title: [On the risk of spread of E. coli/EHEC O104:H4 stx 2 positive bacteria via sewerage treatment plants during the 2011 EHEC outbreak in north Germany].
abstract: During an EHEC outbreak with E. coli O104:H4 stx2-pos in northern Germany 2 sewage treatment plants (Cuxhaven and Stade) of highly affected areas were monitored for the presence of the outbreak strain. 7 efflux water samples were collected at 1 h and 6 h intervals. The overall E. coli content of the treated sewage water was approximately 35 000 CFU/100 mL in both treatment plants. Among these about 500 were ESBL-E. coli (1.4%). ESBL-Agar was used as selective medium as the outbreak strain is highly resistant to 3rd generation cephalosporins. From the ESBL-isolates 208 strains have been typed by molecular methods for markers specific to the outbreak strain (O104rfb -351 base pairs (bp), flic H4-201 bp, stx2-584 bp, Tellur D - 434 bp). No outbreak strain was detected. The number of E. coli O104:H4 stx2-pos was calculated to be less than 3 per 100 mL in the treated sewage at the time of the study. Therefore it can be concluded that there was no threat for bathers to fall sick with this highly pathogenic strain from possibly sewage-contaminated bathing waters during the outbreak. The national limit value of 1 800 E. coli in 100 mL offers a high safety margin.
authors.affiliation: Niedersächsisches Landesgesundheitsamt, Standort Aurich.
authors.forename: E-A
authors.initials: EA
authors.lastname: Heinemeyer
authors.forename: K
authors.initials: K
authors.lastname: Luden
authors.forename: M
authors.initials: M
authors.lastname: Monazahian
mesh_terms: D001494:Baths / Q000706:statistics & numerical data*; D004196:Disease Outbreaks / Q000706:statistics & numerical data; D054324:Enterohemorrhagic Escherichia coli / Q000302:isolation & purification*; D005858:Germany / Q000453:epidemiology; D006463:Hemolytic-Uremic Syndrome / Q000453:epidemiology* / Q000382:microbiology*; D006801:Humans; D018570:Risk Assessment; D012722:Sewage / Q000382:microbiology* / Q000706:statistics & numerical data*; D018508:Water Purification / Q000706:statistics & numerical data*; D014881:Water Supply / Q000706:statistics & numerical data
chemical_list: D012722:Sewage