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Stagg HR, Bothamley GH, Davidson JA, Kunst H, Lalor MK, Lipman MC, Loutet MG, Lozewicz S, Mohiyuddin T, Abbara A, Alexander E, Booth H, Creer DD, Harris RJ, Kon OM, Loebinger MR, McHugh TD, Milburn HJ, Palchaudhuri P, Phillips PPJ, Schmok E, Taylor L, Abubakar I. Fluoroquinolones and isoniazid-resistant tuberculosis: implications for the 2018 WHO guidance. Eur Respir J 2019; 54:13993003.00982-2019. [PMID: 31371444 PMCID: PMC6785706 DOI: 10.1183/13993003.00982-2019] [Citation(s) in RCA: 9] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/15/2019] [Accepted: 07/01/2019] [Indexed: 01/15/2023]
Abstract
Introduction 2018 World Health Organization (WHO) guidelines for the treatment of isoniazid (H)-resistant (Hr) tuberculosis recommend a four-drug regimen: rifampicin (R), ethambutol (E), pyrazinamide (Z) and levofloxacin (Lfx), with or without H ([H]RZE-Lfx). This is used once Hr is known, such that patients complete 6 months of Lfx (≥6[H]RZE-6Lfx). This cohort study assessed the impact of fluoroquinolones (Fq) on treatment effectiveness, accounting for Hr mutations and degree of phenotypic resistance. Methods This was a retrospective cohort study of 626 Hr tuberculosis patients notified in London, 2009–2013. Regimens were described and logistic regression undertaken of the association between regimen and negative regimen-specific outcomes (broadly, death due to tuberculosis, treatment failure or disease recurrence). Results Of 594 individuals with regimen information, 330 (55.6%) were treated with (H)RfZE (Rf=rifamycins) and 211 (35.5%) with (H)RfZE-Fq. The median overall treatment period was 11.9 months and median Z duration 2.1 months. In a univariable logistic regression model comparing (H)RfZE with and without Fqs, there was no difference in the odds of a negative regimen-specific outcome (baseline (H)RfZE, cluster-specific odds ratio 1.05 (95% CI 0.60–1.82), p=0.87; cluster NHS trust). Results varied minimally in a multivariable model. This odds ratio dropped (0.57, 95% CI 0.14–2.28) when Hr genotype was included, but this analysis lacked power (p=0.42). Conclusions In a high-income setting, we found a 12-month (H)RfZE regimen with a short Z duration to be similarly effective for Hr tuberculosis with or without a Fq. This regimen may result in fewer adverse events than the WHO recommendations. WHO has assessed regimen recommendations for isoniazid-resistant TB to be of very low certainty. The addition of fluoroquinolones to a 12-month (isoniazid, rifamycin, ethambutol, short-duration pyrazinamide) regimen may be unnecessary in certain settings.http://bit.ly/2XoTgNL
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Lipworth S, Hough N, Buchanan R, Smith EG, Robinson E, Alexander E, Peto T, Crook D, Walker T. Improved Performance Predicting Clarithromycin Resistance in Mycobacterium abscessus on an Independent Data Set. Antimicrob Agents Chemother 2019; 63:e00400-19. [PMID: 31160290 PMCID: PMC6658746 DOI: 10.1128/aac.00400-19] [Citation(s) in RCA: 8] [Impact Index Per Article: 1.6] [Reference Citation Analysis] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/16/2022] Open
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Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Long-term retention in an employer-based, commercial weight-loss programme. Clin Obes 2019; 9:e12284. [PMID: 30248246 DOI: 10.1111/cob.12284] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 06/11/2018] [Revised: 08/05/2018] [Accepted: 08/28/2018] [Indexed: 01/14/2023]
Abstract
The aim of this study is to examine factors associated with long-term retention in a commercial weight-loss programme. We conducted a retrospective analysis of an employer-based, commercial programme from 2013 to 2016. Our dependent variable was 'long-term retention', defined as continuously enrolled participants who actively engaged through coach calls at 6 and 12 months. Independent variables included baseline demographics, programme engagement and weight change. We conducted multivariate logistic regression analyses assessing for differences in long-term retention by several factors, adjusted for employer clustering. Overall, 68.3% were retained at 6% and 45.9% at 12 months. Greater number of coach calls and website logins during the first 3 months significantly increased the odds of long-term retention, while having chronic conditions significantly decreased the odds. Weight-loss success (≥5% loss at 6 months) was significantly associated with increased odds of retention (12-month: odds ratio [OR] 2.80, P < 0.001), while early weight-loss failure (≥0% weight change at 1 month) significantly decreased odds of retention (12-month: OR 0.66, P = 0.008). In an employer-based, commercial weight loss programme, greater early programme engagement was associated with long-term retention. Given these programmes' popularity and potential reach, our results could be used to develop and test strategies designed to improve retention in commercial weight-loss programmes.
