Description of Kinetic Behavior of Pathogenic Escherichia coli in Cooked Pig Trotters under Dynamic Storage Conditions Using Mathematical Equations

A dynamic model was developed to predict the Escherichia coli cell counts in pig trotters at changing temperatures. Five-strain mixture of pathogenic E. coli at 4 Log CFU/g were inoculated to cooked pig trotter samples. The samples were stored at 10°C, 20°C, and 25°C. The cell count data was analyzed with the Baranyi model to compute the maximum specific growth rate (μ_max) (Log CFU/g/h) and lag phase duration (LPD) (h). The kinetic parameters were analyzed using a polynomial equation, and a dynamic model was developed using the kinetic models. The model performance was evaluated using the accuracy factor (A_f), bias factor (B_f), and root mean square error (RMSE). E. coli cell counts increased (p<0.05) in pig trotter samples at all storage temperatures (10°C–25°C). LPD decreased (p<0.05) and μ_max increased (p<0.05) as storage temperature increased. In addition, the value of h₀ was similar at 10°C and 20°C, implying that the physiological state was similar between 10°C and 20°C. The secondary models used were appropriate to evaluate the effect of storage temperature on LPD and μ_max. The developed kinetic models showed good performance with RMSE of 0.618, B_f of 1.02, and A_f of 1.08. Also, performance of the dynamic model was appropriate. Thus, the developed dynamic model in this study can be applied to describe the kinetic behavior of E. coli in cooked pig trotters during storage.

Influence of milk microbiota on Listeria monocytogenes survival during cheese ripening

This study aimed to compare the three strains of Listeria monocytogenes survival in raw milk cheese and pasteurized milk cheese and to suggest the effect of milk microbiota on survival. L. monocytogenes cell counts decreased in all cheese as ripening time increased, and the survival rate was different for the strains of L. monocytogenes. Furthermore, L. monocytogenes survived longer in raw milk cheese than in pasteurized milk cheese. The difference of bacterial survival in each cheese was independent of Aw or the Lactobacillus spp. populations in cheeses; there was no difference in Aw or Lactobacillus spp. populations in all cheeses. The richness of microbiota in raw milk was little higher than in pasteurized milk, and five phyla (Chloroflexi, Cyanobacteria, Deinococcus-Thermus, Lentisphaerae, and Verrucomicrobia) were present only in raw milk. Also, organic acid-producing bacteria were presented more in pasteurized milk compared with raw milk; thus, the growth of L. monocytogenes was slower in pasteurized milk. In conclusion, differences in the microbial community of milk can affect the growth of L. monocytogenes. Making cheese using raw milk is a risk of L. monocytogenes infection; thus, efforts to prevent growth of L. monocytogenes such as the use of appropriate food additives are required.

The role of Pseudomonas aeruginosa DesB in pathogen-host interaction

Pseudomonas aeruginosa, commonly found in environments, can cause chronic lung disease in immunocompromised patients. In previous study, an aerobic desaturase (DesB) in P. aeruginosa exerted considerable effects on virulence factor production. The objective of this study was to analyze the role of DesB on the virulence traits of P. aeruginosa in the host. For the in vitro experiments, cells and supernatants from wild-type (WT) P. aeruginosa and its desB mutant were collected. The diluted cells were added to the A549 cell monolayer in order to determine cell viability, invasion ability, and/or immune response. For the in vivo experiments, 6-week-old ICR mice were infected with 6-7 log CFU bacterial cells using endotracheal intubation. The ratio of lung weight to body weight and survival rate of each bacterial strain in the lung were measured. The histopathology of lung tissue was also studied. desB mutants exhibited lower cytotoxicity in A549 cells. In addition, more pro-inflammatory cytokines and chemokines were present in desB mutant-treated. In the lungs of mouse model, WT survived longer than desB mutant, and the WT migrated from the lung to the liver and spleen. The results suggest that P. aeruginosa DesB affects the pathogenicity of the organism in the host.

