title: Dissemination of extended-spectrum beta-lactamase-producing bacteria: the food-borne outbreak lesson.
abstract: OBJECTIVE
  Commensal and opportunistic bacteria producing extended-spectrum beta-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.
authors.affiliation: Servei de Microbiologia, Hospital Vall d'Hebron, Barcelona, Spain.
authors.forename: S
authors.initials: S
authors.lastname: Lavilla
authors.forename: J J
authors.initials: JJ
authors.lastname: González-López
authors.forename: E
authors.initials: E
authors.lastname: Miró
authors.forename: A
authors.initials: A
authors.lastname: Domínguez
authors.forename: M
authors.initials: M
authors.lastname: Llagostera
authors.forename: R M
authors.initials: RM
authors.lastname: Bartolomé
authors.forename: B
authors.initials: B
authors.lastname: Mirelis
authors.forename: F
authors.initials: F
authors.lastname: Navarro
authors.forename: G
authors.initials: G
authors.lastname: Prats
mesh_terms: D000818:Animals; D015373:Bacterial Typing Techniques; D016172:DNA Fingerprinting; D004196:Disease Outbreaks; D004197:Disease Reservoirs; D018562:Disease Transmission, Infectious; D016521:Electrophoresis, Gel, Pulsed-Field; D004755:Enterobacteriaceae / Q000145:classification* / Q000187:drug effects* / Q000302:isolation & purification; D005243:Feces / Q000382:microbiology; D005516:Food Microbiology; D005517:Foodborne Diseases / Q000453:epidemiology* / Q000382:microbiology*; D005759:Gastroenteritis / Q000453:epidemiology / Q000382:microbiology; D006801:Humans; D008826:Microbial Sensitivity Tests; D019105:Random Amplified Polymorphic DNA Technique; D012703:Serotyping; D013030:Spain / Q000453:epidemiology; D001618:beta-Lactamases / Q000096:biosynthesis / Q000145:classification*
chemical_list: D001618:beta-Lactamases