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Alexander E, Tseng E, Durkin N, Jerome GJ, Dalcin A, Appel LJ, Clark JM, Gudzune KA. Factors associated with early dropout in an employer-based commercial weight-loss program. Obes Sci Pract 2018; 4:545-553. [PMID: 30574348 PMCID: PMC6298204 DOI: 10.1002/osp4.304] [Citation(s) in RCA: 13] [Impact Index Per Article: 2.2] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/25/2018] [Revised: 09/20/2018] [Accepted: 09/22/2018] [Indexed: 01/14/2023] Open
Abstract
OBJECTIVE Minimizing program dropout is essential for weight-loss success, but factors that influence dropout among commercial programs are unclear. This study's objective was to determine factors associated with early dropout in a commercial weight-loss program. METHODS A retrospective analysis of a remotely delivered, employer-based commercial program from 2013 to 2016 was conducted. The dependent variable was 'early dropout', defined as enrollees who disengaged from telephone coaching by month 2's end. Independent variables included demographics, program website engagement and early weight change. Multivariate logistic regression analyses were used to assess for differences in early dropout by several factors, adjusted for employer clustering. RESULTS Of the 5,274 participants, 26.8% dropped out early. Having ≥1 chronic condition (odds ratio [OR] 1.41, p < 0.001) and 'weight-loss failure' defined as ≥0% weight change at month 1's end (OR 1.86, p < 0.001) had significantly increased odds of early dropout. Increasing age by 10-year intervals (OR 0.90, p = 0.002) and 'meeting the website login goal' defined as ≥90 logins in 3 months (OR 0.13, p < 0.001) significantly decreased the odds of early dropout. CONCLUSIONS Presence of comorbidities, less online engagement and weight-loss failure were associated with early dropout in a commercial program. Strategies to prevent dropout among high-risk participants, such as increased support or program tailoring, should be developed and tested.
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Buchanan R, Alexander E. Drug susceptibility of non-tuberculous mycobacteria in East London: A four year retrospective review. J Infect 2018; 77:349-356. [PMID: 30081069 DOI: 10.1016/j.jinf.2018.07.016] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/23/2018] [Revised: 07/27/2018] [Accepted: 07/31/2018] [Indexed: 10/28/2022]
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Scriven JE, Scobie A, Verlander NQ, Houston A, Collyns T, Cajic V, Kon OM, Mitchell T, Rahama O, Robinson A, Withama S, Wilson P, Maxwell D, Agranoff D, Davies E, Llewelyn M, Soo SS, Sahota A, Cooper MA, Hunter M, Tomlins J, Tiberi S, Kendall S, Dedicoat M, Alexander E, Fenech T, Zambon M, Lamagni T, Smith EG, Chand M. Mycobacterium chimaera infection following cardiac surgery in the United Kingdom: clinical features and outcome of the first 30 cases. Clin Microbiol Infect 2018; 24:1164-1170. [PMID: 29803845 DOI: 10.1016/j.cmi.2018.04.027] [Citation(s) in RCA: 46] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/05/2018] [Revised: 04/22/2018] [Accepted: 04/24/2018] [Indexed: 12/25/2022]
Abstract
OBJECTIVES Mycobacterium chimaera infection following cardiac surgery, due to contaminated cardiopulmonary bypass heater-cooler units, has been reported worldwide. However, the spectrum of clinical disease remains poorly understood. To address this, we report the clinical and laboratory features, treatment and outcome of the first 30 UK cases. METHODS Case note review was performed for cases identified retrospectively through outbreak investigations and prospectively through ongoing surveillance. Case definition was Mycobacterium chimaera detected in any clinical specimen, history of cardiothoracic surgery with cardiopulmonary bypass, and compatible clinical presentation. RESULTS Thirty patients were identified (28 with prosthetic material) exhibiting a spectrum of disease including prosthetic valve endocarditis (14/30), sternal wound infection (2/30), aortic graft infection (4/30) and disseminated (non-cardiac) disease (10/30). Patients presented a median of 14 