Quantitative microbial risk assessment for Clostridium perfringens foodborne illness following consumption of kimchi in South Korea

The purpose of this study was to conduct a risk assessment for Clostridium perfringens foodborne illness via kimchi consumption in South Korea. Prevalence of C. perfringens in kimchi, kimchi consumption amount and frequency, and distribution conditions (time and temperature) from manufacture to the home were determined. C. perfringens initial contamination level was estimated using Beta distribution [Beta (6, 79)]. Potential C. perfringens cell counts during distribution were predicted using the Weibull model (primary models, R ² = 0.923-0.953) and a polynomial model [(δ = 1/(0.2385 + (- 0.0307 × Temp) + (0.0011 × Temp²)), R ² = 0.719]. Average daily consumption data was assessed using Gamma distribution [1.0444, 91.767, RiskShift (0.16895), RiskTruncate (0, 1078)]. The mean risk of C. perfringens-associated foodborne illness following kimchi consumption was found to be 1.21 × 10^-17. These results suggest that the risk of C. perfringens foodborne illness from kimchi consumption, under current conditions, can be considered to be very low in S. Korea.

Transplant outcomes in kidney recipients with lupus nephritis, and systematic review

Background

Despite improved survival of patients with lupus nephritis (LN), some require kidney transplantation because of progression to end-stage renal disease (ESRD). However, the transplant outcomes of these patients and other recipients have not been thoroughly compared.

Methods

In total, 1848 Korean kidney recipients who underwent transplantation from 1998 to 2017 at two tertiary referral centers were evaluated retrospectively. Among them, 28 recipients with LN, and 50 control recipients matched by age, sex, and donor type, were compared with respect to graft and patient survival. We pooled our data with 17 previous cohort studies in which the graft survival of recipients with LN was described in detail.

Results

During the median follow-up period of 9.5 years (maximum 21 years), graft failure (GF) occurred in 10.7% and 16.0% of LN and control recipients, respectively. No differences were found in the rates of GF and death-censored graft failure or patient survival between the two groups. The risks of acute T cell-mediated and antibody-mediated rejection were also similar between the two groups. The pooled analysis showed similar 1- and 5-year graft survival rates between LN and control recipients.

Conclusions

Kidney transplantation is an acceptable option in patients with concurrent LN and ESRD.

Combined Enrichment and Quantitative Polymerase Chain Reaction to Improve Sensitivity and Reduce Time of Detection of Listeria monocytogenes in Mushrooms

This study evaluated a combined method for the detection of Listeria monocytogenes in mushrooms, involving enrichment and quantitative real-time polymerase chain reaction (qPCR), to improve sensitivity and reduce detection time. The growth of L. monocytogenes was evaluated in Listeria enrichment broth (LEB) with modified carbon and nitrogen sources, increasing sodium concentrations, and added micronutrients. Primers targeting the L. monocytogenes iap (iap1 and iap2), hlyA (hlyA1-hlyA6), and prfA (prfA1-prfA4) genes were developed and their sensitivity and specificity were evaluated. The greatest increase in L. monocytogenes cell count was observed after 6-h incubation at 30°C in LEB+2 × FAC (LEB plus 20 mL/L ferric ammonium citrate), where cell count increased by 1.4 log CFU (colony-forming unit)/mL, compared with 0.9 log CFU/mL in LEB (p < 0.05). iap2 primers targeting the iap gene showed high specificity and were the most sensitive among those tested, with a detection limit of 2 log CFU/mL in LEB medium, 3.1 log CFU/g in golden needle mushroom, and 3.5 log CFU/g in large oyster mushroom. When applied to detection in golden needle mushrooms, a combination of 3-h incubation in LEB+2 × FAC medium and qPCR analysis with iap2 primers permitted detection of L. monocytogenes, even at an inoculum of 1 log CFU/g. Similarly, in large oyster mushrooms, 10-h enrichment in LEB+2 × FAC medium resulted in a cell count of 3.7 log CFU/g. These results indicate that a combined detection method, using LEB+2 × FAC medium for enrichment followed by qPCR with iap2 primer pair, can reduce enrichment time and improve the sensitivity and specificity of L. monocytogenes detection in mushrooms.

P5731Optimal blood pressure in diabetic hypertensive patients with overt proteinuria

Background

Evidence for the benefit of intensive blood pressure lowering in diabetic nephropathy is not clear at this time. The objective of this study was to demonstrate whether lower mean blood pressure (BP) in treated hypertensive patients with diabetic nephropathy is associated with better prognosis.

Methods

From the National Health Insurance Service (NHIS) Health Examination Database, diabetic hypertensive subjects with proteinuria between 2009 and 2010 were selected and followed-up until 2015 (N=8,663). Mean of the recorded systolic and diastolic BP during follow-up health examinations were stratified into five categories (SBP: <120, 120 to <130, 130 to <140, 140 to <150, and ≥150 mmHg; DBP: <70, 70 to <80, 80 to <90, 90 to <100, and ≥100 mmHg). All-cause death, myocardial infarction (MI), stroke, and renal outcome (progression to end stage renal disease or doubling of serum creatinine) were examined by Cox proportional hazard models with the propensity scores adjusted method.

