title: Shiga (Vero)-toxin producingEscherichia coliisolated from the hospital foods; virulence factors, o-serogroups and antimicrobial resistance properties.
abstract: BACKGROUND
  According to the presence of the weak, diabetic and immunosuppressive patients in hospitals, hospital foods should have a high quality and safety. Cooking a lot of foods higher than daily requirement, storage of cooked foods in an inappropriate condition and presence of nurses and servants in distribution of food to patients are the main reasons caused contamination of hospital foods. Shiga toxigenicEscherichia coliis one of the common cause of food poisoning in hospitals. The present research was carried out to study the distribution of virulence factors, O-serogroups and antibiotic resistance properties in STEC strains recovered from Iranian hospital food samples.
  
  
  METHODS
  Five-hundred and eighty raw and cooked food samples were collected and immediately transferred to the laboratory.E. coli-positive strains were subjected to PCR and disk diffusion method.
  
  
  RESULTS
  Thirty-nine out of 580 (6.72%) hospital food samples were contaminated withE. coli. Raw (20%) and cooked meat (6%) were the most commonly contaminated samples. Raw samples had the higher prevalence ofE. coli(P<0.01). Samples which were collected in the summer season had the highest prevalence of bacteria (64.10%). Significant difference was seen between the prevalence of EHEC and AEEC subtypes (P<0.01). The most commonly detected virulence factors in both EHEC and AEEC subtypes were stx1andeae. The most commonly detected serogroups were O26 (43.75%) and O157 (25%) and there were no positive results for O103, O145, O91, O113 and O128 serogroups.Aac(3)-IV(100%),CITM(100%) andtetA(62.50%) were the most commonly detected antibiotic resistance genes. STEC strains harbored the highest levels of resistance against ampicillin (93.75%), gentamycin (93.75%), tetracycline (87.50%) and ciprofloxacin (81.25%). All of the STEC strains were resistant to at least 3 antibiotics, while the prevalence of resistance against more than 12 antibiotics were 12.50%.
  
  
  CONCLUSIONS
  High presence of O157 serogroups, EHEC strains and animal-based antibiotics in cooked foods showed insufficiency of cooking time and temperature in the kitchens of hospitals. Judicious prescription of antibiotics and attentions to the principles of food safety can reduce the risk of resistant and virulent strains of STEC in hospital foods.
authors.affiliation: Molecular Biology Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Reza
authors.initials: R
authors.lastname: Ranjbar
authors.affiliation: Doctor Veterinary Medicine, College of Veterinary Medicine, Islamic Azad University, Shahrekord Branch, Shahrekord, Iran.
authors.forename: Mojtaba
authors.initials: M
authors.lastname: Masoudimanesh
authors.affiliation: Young Researchers and Elites Club, Shahrekord Branch, Islamic Azad University, Shahrekord, Iran.
authors.forename: Farhad Safarpoor
authors.initials: FS
authors.lastname: Dehkordi
authors.affiliation: Health Research Center, Baqiyatallah University of Medical Sciences, Tehran, Iran.
authors.forename: Nematollah
authors.initials: N
authors.lastname: Jonaidi-Jafari
authors.affiliation: Department of Food Hygiene and Public Health, College of Veterinary Medicine, Shahrekord Branch, Shahrekord, Iran.
authors.forename: Ebrahim
authors.initials: E
authors.lastname: Rahimi
keywords: Antibiotic resistance properties; Hospital foods; Iran; O-serogroups; Shiga-toxin producing escherichia coli; Virulence factors