Poor hand hygiene may be biggest transmitter of superbug E.coli


One of the best ways to cut down on antibiotic-resistant E. coli infections would be making sure that everyone washes their hands after using the toilet, a UK study suggests.

Outbreaks of E. coli - a potentially fatal illness - are commonly blamed on undercooked meat or raw vegetables, but when researchers did a genetic analysis of thousands of samples, they found that most E. coli infections in the UK were caused by a strain often found in the human gut and in sewage, but not seen much in the food supply.

That suggests the infection is primarily being spread as a result of human fecal particles transmitted from person to person, the study team writes in Lancet Infectious Diseases.

David M Livermore, a medical microbiologist at the University of East Anglia, and his colleagues call E. coli a "Jekyll and Hyde organism." E. coli mainly lives harmlessly in the guts of humans and animals, but a handful of nasty strains can cause food poisoning and bloodstream infections.

E. coli is the most common cause of bloodstream infection, or bacteremia, in England, Livermore said in a phone interview. "Over the past 15 years, E. coli has become substantially more resistant to antibiotics and harder to treat," he added.

Researchers have known that superbug E. coli strains circulate in humans and food animals like chickens. But it was unclear if the bloodstream infections they cause are picked up from the food chain or passed between people.

To find out, the researchers performed genome sequencing on samples collected in 2013 and 2014 from people, animals and sewage in five areas: London, East Anglia, Northwest England, Scotland and Wales.

The samples they compared came from human bloodstream infections, human feces, animal slurry, as well as foods like beef, pork, chicken, fruits and vegetables.

DNA sequencing showed that antibiotic-resistant E. coli were often seen in sewage and on retail chicken meat, but rarely on other meats and never on plant-based foods.

In addition, samples of a particular antibiotic-resistant strain of E. coli called ST131 collected from human blood, feces and sewage all matched each other - but they didn't match strains in chicken, cattle and animal slurry.

"It tells us the problem in humans is the circulation of human-adapted, resistant E. coli and not infections coming down the food chain. At least, in this particular case," Livermore explained.

"I would say one caveat was (our) study relates to the here and now," Livermore said. "Resistant E. coli in the future could be food chain-related."

"It is important to practice good food safety practices, but the study demonstrates good hand hygiene to prevent transmission is by far the most important," said Dr Tamar Barlam, chief of infectious diseases and director of the Antimicrobial Stewardship Program at Boston Medical Center, who wasn't involved in the study.

Both Livermore and Barlam noted that careful hygiene is especially important in homes for the elderly, as most of the severe E. coli urinary tract infections and bacteremias occur in those settings.

"Nursing facilities serve as reservoirs for antibiotic-resistant bacteria, and their residents may need help with hygiene while using the toilet or may have urinary catheters," Barlam said.

© (c) Copyright Thomson Reuters 2019.

©2019 GPlusMedia Inc.

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Regular handwashing and other hygiene and sanitation measures are the number one defense against contracting diseases.

5 ( +5 / -0 )

The computer keyboard is very much an item of neglect when it comes to hygiene some people's board have more virus than a toilet seat. At my last job in the UK I worked for the No1 telecommunication company and was responsible to resting and taking care of many thousands of computers. Would never touch them with my bare hands and always wiped them with a medical wipe. Washed my hands when I got back to my shop.

Hand hygiene is very import. I wash my hand s many times in a single day. When I enter I kitchen I wash my hands first. My wife the same. Returning home the first action is washing hands and gargling too. Entering and leaving hospitals too.

When out and about don't touch your eyes or mouth with your fingers.

6 ( +7 / -1 )

I don't know about the rest of Japan, but in Tohoku many toilet facilities, especially JR ones, lack soap. A major sanitation fail.

Add "setsuden" to the mix, hand dryers blasting cold air, washets squirting freezing water up people's behinds - and you can see that hygene is not really taken seriously in Japan.

5 ( +6 / -1 )

It's a serious issue even in Japan.

Just this morning, I went to use a public restroom. Some guy flushes in a toilet stall, comes out and walks right out of the restroom. Must be nice to have sh!t so clean you can wash your hands with it! /sarcasm

7 ( +7 / -0 )

Poor hand hygiene....

Tell me about it. I have seen a guy in fancy suite come out from a stall without even washing his hands. That's why I try to avoid hand shake if at all possible.

6 ( +6 / -0 )

Saw something this week that in USA aprox 2/3 men and 1/3 of women do not wash hands on existing the restrooms. Disgusting to say the least.

Still think it is unusual that in so many restrooms (JR/parks etc) there is no soap at all and many are just cold water. No towels as we all know.

For a country that invented washlets, heated seats and all kinds of great shower/tub facilities, it is amazing that they are so far behind the times in hand washing.

5 ( +5 / -0 )

Handwashing and the hygiene etiquette consciousness is seriously lacking in Japan. It mystifies me because so much attention is given to washlets or face masks or removing shoes but almost none to coughing and sneezing into the air or into one's hands and touching all sorts of surfaces touched by others with impunity.

I've witnessed those who do "wash" their hands dampen and flink their fingers before drying them in a towel carried in a purse or pocket. Brilliant. Doing so gives the offending bacteria a breeding ground. And the "good news" is that there are more of those under the fingernails than on toilet seats.

Though soap and water are the better anti-bacterial measure, I carry individually wrapped, sanitizing hand wipes and scrub hard with them when other options do not exist. The key is scrubbing as that's what dislodges and kills the bacteria.

It only takes one person to infect hundreds when handling mass-produced food or spread contagion. Or when helping themselves from the cases of deli-foods at the supermarket, or the cutlery, chopsticks or toothpicks commonly found in restaurants. That, for me, is a much greater "ew" factor than removing my shoes.

Zichi is correct. We also need to properly clean our phones and computer keyboards.

2 ( +2 / -0 )

Not washing your hands is bad enough, but even worse are those who dangle their fingerstips under a dribble of cold water and THINK they have washed their hands.

1 ( +1 / -0 )

Nippori Nick,

Believe it or not, Japan did not invent the Washlet - they did buy the patent off the US inventor though.

0 ( +0 / -0 )

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