Results

Compared to SBP of 130 to <140 mmHg, SBP of 120 to <130 mmHg was associated with lower risk of all-cause death (HR=0.78; 95% CI, 0.64–0.95), stroke (HR: 0.65; 95% CI, 0.45–0.94), and renal outcome (HR: 0.81; 95% CI, 0.68–0.97). SBP of <120 mmHg was associated with benefit for renal outcomes (HR: 0.69; 95% CI 0.55–0.88) but not with elevated risk of other outcomes. Compared to DBP of 80 to <90 mmHg, DBP of 70 to <80 mmHg were associated with lower risk of all-cause death (HR: 0.75; 95% CI, 0.64–0.88) but with higher risk of MI (HR: 1.52; 95% CI, 1.05–2.21). DBP of <70 mmHg was associated with reduced risk of all-cause death (HR: 0.79; 95% CI, 0.64–0.98).

Conclusion

In diabetic hypertensive subjects with overt proteinuria, deterioration of renal function decreased with decreasing SBP and the lowest risk of all-cause death and stroke were observed in SBP <130 mmHg. Low DBP was associated with low risk of all-cause death but there was a J curve phenomenon for MI in DBP of 70 to <80 mmHg.

P3555Lower native T1, extracellular volume and T2 on cardiac magnetic resonance imaging is related to more left ventricular reverse remodeling in nonischemic dilated cardiomyopathy

Introduction

Guideline-directed medical therapy can induce left ventricular reverse remodeling (LVRR) in nonischemic dilated cardiomyopathy (NIDCM). Some predictors for LVRR have been reported but, there were few studies about the relationship between cardiac magnetic resonance imaging (CMR) parameters and LVRR in NIDCM on optimal GDMT.

Methods

We retrospectively analyzed echocardiogram and CMR data of newly diagnosed 142 NIDCM patients (age: 57±16 years old, 71.8% male) in a single center from Jan 2012 to Dec 2017. NIDCM was defined as left ventricular ejection fraction (LVEF) <45% and the ischemic etiology was excluded by CMR, coronary angiography or coronary CT or SPECT scan. LVRR was defined as improvement in LVEF ≥10% during follow-up period (median 403 days).

Results

Baseline LVEF and LV end diastolic dimension (LVEDD) were 27±8% and 64±8 mm. There were 87 patients (61.3%) of LVRR in our cohort. In LVRR group, native T1 value was significantly lower (1326±66 for LVRR vs 1369±72ms, p<0.001), extracellular volume (ECV) was significantly lower (28.3±3.6 for LVRR vs 32.4±4.4%, p<0.001), and T2 value was significantly lower (49.6±4.6 for LVRR vs 52.1±5.4ms, p=0.004) compared with non-LVRR group. ECV was an independent predictor for LVRR after adjusting current LVRR predictors such as age, sex, LVEF, LVEDD, systolic blood pressure, heart rate and QRS duration (Odd ratio 0.706, 95% confidence interval 0.616–0.809, p<0.001).

Conclusion

Lower native T1, ECV and T2 on CMR is related to higher incidence of LVRR in NIDCM. Further larger prospective study should be warranted to confirm the relationship between CMR parameters and LVRR in NIDCM.

Quantitative Microbial Risk Assessment for Campylobacter jejuni in Ground Meat Products in Korea

This study evaluated Campylobacter jejuni risk in ground meat products. The C. jejuni prevalence in ground meat products was investigated. To develop the predictive model, survival data of C. jejuni were collected at 4°C-30°C during storage, and the data were fitted using the Weibull model. In addition, the storage temperature and time of ground meat products were investigated during distribution. The consumption amount and frequency of ground meat products were investigated by interviewing 1,500 adults. The prevalence, temperature, time, and consumption data were analyzed by @RISK to generate probabilistic distributions. In 224 samples of ground meat products, there were no C. jejuni-contaminated samples. A scenario with a series of probabilistic distributions, a predictive model and a dose-response model was prepared to calculate the probability of illness, and it showed that the probability of foodborne illness caused by C. jejuni per person per day from ground meat products was 5.68×10^-10, which can be considered low risk.