months post surgery (maximum 5 years) most commonly complaining of fever and weight loss. Investigations frequently revealed lymphopenia, thrombocytopenia, liver cholestasis and non-necrotizing granulomatous inflammation. Diagnostic sensitivity for a single mycobacterial blood culture was 68% but increased if multiple samples were sent. In all, 27 patients started macrolide-based combination treatment and 14 had further surgery. To date, 18 patients have died (60%) a median of 30 months (interquartile range 20-39 months) after initial surgery. Survival analysis identified younger age, mitral valve surgery, mechanical valve replacement, higher serum sodium concentration and lower C-reactive protein as factors associated with better survival. CONCLUSIONS Mycobacterium chimaera infection following cardiac surgery is associated with a wide spectrum of disease. The diagnosis should be considered in all patients who develop an unexplained illness following cardiac surgery.
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Alexander E, Nadolski G, Soulen M, Stavropoulos S, Hunt S, Gade T, Itkin M, Shamimi-Noori S. 4:21 PM Abstract No. 270 Iatrogenic celiac axis and hepatic artery dissections during intra-arterial regional tumor therapies: a 16-year retrospective review. J Vasc Interv Radiol 2018. [DOI: 10.1016/j.jvir.2018.01.301] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/17/2022] Open
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Alexander E, Fryhofer G, Nadolski G, Mondschein J, Stavropoulos S, Soulen M, Alexander E. Combined chemoembolization and thermal ablation for the treatment of metastases to the liver. J Vasc Interv Radiol 2017. [DOI: 10.1016/j.jvir.2016.12.1119] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/20/2022] Open
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Rumble C, Addiman S, Balasegaram S, Chima K, Ready D, Heard J, Alexander E. Role of Food Handlers in Norovirus Outbreaks in London and South East England, 2013 to 2015. J Food Prot 2017; 80:257-264. [PMID: 28221985 DOI: 10.4315/0362-028x.jfp-16-083] [Citation(s) in RCA: 7] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/11/2022]
Abstract
Outbreaks caused by norovirus infection are common and occur throughout the year. Outbreaks can be related to food outlets either through a contaminated food source or an infected food handler. Both asymptomatic and symptomatic food handlers are potentially implicated in outbreaks, but evidence of transmission is limited. To understand potential food handler transmission in outbreak scenarios, epidemiological and microbiological data on possible and confirmed norovirus outbreaks reported in London and South East England in a 2-year period were reviewed. One hundred eighty-six outbreaks were associated with a food outlet or registered caterer in this period. These occurred throughout the year with peaks in quarter 1 of study years. A case series of 17 outbreaks investigated by the local field epidemiological service were evaluated further, representing more than 606 cases. In five outbreaks, symptomatic food handlers were tested and found positive for norovirus. In four outbreaks, symptomatic food handlers were not tested. Asymptomatic food handlers were tested in three outbreaks but positive for norovirus in one only. Environmental sampling did not identify the causative agent conclusively in any of the outbreaks included in this analysis. Food sampling identified norovirus in one outbreak. Recommendations from this study include for outbreak investigations to encourage testing of symptomatic food handlers and for food and environmental samples to be taken as soon as possible. In addition, sampling of asymptomatic food handlers should be considered when possible. However, in light of the complexity in conclusively identifying a source of infection, general measures to improve hand hygiene are recommended, with specific education among food handlers about the potential for foodborne pathogen transmission during asymptomatic infection, as well as reinforcing the importance of self-exclusion from food handling activities when symptomatic.
