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Risk Factors for Non-O157 Shiga Toxin–Producing Escherichia coli Infections, United States

by Marder, Ellyn P. , Richardson, LaTonia Clay , Comstock, Nicole , Griffin, Patricia M. , Cieslak, Paul R. , Cui, Zhaohui , Garman, Katie , Wilson, Siri , Vugia, Duc J. , Olson, Danyel , Bruce, Beau B. , McGuire, Suzanne , Lathrop, Sarah , Boyle, Michelle M. , Medus, Carlota

in Age / Animals / Antigens / bacteria / case-control / Case-Control Studies / Cattle / Diarrhea - epidemiology / Disease control / E coli / enteric infections / Epidemics / Escherichia coli / Escherichia coli infections / Escherichia coli Infections - epidemiology / Ethnicity / Fast food / Food / Food safety / Guardians / Illnesses / Infections / Infections, United States / International travel / Lettuce / Medical laboratories / Patients / Population / Public health / Questionnaires / Regression analysis / Restaurants / Risk Factors / Shiga toxin–producing Escherichia coli / Shiga-Toxigenic Escherichia coli / Statistics / STEC / Surveillance / Tomatoes / Toxins / United States - epidemiology

2023

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Risk Factors for Non-O157 Shiga Toxin–Producing Escherichia coli Infections, United States

2023

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2023

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Journal Article

Risk Factors for Non-O157 Shiga Toxin–Producing Escherichia coli Infections, United States

Marder, Ellyn P.,

Richardson, LaTonia Clay,

Comstock, Nicole,

Griffin, Patricia M.,

Cieslak, Paul R.,

Cui, Zhaohui,

Garman, Katie,

Wilson, Siri,

Vugia, Duc J.,

Olson, Danyel,

Bruce, Beau B.,

McGuire, Suzanne,

Lathrop, Sarah,

Boyle, Michelle M.,

Medus, Carlota

2023

Overview

Shiga toxin-producing Escherichia coli (STEC) causes acute diarrheal illness. To determine risk factors for non-O157 STEC infection, we enrolled 939 patients and 2,464 healthy controls in a case-control study conducted in 10 US sites. The highest population-attributable fractions for domestically acquired infections were for eating lettuce (39%), tomatoes (21%), or at a fast-food restaurant (23%). Exposures with 10%-19% population attributable fractions included eating at a table service restaurant, eating watermelon, eating chicken, pork, beef, or iceberg lettuce prepared in a restaurant, eating exotic fruit, taking acid-reducing medication, and living or working on or visiting a farm. Significant exposures with high individual-level risk (odds ratio >10) among those >1 year of age who did not travel internationally were all from farm animal environments. To markedly decrease the number of STEC-related illnesses, prevention measures should focus on decreasing contamination of produce and improving the safety of foods prepared in restaurants.

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Publisher

U.S. National Center for Infectious Diseases,Centers for Disease Control and Prevention

Subject

/ Animals

/ Case-Control Studies

/ Cattle