Intestinal bacterial and parasitic infections among food handlers in a tertiary care hospital of North India.

BACKGROUND: Intestinal infection is still an important public health problem in developing countries like India. Food handlers may be infected by a wide range of enteropathogens and have been implicated in the transmission of many infections to the public in the community and to patients in hospitals. AIM: To study the presence of enteropathogenic bacteria and parasites in food handlers working in the food service establishments of a tertiary care centre in North India. METHOD: The stool samples received from food handlers during January 2001 to December 2006 were examined by wet mount, iodine mount and modified acid fast staining directly and after formol ether concentration technique for parasites. For enteropathogenic bacteria, samples were inoculated onto MacConkey's agar, Deoxycholate Citrate Agar, Xylose Lysine Deoxycholate agar (XLD) as per the WHO protocol. RESULTS: During the years 2001-2006 respectively, 8.75%, 16%, 1.4%, 6.75%, 2.56% and 6.75% food handlers were infected with enteropathogens. The parasitic infections in our study were 1.3 to 7% while the enteropathogenic bacteria were reported from 0% to 13.3% during the years 2001-6. Giardia was the most common parasite while Shigella was the most common bacteria isolated from food handlers. During the year 2001, there was an outbreak of ETEC in the neonatal ICU, Advanced Paediatric Centre, PGIMER, which was traced back to a food handler involved in the preparation of the milk feed. CONCLUSION: Routine screening of food handlers is a valuable tool for prevention of nosocomial food-borne infections.