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Cresswell FV, Ross S, Booth T, Pinto-Sander N, Alexander E, Bradley J, Paul J, Richardson D. Shigella flexneri: A Cause of Significant Morbidity and Associated With Sexually Transmitted Infections in Men Who Have Sex With Men. Sex Transm Dis 2016; 42:344. [PMID: 25970314 DOI: 10.1097/olq.0000000000000295] [Citation(s) in RCA: 14] [Impact Index Per Article: 1.8] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
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Loeffler JS, Alexander E. Radiosurgery in the definitive management of CNS malignancies. FRONTIERS OF RADIATION THERAPY AND ONCOLOGY 2015; 27:227-44. [PMID: 8389307 DOI: 10.1159/000422095] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 01/30/2023]
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Alexander E, McNair H, Landeg S, Hansen V, Dearnaley D. Initial Results of a Prospective Clinical Trial Examining a Novel Rectal Obturator to Localise the Prostate and Spare the Rectum during Radical Prostate Radiotherapy. Clin Oncol (R Coll Radiol) 2014. [DOI: 10.1016/j.clon.2013.11.006] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/25/2022]
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Alexander E, Holtmann-Rice D, Zucker S. When Shading Flows With Color: Grounding Shape and Material Inference. J Vis 2013. [DOI: 10.1167/13.9.257] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Holtmann-Rice D, Alexander E, Fleming R, Zucker S. When Color Flows With Shading: making depth disappear. J Vis 2013. [DOI: 10.1167/13.9.467] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.2] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022] Open
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Buettner F, Alexander E, McNair H, Bulbrook L, Gulliford S, Partridge M, Dearnaley D. SU-E-T-255: A Novel Rectal Obturator for Prostate Radiotherapy Improves the Spatial Distribution of Dose and Reduces the Predicted Risk for Rectal Bleeding and Subjective Sphincter Control. Med Phys 2012; 39:3762. [PMID: 28517352 DOI: 10.1118/1.4735322] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/07/2022] Open
Abstract
PURPOSE To investigate the effects of an endorectal device during prostate radiotherapy on the spatial distribution of dose to the ano-rectal region and quantify implications for normal-tissue-complication probabilities. METHODS Twenty-three patients with localised prostate cancer, referred for external beam radiotherapy had 2 CT scans acquired, without and with the rectal obturator (ProSpare) in-situ. For each patient two dose distributions were generated, based on both CT scans. Dose-surface maps for the rectal surface and the anal surface were generated and mean dose as well as a spatial measure (circumference of the dose distribution) were determined for all patients, with and without ProSpare. Using previously published NTCP models, the effect of ProSpare on NTCP was investigated for rectal bleeding and subjective sphincter control. RESULTS In a previous study subjective sphincter control correlated strongest with mean dose and lateral extent at 53 Gy. The use of ProSpare resulted in a highly significant reduction of the lateral extent at 53 Gy (p=0.006), mean dose (p=0.0009) and NTCP according to the LKB model (p=0.002 for grade 2 and p=0.001 for grade >=1). In a previous study we reported that rectal bleeding correlated most strongly with the lateral extent at 55 Gy and presented the constraint that it should not exceed 42% of the circumference. Using ProSpare resulted in a significant reduction of the lateral extent at 55 Gy (p=0.001) and significantly more patients met that proposed constraint (p=0.047). ProSpare resulted in a significant reduction of NTCP for grade-2 rectal bleeding (p=0.007) and a reduction for rectal bleeding grade >=1 (p=0.053). CONCLUSIONS ProSpare resulted in a significant reduction of mean dose to the anal sphincter and a significant reduction of the lateral extent at 55 Gy. This corresponded to a significant reduction in the predicted risk of reporting subjective sphincter control and grade-2 rectal bleeding.
