title: Pathogenic Escherichia coli and food handlers in luxury hotels in Nairobi, Kenya.
abstract: BACKGROUND
  The epidemiology and virulence properties of pathogenic Escherichia coli among food handlers in tourist destination hotels in Kenya are largely uncharacterized.
  
  
  METHODS
  This cross-sectional study among consenting 885 food handlers working in nine luxurious tourist hotels in Nairobi, Kenya determined the epidemiology, virulence properties, antibiotics susceptibility profiles and conjugation abilities of pathogenic Escherichia coli.
  
  
  RESULTS
  Pathogenic Escherichia coli was detected among 39 (4.4%) subjects, including 1.8% enteroaggregative Escherichia coli (EAEC) harboring aggR genes, 1.2% enterotoxigenic Escherichia coli (ETEC) expressing both LT and STp toxins, 1.1% enteropathogenic Escherichia coli (EPEC) and 0.2% Shiga-like Escherichia coli (EHEC) both harboring eaeA and stx2 genes respectively. All the pathotypes had increased surface hydrophobicity. Using multivariate analyses, food handlers with loose stools were more likely to be infected with pathogenic Escherichia coli. Majority 53.8% of the pathotypes were resistant to tetracycline with 40.2% being multi-drug resistant. About 85.7% pathotypes trans-conjugated with Escherichia coli K12 F(-) NA(r) LA.
  
  
  CONCLUSIONS
  The carriage of multi-drug resistant, toxin expressing pathogenic Escherichia coli by this population is of public health concern because exposure to low doses can result in infection. Screening food handlers and implementing public awareness programs is recommended as an intervention to control transmission of enteric pathogens.
authors: Department of Biochemistry and Biotechnology, Kenyatta University, P.O. Box 43844-00100, Nairobi, Kenya. aodhiambo.umsom@gmail.com
authors: Abel O
authors: AO
authors: Onyango
authors: Eucharia U
authors: EU
authors: Kenya
authors: John J N
authors: JJ
authors: Mbithi
authors: Musa O
authors: MO
authors: Ng'ayo
mesh_terms: D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents; D003430:Cross-Sectional Studies; D024901:Drug Resistance, Multiple, Bacterial; D054308:Enteropathogenic Escherichia coli / Q000302:isolation & purification* / Q000472:pathogenicity; D004768:Enterotoxins / Q000096:biosynthesis; D004927:Escherichia coli Infections / Q000188:drug therapy / Q000453:epidemiology* / Q000235:genetics; D029968:Escherichia coli Proteins / Q000235:genetics; D005243:Feces / Q000382:microbiology*; D005260:Female; D005511:Food Handling; D006801:Humans; D007630:Kenya; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D015999:Multivariate Analysis; D015995:Prevalence; D014195:Travel; D055815:Young Adult
chemical_list: D000900:Anti-Bacterial Agents; D004768:Enterotoxins; D029968:Escherichia coli Proteins