7感染的新载体，鹿粪是污染源，并强调了野生动物污染农产品和当地种植农产品的监管豁免问题。一个全面的假设生成问卷使牵连产品的快速识别。良好的农业规范是防止野生动物粪便污染农产品的关键障碍。
Background. An outbreak of Escherichia coli O157:H7 was identified in Oregon through an increase in Shiga toxin-producing E. coli cases with an indistinguishable, novel pulsed-field gel electrophoresis (PFGE) subtyping pattern.Methods. We defined confirmed cases as persons from whom E. coli O157: H7 with the outbreak PFGE pattern was cultured during July-August 2011, and presumptive cases as persons having a household relationship with a case testing positive for E. coli O157: H7 and coincident diarrheal illness. We conducted an investigation that included structured hypothesis-generating interviews, a matched case-control study, and environmental and traceback investigations.Results. We identified 15 cases. Six cases were hospitalized, including 4 with hemolytic uremic syndrome (HUS). Two cases with HUS died. Illness was significantly associated with strawberry consumption from roadside stands or farmers' markets (matched odds ratio, 19.6; 95% confidence interval, 2.9-infinity). A single farm was identified as the source of contaminated strawberries. Ten of 111 (9%) initial environmental samples from farm A were positive for E. coli O157: H7. All samples testing positive for E. coli O157: H7 contained deer feces, and 5 tested farm fields had >= 1 sample positive with the outbreak PFGE pattern.Conclusions. The investigation identified fresh strawberries as a novel vehicle for E. coli O157: H7 infection, implicated deer feces as the source of contamination, and highlights problems concerning produce contamination by wildlife and regulatory exemptions for locally grown produce. A comprehensive hypothesis-generating questionnaire enabled rapid identification of the implicated product. Good agricultural practices are key barriers to wildlife fecal contamination of produce.