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Forde C, Alexander E, Thaler T, Martin N, Brunstrom J. Expectations of satiation and satiety are a better predictor of self-selected portion size than liking. Appetite 2011. [DOI: 10.1016/j.appet.2011.05.070] [Citation(s) in RCA: 5] [Impact Index Per Article: 0.4] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/24/2022]
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Alexander E, Yach D, Mensah GA. P1-126 Nutrition needs to develop effective measurement policies. Br J Soc Med 2011. [DOI: 10.1136/jech.2011.142976d.19] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
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Talbot BEM, Webster D, Fisher M, Alexander E. High-dose amoxicillin should be included in the empirical treatment of suspected meningitis in patients at risk of HIV infection. BMJ Case Rep 2011; 2011:bcr.04.2011.4057. [PMID: 22696737 DOI: 10.1136/bcr.04.2011.4057] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022] Open
Abstract
The authors report on a case of Listeria rhomboencepahlitis in a previously undiagnosed HIV positive man. This case is of interest as the incidence of Listeria has increased dramatically in recent years and so may increase in the HIV-infected population. The organism is inherently resistant to cephalosporin antibiotics, empirically employed in the treatment of central nervous system infections and thus highlights the need to include amoxicillin in meningitis treatment regimes in patients at risk of HIV infection as well as the older and those known to be immuno-compromised.
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McNair H, Kavanagh A, Alexander E, Eagle S, Ingram W, South C, Evans P, Dearnaley D. 1249 poster IMPLEMENTATION OF AN ELECTROMAGNETIC TRACKING SYSTEM FOR PATIENTS RECEIVING RADIOTHERAPY TO THE PROSTATE. Radiother Oncol 2011. [DOI: 10.1016/s0167-8140(11)71371-8] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 10/18/2022]
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Graupner V, Alexander E, Overkamp T, Rothfuss O, De Laurenzi V, Gillissen BF, Daniel PT, Schulze-Osthoff K, Essmann F. Differential regulation of the proapoptotic multidomain protein Bak by p53 and p73 at the promoter level. Cell Death Differ 2011; 18:1130-9. [PMID: 21233848 DOI: 10.1038/cdd.2010.179] [Citation(s) in RCA: 54] [Impact Index Per Article: 4.2] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/09/2022] Open
Abstract
During apoptosis Bcl-2 proteins control permeabilization of the mitochondrial outer membrane leading to the release of cytochrome c. Essential gatekeepers for cytochrome c release are the proapoptotic multidomain proteins, Bax, and Bak. The expression of Bax is upregulated upon cellular stress by the tumor suppressor p53. Despite the high functional homology of Bax and Bak, little is known about how the bak gene is regulated. To investigate its transcriptional regulation in further detail, we have analyzed a region spanning 8200 bp upstream of the bak start codon (within exon 2) for transcription factor-binding sites, and identified three p53 consensus sites (BS1-3). Reporter gene assays in combination with site-directed mutagenesis revealed that only one putative p53-binding site (BS3) is necessary and sufficient for induction of reporter gene expression by p53. Consistently, p53 induces expression of endogenous Bak. At the mRNA level, induction of Bak expression is weaker than induction of Puma and p21. Interestingly, Bak expression can also be induced by p73 that binds however to each of the three p53-binding sites within the bak promoter region. Our data suggest that expression of Bak can be induced by both, p53 and p73 utilizing different binding sites within the bak promoter.
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Park EJ, Alexander E, Taylor GA, Costa R, Kang DH. Effects of organic matter on acidic electrolysed water for reduction of foodborne pathogens on lettuce and spinach. J Appl Microbiol 2008; 105:1802-9. [PMID: 19120630 DOI: 10.1111/j.1365-2672.2008.03928.x] [Citation(s) in RCA: 22] [Impact Index Per Article: 1.4] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/29/2022]
Abstract
AIMS To evaluate the efficacy of acidic electrolysed water (EW) in the presence of organic matter (bovine serum) on the inoculated surfaces of lettuce and spinach. MATERIALS AND RESULTS Lettuce and spinach leaves were inoculated with a cocktail of three strains each of Escherichia coli O157:H7, Salmonella Typhimurium and Listeria monocytogenes and treated with deionized water, acidic EW and acidic EW containing bovine serum (5, 10, 15 and 20 ml l(-1)) for 15 s, 30 s, 1 min, 3 min and 5 min at room temperature (22 +/- 2 degrees C). In the absence of bovine serum, acidic EW treatment reduced levels of cells below the detection limit (0.7 log) in 5 min. In the presence of bovine serum, bactericidal activity of acidic EW decreased with increasing serum concentration. CONCLUSIONS Organic matter reduces the effectiveness of acidic EW for reducing pathogens on the surfaces of lettuce and spinach. SIGNIFICANCE AND IMPACT OF THE STUDY From a practical standpoint, organic matter reduces the efficacy of acidic EW. This study was conducted to confirm the effect of organic matter on the properties of acidic EW in the inactivation of foodborne pathogens on the surface of vegetables.
