Bactérie Escherichia coli dans des pizzas Buitoni : un pathovar particulier responsable de syndromes hémolytiques et urémiques (SHU)
Escherichia coli (E. coli) est une bactérie qui colonise les tractus digestifs des êtres humains et des animaux dès la naissance et qui fait partie du microbiote intestinal. Certaines souches de E. coli sont pathogènes, parmi lesquelles, les souches dites entérohémorragiques (EHEC pour Entero Hemorragic E. coli). Ces souches bactériennes ont la capacité de produire dans l’intestin une toxine que l’on appelle Shigatoxine (Stx). On peut ainsi aussi dénommer les EHEC comme des STEC pour Shigatoxin-producing E. coli. Cette toxine va diffuser dans l’organisme et cibler préférentiellement les cellules endothéliales qui tapissent les vaisseaux sanguins. Alors elle peut entrainer la mort de ces cellules, à l’origine des symptômes les plus graves observés : syndrome hémolytique et urémique (SHU), principalement chez le jeune enfant, ou microangiopathie thrombotique (MAT) chez l’adulte, voire une encéphalopathie, engageant ainsi le pronostic vital.
Le principal réservoir de ces bactéries est le tractus digestif des ruminants (vache, mouton…), mais la bactérie peut aussi être en portage asymptomatique chez l’être humain. On se contamine par voie orale en ingérant des aliments ou en buvant de l’eau contaminés par ces bactéries pathogènes et également (pour les plus jeunes) en mettant ses doigts souillés dans la bouche. Chez le jeune enfant, la dose infectieuse peut-être de moins de 500 bactéries quand on sait que l’on peut trouver plusieurs millions de ces bactéries dans un gramme de matière fécale.
Pour tous, il est recommandé de se laver les mains après être allé aux toilettes, mais aussi avant la préparation et la prise des repas. Pour les populations sensibles (en particulier les enfants), il est recommandé de bien cuire à cœur (70°C) les viandes hachées et les produits à base de viande hachée et d’éviter la consommation de lait cru (potentiellement contaminé par les féces des ruminants) et de produits au lait cru (à l’exception des fromages à pâte pressée cuite). Les légumes, mais aussi les fruits et les herbes aromatiques, en particulier ceux qui vont être consommés crus, doivent être soigneusement lavés.
La présence d’EHEC dans des pizzas congelées n’avait pas été rapportée jusqu’à présent. Les investigations en cours devraient permettre de déterminer l’origine de la contamination et d’émettre de nouvelles recommandations quant à la fabrication et/ou à la consommation de ce type de produit.
Inserm U1220-INRAE U1416-ENVT-Université de Toulouse
Pour en savoir plus :
https://www.santepubliquefrance.fr/maladies-et-traumatismes/maladies-infectieuses-d-origine-alimentaire/syndrome-hemolytique-et-uremique-pediatrique/documents/article/e.-coli-producteurs-de-shigatoxines-stec-definitions-virulence-et-proprietes-des-souches-enterohemorragiques-ehec
https://www.anses.fr/fr/content/les-escherichia-coli-ent%C3%A9roh%C3%A9morragiques-ehec
https://www.pasteur.fr/fr/sante-publique/CNR/les-cnr/escherichia-coli-shigella-salmonella/la-maladie-recommandations
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