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Role of Foods in Sporadic ListeriosisII. Microbilogic and Epidemiologic Investigation
Robert W. Pinner, MD;
Anne Schuchat, MD;
B. Swaminathan, PhD;
Peggy S. Hayes;
Katherine A. Deaver;
Robert E. Weaver, MD, PhD;
Brian D. Plikaytis, MS;
Michael Reeves, PhD;
Claire V. Broome, MD;
Jay D. Wenger, MD;
Listeria Study Group;
Gloria Ajello;
Vincent Przybyszewski;
Georgia Malcolm;
Ray Ransom;
Lewis M. Graves;
Mariam Egal;
Richard Pierce;
Gretchen Anderson;
Elizabeth Stone;
Kevin Krauss;
Arthur Reingold, MD;
Maribel Castillon;
Laurene Mascola, MD;
Christopher Harvey;
Tina Stull, MD;
David Stephens, MD;
Monica Farley, MD;
Pam Archer;
Jane Strack;
Gregory Istre, MD;
Margaret Rados;
Jo Taylor;
Lewis Lefkowitz, MD
JAMA. 1992;267(15):2046-2050.
Abstract
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Objective.
—To evaluate the role of foods in sporadic listeriosis.
Design.
—Microbiologic survey of foods collected from refrigerators of patients with listeriosis identified through active laboratory-based surveillance. Patient and food Listeria monocytogenes isolates were subtyped to identify foods contaminated with the same strain of L monocytogenes that caused illness in the patient; samples of these foods were obtained from the retail source.
Setting.
—Multistate population-based study conducted between 1988 and 1990.
Results.
—Listeria monocytogenes grew from at least one food specimen in the refrigerators of 79 (64%) of 123 listeriosis patients; 11% of more than 2000 food specimens collected in the study contained L monocytogenes. Twenty-six (33%) of 79 refrigerators with foods that grew L monocytogenes contained at least one food isolate of the same strain as that in the corresponding patient, a frequency much higher than would be expected by chance (P<.001). Multivariate analysis showed that of the food specimens that grew L monocytogenes, foods that were ready-to-eat, foods that grew L monocytogenes by a direct-plating method (a measure of the level of contamination), and foods that contained serotype 4b isolates were independently associated with an increased likelihood of containing the patient-matching strain.
Conclusion.
—We identified specific food and L monocytogenes isolate characteristics—ready-to-eat foods, foods containing higher concentrations of L monocytogenes, and foods containing serotype 4b—which were associated with disease-causing strains. These results can provide guidance to industry and regulatory agencies in developing strategies to prevent listeriosis.
(JAMA. 1992;267:2046-2050)
Author Affiliations
Centers for Disease Control, Atlanta, Ga; San Francisco (Calif) Department of Health; Alameda County Department of Health, Oakland, Calif; School of Public Health, University of California at Berkeley; Acute Communicable Disease Control, Los Angeles County (Calif) Health Department; Department of Medicine, Emory University, Atlanta, Ga; Oklahoma State Department of Health, Oklahoma City; Department of Preventive Medicine, Vanderbilt University, Nashville, Tenn.
From the Meningitis and Special Pathogens Branch (Drs Pinner, Schuchat, Swaminathan, Weaver, Reeves, Broome, Wenger, and Mss Hayes and Deaver), and the Biostatistics and Information Branch (Mr Plikaytis), Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Atlanta, Ga.
Footnotes
Reprint requests to Division of Bacterial and Mycotic Diseases, Centers for Disease Control, Mailstop C09, 1600 Clifton Road NE, Atlanta, GA 30333 (Dr Pinner).
A complete list of the members of the Listeria Study Group appears at the end of this article.
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