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Toxins 2018, 10(12), 523; https://doi.org/10.3390/toxins10120523

Characterization of A Staphylococcal Food Poisoning Outbreak in A Workplace Canteen during the Post-Earthquake Reconstruction of Central Italy

1
Istituto Zooprofilattico Sperimentale Umbria e Marche “Togo Rosati”, via G. Salvemini 1, 06126 Perugia, Italy
2
National Reference Laboratory for Coagulase Positive Staphylococci - Istituto Zooprofilattico Sperimentale del Piemonte, Liguria e Valle d’Aosta, via Bologna 148, 10154 Torino, Italy
3
European Union Reference Laboratory for Coagulase Positive Staphylococci - Laboratory for Food Safety, Anses, Université Paris-Est, F-94700 Maisons-Alfort, France
4
Presidio Ospedaliero C. e G. Mazzoni, Azienda Sanitaria Unica Regione Marche, Area Vasta n°5, via Degli Iris 1, 63100 Ascoli Piceno, Italy
5
Dipartimento di Prevenzione, Azienda Sanitaria Unica Regione Marche, Area Vasta n°5, Viale Marcello Federici, 63100 Ascoli Piceno, Italy
*
Author to whom correspondence should be addressed.
Received: 12 October 2018 / Revised: 30 November 2018 / Accepted: 3 December 2018 / Published: 6 December 2018
(This article belongs to the Special Issue Bacterial Enterotoxins in Food Safety)
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Abstract

In summer 2017, a foodborne outbreak occurred in Central Italy, involving 26 workers employed in the post-earthquake reconstruction. After eating a meal provided by a catering service, they manifested gastrointestinal symptoms; 23 of them were hospitalized. The retrospective cohort study indicated the pasta salad as the most likely vehicle of poisoning. Foods, environmental samples, and food handlers’ nasal swabs were collected. Bacillus cereus (Bc) and coagulase-positive staphylococci (CPS) including S. aureus, together with their toxins, were the targets of the analysis. CPS, detected in all the leftovers, exceeded 105 CFU/g in the pasta salad, in which we found Staphylococcal Enterotoxins (SEs) (0.033 ng SEA/g; 0.052 ng SED/g). None of the environmental and human swabs showed contamination. We characterized 23 S. aureus from foods. They all belonged to the human biotype, showed the same toxigenic profile (sea, sed, sej, and ser genes), and had the same Pulsed Field Gel Electrophoresis (PFGE) pattern; none of them harbored mecA or mupA genes. We also detected Bc contamination in the pasta salad but none of the isolates harbored the ces gene for the emetic toxin cereulide. The EU Reference Laboratory for CPS confirmed the case as a strong-evidence outbreak caused by the ingestion of SEs produced by a single strain of S. aureus carried by the same human source. This outbreak was successfully investigated despite the emergency situation in which it occurred. View Full-Text
Keywords: Staphylococcus aureus; Staphylococcal Enterotoxins; Food poisoning; Outbreak investigation; PFGE; biotyping Staphylococcus aureus; Staphylococcal Enterotoxins; Food poisoning; Outbreak investigation; PFGE; biotyping
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Guidi, F.; Duranti, A.; Gallina, S.; Nia, Y.; Petruzzelli, A.; Romano, A.; Travaglini, V.; Olivastri, A.; Calvaresi, V.; Decastelli, L.; Blasi, G. Characterization of A Staphylococcal Food Poisoning Outbreak in A Workplace Canteen during the Post-Earthquake Reconstruction of Central Italy. Toxins 2018, 10, 523.

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