Multiple-aetiology enteric infections involving non-O157 Shiga toxin-producing Escherichia coli--FoodNet, 2001-2010.
We describe multiple-aetiology infections involving non-O157 Shiga toxin-producing Escherichia coli (STEC) identified through laboratory-based surveillance in nine FoodNet sites from 2001 to 2010. A multiple-aetiology infection (MEI) was defined as isolation of non-O157 STEC and laboratory evidence of any of the other nine pathogens under surveillance or isolation of >1 non-O157 STEC serogroup from the same person within a 7-day period. We compared exposures of patients with MEI during 2001-2010 with those of patients with single-aetiology non-O157 STEC infections (SEI) during 2008-2009 and with those of the FoodNet population from a survey conducted during 2006-2007. In total, 1870 non-O157 STEC infections were reported; 68 (3.6%) were MEI; 60 included pathogens other than non-O157 STEC; and eight involved >1 serogroup of non-O157 STEC. Of the 68 MEI, 21 (31%) were part of six outbreaks. STEC O111 was isolated in 44% of all MEI. Of patients with MEI, 50% had contact with farm animals compared with 29% (P < 0.01) of persons with SEI; this difference was driven by infections involving STEC O111. More patients with non-outbreak-associated MEI reported drinking well water (62%) than respondents in a population survey (19%) (P < 0.01). Drinking well water and having contact with animals may be important exposures for MEI, especially those involving STEC O111.
Centers for Disease Control and Prevention, Atlanta, GA, USA.
R E
RE
Luna-Gierke
K
K
Wymore
J
J
Sadlowski
P
P
Clogher
R W
RW
Gierke
M
M
Tobin-D'Angelo
A
A
Palmer
C
C
Medus
C
C
Nicholson
S
S
McGuire
H
H
Martin
K
K
Garman
P M
PM
Griffin
R K
RK
Mody
D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000818:Animals; D000829:Animals, Domestic / Q000382:microbiology; D002169:Campylobacter Infections / Q000209:etiology; D002648:Child; D002675:Child, Preschool; D003457:Cryptosporidiosis / Q000209:etiology; D004927:Escherichia coli Infections / Q000453:epidemiology* / Q000209:etiology*; D019453:Escherichia coli O157 / Q000302:isolation & purification; D005260:Female; D006801:Humans; D007223:Infant; D008297:Male; D008875:Middle Aged; D011159:Population Surveillance; D012307:Risk Factors; D012480:Salmonella Infections / Q000209:etiology; D022621:Shiga Toxin / Q000302:isolation & purification; D054323:Shiga-Toxigenic Escherichia coli / Q000302:isolation & purification; D014481:United States / Q000453:epidemiology; D055815:Young Adult; D015047:Zoonoses / Q000453:epidemiology / Q000209:etiology* / Q000382:microbiology*
D022621:Shiga Toxin
Shiga toxin-producing Escherichia coli; diarrhoea; multiple-aetiology infections