Role of Pseudomonas aeruginosa DesB in Adaptation to Osmotic Stress

Proper membrane fluidity is maintained by adjusting the ratio of saturated fatty acids to unsaturated fatty acids (UFAs), and the control of membrane fluidity plays an important role in bacterial adaptation to stress. Adaptability to these stresses involves survival and colonization of bacteria, thus contributing to bacterial contamination in food. UFAs are synthesized by FabAB- and Des-mediated pathways in Pseudomonas aeruginosa. Therefore, in this study, the roles of UFA-synthesizing proteins of P. aeruginosa in resistance to stresses were examined. The growth and transcription levels of wild-type (WT) P. aeruginosa PAO1 and its mutants were compared. The growth of all strains was inhibited by exposure to 0.5 or 1.0 M sodium chloride, but it was not affected by oxidative or pH stress. In particular, growth was impaired more substantially in the desB mutant than in the WT strain and other mutants, suggesting that DesB has a role in response to salt stress. A comparative transcriptional analysis showed that genes involved in the synthesis of osmoprotectants (trehalose, N-acetylglutaminylglutamine amide, and hydrophilin) were highly expressed in WT P. aeruginosa in response to high salt, but they were rarely expressed in the desB mutant. Furthermore, decreases in osmoprotectant production by the desB mutant were partially complemented by the addition of betaine. These results indicate that P. aeruginosa DesB contributes to adaptation to high salinity by positively regulating the synthesis of osmoprotectants.

Vitamin E (α-tocopherol) consumption influences gut microbiota composition

This study evaluated if vitamin E consumption affects gut microbiota. Mice were grouped into control, low vitamin E (LV), and high vitamin E (HV). LV and HV were fed DL-α-tocopherol at 0.06 mg/20 g and 0.18 mg/20 g of body weight per day, respectively, for 34 days. Body weight of mice was measured before and after vitamin E treatment. Animals were sacrificed, liver, spleen, small intestine and large intestine collected, and weight and length were measured. Composition of gut microbiota was determined by microbiome analysis. Spleen weight index of LV was the highest. However, liver weight indices and intestinal lengths were not different. Body weights of LV group were higher than those of control. Ratio of Firmicutes to Bacteroidetes was different in LV compared to control and HV. These results indicate that low-level consumption of vitamin E increases spleen and body weight, and changes gut microbiota.

Mathematical Models to Describe the Kinetic Behavior of Staphylococcus aureus in Jerky

The objective of this study was to develop mathematical models for describing the kinetic behavior of Staphylococcus aureus (S. aureus) in seasoned beef jerky. Seasoned beef jerky was cut into 10-g pieces. Next, 0.1 mL of S. aureus ATCC13565 was inoculated into the samples to obtain 3 Log CFU/g, and the samples were stored aerobically at 10°C, 20°C, 25°C, 30°C, and 35°C for 600 h. S. aureus cell counts were enumerated on Baird Parker agar during storage. To develop a primary model, the Weibull model was fitted to the cell count data to calculate Delta (required time for the first decimal reduction) and ρ (shape of curves). For secondary modeling, a polynomial model was fitted to the Delta values as a function of storage temperature. To evaluate the accuracy of the model prediction, the root mean square error (RMSE) was calculated by comparing the predicted data with the observed data. The surviving S. aureus cell counts were decreased at all storage temperatures. The Delta values were longer at 10°C, 20°C, and 25°C than at 30°C and 35°C. The secondary model well-described the temperature effect on Delta with an R² value of 0.920. In validation analysis, RMSE values of 0.325 suggested that the model performance was appropriate. S. aureus in beef jerky survives for a long period at low storage temperatures and that the model developed in this study is useful for describing the kinetic behavior of S. aureus in seasoned beef jerky.

The risk of aerotolerant Campylobacter jejuni strains in poultry meat distribution and storage

