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1992: Pinner R W; Schuchat A; Swaminathan B; Hayes P S; Deaver K A; Weaver R E; Plikaytis B D; Reeves M; Broome C V; Wenger J D
Role of foods in sporadic listeriosis. II. Microbiologic and epidemiologic investigation. The Listeria Study Group.
JAMA : the journal of the American Medical Association 1992;267(15):2046-50.
OBJECTIVE--To evaluate the role of foods in sporadic listeriosis. DESIGN--Microbiologic survey of foods collected from refrigerators of patients with listeriosis identified through active laboratory-based surveillance. Patient and food Listeria monocytogenes isolates were subtyped to identify foods contaminated with the same strain of L monocytogenes that caused illness in the patient; samples of these foods were obtained from the retail source. SETTING--Multistate population-based study conducted between 1988 and 1990. RESULTS--Listeria monocytogenes grew from at least one food specimen in the refrigerators of 79 (64%) of 123 listeriosis patients; 11% of more than 2000 food specimens collected in the study contained L monocytogenes. Twenty-six (33%) of 79 refrigerators with foods that grew L monocytogenes contained at least one food isolate of the same strain as that in the corresponding patient, a frequency much higher than would be expected by chance (P less than .001). Multivariate analysis showed that of the food specimens that grew L monocytogenes, foods that were ready-to-eat, foods that grew L monocytogenes by a direct-plating method (a measure of the level of contamination), and foods that contained serotype 4b isolates were independently associated with an increased likelihood of containing the patient-matching strain. CONCLUSION--We identified specific food and L monocytogenes isolate characteristics--ready-to-eat foods, foods containing higher concentrations of L monocytogenes, and foods containing serotype 4b--which were associated with disease-causing strains. These results can provide guidance to industry and regulatory agencies in developing strategies to prevent listeriosis.

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