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Park EJ, Alexander E, Taylor GA, Costa R, Kang DH. Effect of electrolyzed water for reduction of foodborne pathogens on lettuce and spinach. J Food Sci 2008; 73:M268-72. [PMID: 19241556 DOI: 10.1111/j.1750-3841.2008.00809.x] [Citation(s) in RCA: 36] [Impact Index Per Article: 2.3] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Abstract
The ability of electrolyzed water (EW) to inactivate foodborne pathogens on the surfaces of lettuce and spinach was investigated. Lettuce and spinach leaves were inoculated with a cocktail of 3 strains each of Escherichia col O157:H7, Salmnonella Typhimurium, and Listeria monocytogenes and treated with acidic electrolyzed water (AC-EW), alkaline electrolyzed water (AK-EW), alkaline electrolyzed water followed by acidic electrolyzed water (sequential treatment, AK-EW + AC-EW), deionized water followed by acidic electrolyzed water (sequential treatment, DW + AC-EW), and deionized water (control, DW) for 15, 30 s, and 1, 3, and 5 min at room temperature (22 +/- 2 degrees C). For all 3 pathogens, the same pattern of microbial reduction on lettuce and spinach were apparent. The relative efficacy of reduction was AC-EW > DW + AC-EW approximately = AK-EW + AC-EW > AK-EW > control. After a 3-min treatment of AC-EW, the 3 tested pathogens were reduced below the detection limit (0.7 log). DW + AC-EW and AK-EW + AC-EW produced the same levels of reduction after 5 min when compared to the control. AK-EW did not reduce levels of pathogens even after a 5-min treatment on lettuce and spinach. Results suggest that AC-EW treatment was able to significantly reduce populations of the 3 tested pathogens from the surfaces of lettuce and spinach with increasing time of exposure.
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Park EJ, Alexander E, Taylor GA, Costa R, Kang DH. Fate of foodborne pathogens on green onions and tomatoes by electrolysed water. Lett Appl Microbiol 2008; 46:519-25. [PMID: 18416702 DOI: 10.1111/j.1472-765x.2008.02351.x] [Citation(s) in RCA: 33] [Impact Index Per Article: 2.1] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/27/2022]
Abstract
AIMS To investigate the efficacy of electrolysed water (EW) in killing Escherichia coli O157:H7, Salmonella typhimurium and Listeria monocytogenes on the surfaces of spot-inoculated green onions and tomatoes. METHODS AND RESULTS Green onions and tomatoes were inoculated with a cocktail of three strains each of E. coli O157:H7, Salm. typhimurium and L. monocytogenes and treated with acidic electrolysed water (AC-EW), alkaline electrolysed water (AK-EW), alkaline electrolysed water followed by acidic electrolysed water (AK-EW + AC-EW), deionized water followed by acidic electrolysed water (DW + AC-EW) and deionized water (control, DW) for 15 s, 30 s, 1 min, 3 min and 5 min at room temperature (22 +/- 2 degrees C). The relative efficacy of reduction was AC-EW > DW + AC-EW approximately AK-EW + AC-EW > AK-EW > DW. CONCLUSIONS Acidic EW treatment was able to significantly reduce populations of the three tested pathogens from the surfaces of green onions and tomatoes with increasing exposure time. SIGNIFICANCE AND IMPACT OF THE STUDY Rinsing in acidic EW reveals an effective method to control the presence of E. coli O157:H7, Salm. typhimurium and L. monocytogenes on the surfaces of fresh green onions and tomatoes, without affecting their organoleptic characteristics. This indicates its potential application for the decontamination of fresh produce surfaces.
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