The value of proper handwashing, rather than a quick rinse under a running tap, after trips to the bathroom during a busy working day has been illustrated by new research which indicates that poor toilet hygiene, rather than undercooked chicken and pork, is the key factor behind the spread of deadly strains of E.coli superbugs.

These findings were recently shared in The Lancet Infectious Diseases by a consortium including the University of East Anglia which studied how antibiotic-resistant E. coli is spread.

According to the researchers, E. coli is a Jekyll and Hyde organism. We all harmlessly carry it in our gut, as do animals.

However, some E. coli strains cause food poisoning whereas others cause urinary tract infections (UTIs) as well as infections after gut surgery. At worst, these develop into bacteraemias — bloodstream infections.

E. coli has become considerably more antibiotic resistant over the past 20 years, both in humans and animals.

Particularly important are strains with enzymes that can destroy many important penicillin and cephalosporin antibiotics. Many of these strains often have other key resistances too.

Until now, it has not been known whether antibiotic-resistant E. coli that cause bloodstream infections are picked up through the food chain, or passed from person to person.

To answer this question, scientists sequenced the genomes of resistant E. coli from multiple sources across the UK — including from human bloodstream infections, human faeces, human sewerage, animal slurry and meat including beef, pork and chicken, and fruit and salad.

They found that antibiotic-resistant E. coli is more likely to be spread through poor toilet hygiene than undercooked chicken or other food.

Commenting on the findings Lead author Prof David Livermore, said: “We need to carry on cooking chicken well and never to alternately handle raw meat and salad. But … in the case of ESBL-E. coli … it's much more important to wash your hands after going to the toilet.”

The researchers added that good handwashing hygiene was particularly important in care homes to safeguard elderly residents’ health.

Last reviewed 25 October 2019