In general, foodborne diseases present themselves with gastrointestinal symptoms caused by bacterial, viral, and parasitic pathogens well established to be foodborne. These pathogens are also associated with extraintestinal clinical manifestations. Recent studies have suggested that Escherichia coli and Klebsiella pneumoniae, which both cause common extraintestinal infections such as urinary tract and bloodstream infections, may also be foodborne. The resolution and separation of these organisms into pathotypes versus commensals by modern genotyping methods have led to the identification of key lineages of these organisms causing outbreaks of extraintestinal infections. These epidemiologic observations suggested common- or point-source exposures, such as contaminated food. Here, we describe the spectrum of extraintestinal illnesses caused by recognized enteric pathogens and then review studies that demonstrate the potential role of extraintestinal pathogenic E. coli (ExPEC) and K. pneumoniae as foodborne pathogens. The impact of global food production and distribution systems on the possible foodborne spread of these pathogens is discussed. Expected final online publication date for the Annual Review of Food Science and Technology, Volume 11 is March 25, 2020. Please see http://www.annualreviews.org/page/journal/pubdates for revised estimates.

中文翻译：

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肠外食源性病原体。

一般来说，食源性疾病会出现由细菌、病毒和寄生病原体引起的胃肠道症状，这些病原体已经确定为食源性。这些病原体也与肠外临床表现有关。最近的研究表明，大肠埃希菌和肺炎克雷伯菌均会引起尿路和血流感染等常见的肠外感染，它们也可能是食源性的。通过现代基因分型方法将这些生物体分解和分离为致病型与共生体，已导致鉴定这些生物体的关键谱系，从而导致肠外感染的爆发。这些流行病学观察表明存在共同源或点源暴露，例如受污染的食物。这里，我们描述了由公认的肠道病原体引起的一系列肠外疾病，然后回顾了证明肠外致病性大肠杆菌 (ExPEC) 和肺炎克雷伯菌作为食源性病原体的潜在作用的研究。讨论了全球食品生产和分配系统对这些病原体可能的食源性传播的影响。《食品科学与技术年度评论》第 11 卷的预计最终在线出版日期为 2020 年 3 月 25 日。请参阅 http://www.annualreviews.org/page/journal/pubdates 了解修订后的估计值。讨论了全球食品生产和分配系统对这些病原体可能的食源性传播的影响。《食品科学与技术年度评论》第 11 卷的预计最终在线出版日期为 2020 年 3 月 25 日。请参阅 http://www.annualreviews.org/page/journal/pubdates 了解修订后的估计值。讨论了全球食品生产和分配系统对这些病原体可能的食源性传播的影响。《食品科学与技术年度评论》第 11 卷的预计最终在线出版日期为 2020 年 3 月 25 日。请参阅 http://www.annualreviews.org/page/journal/pubdates 了解修订后的估计值。