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Not washing your hands after going to the bathroom helps the transmission of an E. coli superbug, even more than consuming undercooked meat or food, new U.K. research has found.

A study published Tuesday in the Lancet found the likeliest way for antibiotic-resistant E. coli to spread is directly from human to human with one person’s fecal particles reaching the mouth of another.

Dr. David Livermore, the study’s lead author and professor of medical microbiology at the University of East Anglia, said in a statement that E. coli bacteria normally live in the intestines of healthy people and animals and are often harmless or cause brief diarrhea.

“But E. coli is also the most common cause of blood poisoning, with over 40,000 cases each year in England alone. And around 10 per cent of these cases are caused by highly resistant strains with ESBLs,” he said.

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Extended-spectrum beta-lactamases (ESBLs) are enzymes produced by bacteria, including E. coli, the U.K.’s National Health Service says.

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E. coli strains with ESBLs break down commonly used antibiotics, like penicillin and cephalosporin, making them ineffective for treatment, a Canadian governmental health organization points out.

While these bacteria are normally found in human feces, they can cause serious illness if they enter another part of the body, including the urinary tract or mouth.

“Infections caused by ESBL-E. coli bacteria are difficult to treat,” Livermore said. “And they are becoming more common in both the community and hospitals. Mortality rates among people infected with these superbug strains are double those of people infected with strains that’re susceptible to treatment.”

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Other research shows that ESBL-producing E. coli can cause complicated upper urinary tract infections.

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The researchers analyzed more than 20,000 fecal samples and hundreds of blood samples. They discovered the E. coli strain ST131 dominated in human blood, feces and sewage samples.

What’s more, they found different E. coli strains were more common in animal meat and slurry.

“Resistant E. coli strains from meat, principally chicken, cattle and animal slurry, were largely different to those infecting humans,” the researchers wrote in a statement.

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“ST131 was scarcely seen. Instead, strains ST23, 117 and ST602 dominated. In short, there was little crossover of ESBL-E. coli from animals to humans.”

Livermore and his research team say that in order to prevent the transmission of treatment-resistant E. coli, it is important for people to practise proper hand-washing.

People should still engage in safe food handling and eating habits, too.

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“We need to carry on cooking chicken well and never alternately handle raw meat and salad,” Livermore said.

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“There are plenty of important food-poisoning bacteria, including other strains of E. coli, that do go down the food chain.

But here — in the case of ESBL-E. coli — it’s much more important to wash your hands after going to the toilet.”

Laura.Hensley@globalnews.ca