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Foodhandler-associated salmonella outbreak in a university hospital despite routine surveillance cultures of kitchen employees [Article de Revue]

 
[Epidémie de salmonelle associée à la manipulation de nourriture, malgré des cultures de routine chez les employés de cuisine]
Khuri-Bulos, N ; KHALAF M ; Shehabi, A ; SHAMI K ;
The Jordan University Hospital. Amman. Jordanie
Infection control and hospital epidemiology. 1994/05; 15(5) : 311-314
Summary: Cet article décrit une intoxication alimentaire à salmonella qui est probablement due à la contamination d'une purée de pommes de terre malgré une surveillance systématique des coprocultures des employés. Cette épidémie était probablement due à une contamination massive de la purée de pommes de terre par les mains contaminées d'un employé de cuisine. La coproculture systématique des employés n'est pas rentable et ne devrait pas être considérée comme un substitut à une éducation sur la santé et aux pratiques d'hygiène correctes.

OBJECTIVE: To describe an outbreak of salmonella food poisoning that probably was due to contamination of mashed potatoes by a foodhandler, which occurred despite a policy for routine surveillance stool cultures of kitchen employees. DESIGN: A case control study of 223 individuals who ate the lunch meal on September 23, 1989, at the Jordan University Hospital (JUH) cafeteria. SETTING: Tertiary care university hospital in Amman, the capital of Jordan. PATIENTS: Individuals who developed loose stool or vomiting 6 to 72 hours after eating the lunch meal of September 23, 1989, at the JUH cafeteria.RESULTS: Of 619 individuals, 183 fit the case definition (attack rate, 19.6%); 150 were employees, 26 were inpatients, and seven were visitors. Twelve other employees became sick 4 to 6 days later and probably were infected secondarily. The incubation period ranged from 16 to 72 hours in 183 instances. Symptoms included diarrhea (88%), fever (71%), abdominal pain (74%), dehydration (34%), and bloody stool (5%). Eighty-four were hospitalized. Cultures of eight food items were negative, but stool culture on 90 of 180 patients and 11 of 61 kitchen employees yielded Salmonella enteritidis group D. A cohort study of 223 individuals revealed a food-specific attack rate of 72% for the steak and potato meal and 18% for the rice and meat meal (RR, 4; CI95, 2.62 to 6.24; P < 0.01). Stratified analysis of the steak and potato meal revealed that the potatoes were implicated most strongly (RR, 1.93; CI95, 1.42 to 2.64; P < 0.01). Cultures were obtained from all kitchen employees, and 11 of 61 grew Salmonella enteritidis group D. One asymptomatic, culture-positive employee prepared the mashed potatoes on September 23. All of these employees had negative stool cultures 3 months earlier. CONCLUSION: This outbreak probably was caused by massive contamination of mashed potatoes by the contaminated hands of the foodhandler. Routine stool culture of foodhandlers is not cost-effective and should not be used as a substitute for health education and proper hygienic practices.(RESUME D'AUTEUR)
Publication
, 1994/05

Pages
311-314

Language
Anglais

Number of ref
19

ID notice
318814

Location Call number Status Date due Barcode
CCLIN Est
CClin Est
CHU de Nancy - Hôpitaux de Brabois
Rue du Morvan
54511 Vandoeuvre le Nancy Cedex
Tél : 03.83.15.34.73
cclin.est@chu-nancy.fr
http://www.cclin-est.org/
CCLIN Ouest
CClin Ouest
CHU Hôtel Dieu
CS 26419
35064 Rennes Cedex 2
Tél : 02.99.87.35.31
isabelle.girot@chu-rennes.fr
http://www.cclinouest.com/
CCLIN Paris Nord
CClin Paris-Nord
96 rue Didot
75014 Paris
Tél : 01.40.27.42.00  
karin.lebascle@sap.aphp.fr
http://www.cclinparisnord.org/
CCLIN Sud-Est
CClin Sud-Est
Hospices Civils de Lyon
Hôpital Henry Gabriel
20 route de vourles
69230 Saint-Genis-Laval
Tél : 04.78.86.49.50
cclinse@chu-lyon.fr
http://cclin-sudest.chu-lyon.fr/
CCLIN Sud-Ouest
CClin Sud-Ouest
CHU de Bordeaux
Hôpital Pellegrin - Bâtiment Le Tondu
33076 Bordeaux
Tél : 05.56.79.60.58
cclin.so@chu-bordeaux.fr
http://www.cclin-sudouest.com/

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