Cephalosporin-resistant Escherichia coli among summer camp attendees with salmonellosis

Guillem Prats, Beatriz Mirelis, Elisenda Miró, Ferran Navarro, Teresa Llovet, James R. Johnson, Neus Camps, Angela Domínguez, Lluís Salleras

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38 Citations (Scopus)


Investigation of an acute gastroenteritis outbreak involving >100 persons at a summer camp in Girona, Spain, in June 2002 led to the detection of Salmonella enterica and extended-spectrum cephalosporin-resistant Escherichia coli (ESCREC). Stool cultures were performed for 22 symptomatic campers, three asymptomatic food handlers, and 10 healthy household members. Of the 22 campers, 19 had Salmonella enterica, 9 had an ESCREC strain carrying an extended-spectrum β-lactamase, and 2 had a second ESCREC strain carrying a plasmidic cephamycinase. Related ESCREC were detected in two (salmonella-negative) asymptomatic food handlers and in none of the healthy household members. Fecal ESCREC and its β-lactamases and plasmids were extensively characterized. Three of the five ESCREC clones were recovered from multiple hosts. The apparent dissemination of ESCREC suggests a food or water vehicle. The observed distribution of resistance plasmids and β-lactamase genes in several clones indicates a high degree of horizontal transfer. Heightened vigilance and increased efforts must be made to discover the reservoirs and vehicles for community dissemination of ESCREC.
Original languageEnglish
Pages (from-to)1273-1280
JournalEmerging Infectious Diseases
Issue number10
Publication statusPublished - 1 Oct 2003


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