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. 2023 Jun;86(6):100074.
doi: 10.1016/j.jfp.2023.100074. Epub 2023 Apr 7.

Foodborne Outbreak of Extended Spectrum Beta-lactamase Producing Shigella sonnei Associated with Contaminated Spring Onions in the United Kingdom

Claire Jenkins  1 , Philippa Griffith  2 , Ann Hoban  3 , Claire Brown  4 , Joanna Garner  4 , Megan Bardsley  4 , Caroline Willis  5 , Frieda Jorgensen  5 , Matthew Bird  3 , David R Greig  3 , Matt Edmunds  4 , Charles Beck  4 , Lesley Larkin  3 ; Incident Management Team
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Foodborne Outbreak of Extended Spectrum Beta-lactamase Producing Shigella sonnei Associated with Contaminated Spring Onions in the United Kingdom

Claire Jenkins et al. J Food Prot. 2023 Jun.

Abstract

Globalization of the food supply chain has created conditions favorable for emergence and spread of multidrug-resistant (MDR) foodborne pathogens. In November 2021, the UK Health Security Agency detected an outbreak of 17 cases infected with the same strain of MDR extended spectrum beta-lactamase (ESBL)-producing Shigella sonnei. Phylogenetic analysis of whole-genome sequencing data revealed the outbreak was closely related to strains of S. sonnei isolated from travelers returning to the UK from Egypt. None of the outbreak cases reported travel and all 17 cases reported eating food from a restaurant/food outlet in the week prior to symptom onset, of which 11/17 (64.7%) ate at branches of the same national restaurant franchise. All 17 cases were adults and 14/17 (82.4%) were female. Ingredient-level analyses of the meals consumed by the cases identified spring onions as the common ingredient. Food chain investigations revealed that the spring onions served at the implicated restaurants could be traced back to a single Egyptian producer. The foodborne transmission of ESBL-producing bacteria is an emerging global health concern, and concerted action from all stakeholders is required to ensure an effective response to mitigate the risks to public health.

Keywords: Extended spectrum beta-lactamase; Food of nonanimal origin; Foodborne shigellosis; Shigella sonnei.

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Conflict of interest statement

Declaration of Competing Interest The authors declare that they have no known competing financial interests or personal relationships that could have appeared to influence the work reported in this paper.

Figures

Figure 1
Figure 1
Number of confirmed cases of S. sonnei t5.2559 by sample date (n = 17).
Figure 2
Figure 2
Age and sex distribution of the confirmed cases of S. sonnei t5.2559 (n = 17).
Figure 3
Figure 3
Geographical distribution of the confirmed cases of S. sonnei t5.2559 (n = 17).
Figure 4
Figure 4
Food chain supply lines showing that three of the implicated restaurants sourced spring onions from the same Egyptian producer.
Figure 5
Figure 5
Phylogenetic analysis of the outbreak cluster (highlighted in red) in the context of the most closely related sequences (within a 25 SNP single linkage cluster) in the UKHSA archive. Annotations include the short-read accession number (SRR number), region of residence in the UK, presence of blaCTX-M variants and travel destination if stated.
Figure 6
Figure 6
BRIG representation of the 77kbp IncFII plasmid highlighting the location of blaCTX-M-15 and qnrS1 in red.
See this image and copyright information in PMC

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