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JAC Advance Access originally published online on March 12, 2008
Journal of Antimicrobial Chemotherapy 2008 61(6):1244-1251; doi:10.1093/jac/dkn093
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© The Author 2008. Published by Oxford University Press on behalf of the British Society for Antimicrobial Chemotherapy. All rights reserved. For Permissions, please e-mail: journals.permissions@oxfordjournals.org

Original research

Dissemination of extended-spectrum β-lactamase-producing bacteria: the food-borne outbreak lesson

S. Lavilla1,2, J. J. González-López1,2, E. Miró3, A. Domínguez4, M. Llagostera2, R. M. Bartolomé1,2, B. Mirelis2,3, F. Navarro2,3 and G. Prats1,2,*

1 Servei de Microbiologia, Hospital Vall d'Hebron, Barcelona, Spain 2 Departament de Genètica i de Microbiologia de la Universitat Autònoma de Barcelona, Cerdanyola del Vallès, Spain 3 Servei de Microbiologia, Hospital de la Santa Creu i Sant Pau, Barcelona, Spain 4 Departament de Salut Pública, Universitat de Barcelona, Barcelona, Spain

Received 14 September 2007; returned 2 December 2007; revised 25 January 2008; accepted 16 February 2008

* Correspondence address. Servei de Microbiologia, Hospital Vall d'Hebron, P. Vall d'Hebron, 119-129, 08035 Barcelona, Spain. Tel: +34-93-2746817; Fax: +34-93-2746801; E-mail: gprats{at}vhebron.net

Objectives: Commensal and opportunistic bacteria producing extended-spectrum β-lactamases (ESBL-PB) have undergone a broad and rapid spread within the general population; however, the routes of dissemination have not been totally elucidated. The aim of this study was to determine whether individuals involved in an outbreak of acute gastroenteritis, in addition to the enteropathogenic microorganism, share an ESBL-PB as indirect demonstration of its transmission from a common food source.

Methods: From 2003 to 2004 in Barcelona, Spain, stool samples from 905 people involved in 132 acute gastroenteritis outbreaks and 226 food handlers related to the outbreaks were investigated.

Results: In 31 outbreaks, 58 diners carrying one or more ESBL-PB were detected. In 10 outbreaks, two or more diners shared the same ESBL-PB, and in four of them, the strain was shared with the food handlers.

Conclusions: This study provides circumstantial evidence that foods can be a transmission vector for ESBL-PB, probably from two reservoirs, food animals and food handlers.

Keywords: food handling , epidemiology , reservoir


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