Poultry meat is a major vector for Campylobacter jejuni foodborne illness. Since C. jejuni is microaerophillic, the cell counts gradually decreased during distribution and display under aerobic condition. However, if the pathogen can resist to aerobic condition, it may cause serious problem in food safety. This study determined the aerotolerance of C. jejuni isolated from poultry and the risk of the aerotolerant C. jejuni strains. Fourteen C. jejuni strains isolated from poultry were subjected to aerobic condition in a shaking incubator at 500 rpm and 37 °C. The cell counts of C. jejuni strains were enumerated on modified CCDA-Preston at 0, 24, 72 and 120 h, and the strains, having reduction less than 2 Log CFU/mL for 120 h were determined as aerotolerant C. jejuni strain. Non-aerotolerant and aerotolerant C. jejuni strains were then incubated at 4 °C under aerobic condition to compare the growth between aerotolerant and non-aerotolerant strains. In addition, transcriptomes for virulence and stress response genes (cadF, cdtB, ciaB, clpP and htrB) were compared between non-aerotolerant and aerotolerant C. jejuni strains. Among 14 C. jejuni strains, seven strains (50%) showed less than 2-Log CFU/mL reduction at 37 °C after 24 h, and five strains of them still showed less than 2-Log CFU/mL reduction after 48 h. Especially, C. jejuni SMFM2015-Du7 and C. jejuni SMFM2014-Du16 were still survived after 120 h under aerobic condition, which were then determined as aerotolerant C. jejuni. However, at 4 °C under aerobic condition, there were no significant differences in the reduction of C. jejuni cell counts and virulence gene expressions between non-aerotolerant (C. jejuni SMFM2014-Du8) and aerotolerant strains (C. jejuni SMFM2015-Du7 and C. jejuni SMFM2014-Du16) except for stress response gene (htrB). These results indicate that there are aerotolerant C. jejuni strains, but their risk is similar to non-aerotolerant C. jejuni strains at 4 °C under aerobic condition, which is distribution and storage condition for poultry meat. Therefore, additional food safety management for the aerotolerant C. jejuni is not necessary.

Abstract P1-08-24: Conditional survival of breast cancer patients: Korean nationwide registry

Purpose: Conditional relative survival (CRS) could provide more relevant information on the current prognosis of cancer survivors than standard 5-year relative survival (RS). This study aimed to estimate the 5-year CRS of Korean breast cancer patients.

Patients and Methods: We identified 145,083 breast cancer cases with diagnosis between 2002 and 2013 in the Korea Central Cancer Registry. The CRS was estimated for every year after diagnosis, according to sex, age, histologic types, stage, and year of diagnosis.

Results: The 5-year RS at diagnosis was 90.8% and 10-year RS was 85.7%. Five-year CRS was 91.0% and 94.3% at 1-year and 5-year after diagnosis. Women had better 5-year CRS than men after 5 years of survival (94.3% vs. 79.5%), and very young and very old patients had worse 5-year CRS after 5 years of survival than other age groups (92.2% in &lt;40yr, 92.6% in ≥70yr vs. 95.4% in 40-49, 94.3% in 50-59, and 93.7% in 60-69, relatively). In histologic types, CRS of metaplastic carcinoma has improved from 82.0% to 95.2%, compared to CRS of lobular carcinoma (from 93.1% to 92.5%). Hardly any excess mortality (5-year CRS ≥ 95%) was seen since 7 years after diagnosis. There was hardly any excess mortality at 5 years of survival, for the patients with 40-49 years (95.4%), with localized disease (97.8%), and with metaplastic carcinoma (95.2%).

Conclusion: This study showed that CRS of breast cancer survivors in Korea has been improved, which varied by sex, age, stage, and histologic types. These CRS analysis could provide a more detailed information for survival to breast cancer survivors and clinicians.

Citation Format: Jung S-Y, Jung K-W, Won Y-J, Kwon Y, Ha J, Kim YA, Kong S-Y, Lee ES. Conditional survival of breast cancer patients: Korean nationwide registry [abstract]. In: Proceedings of the 2018 San Antonio Breast Cancer Symposium; 2018 Dec 4-8; San Antonio, TX. Philadelphia (PA): AACR; Cancer Res 2019;79(4 Suppl):Abstract nr P1-08-24.

Development of Hydrogels to Improve the Safety of Yukhoe (Korean Beef Tartare) by Reducing Psychrotrophic Listeria monocytogenes Cell Counts on Raw Beef Surface

This study developed an antimicrobial hydrogel to control Listeria monocytogenes in Yukhoe (Korean beef tartare). Four hydrogels (hydrogel 1: 5% alginate+1% chitosan+0.2% CaCl₂, hydrogel 2: 1% κ-carrageenan+1% chitosan, hydrogel 3: 2% κ-carrageenan+1% CaCl₂, and hydrogel 4: 2% κ-carrageenan+3% CaCl₂) were prepared. The hydrogels then absorbed 0.1% grapefruit seed extract (GSE) and 0.1% citrus extract (CE) for 30, 60, 120, and 240 min to be antimicrobial hydrogels. To select the most effective antimicrobial hydrogel, their swelling ratio (SR) and antilisterial activities were determined. The selected hydrogel (2×2 cm) was then placed on surface of beef (round; 3×3 cm), where L. monocytogenes (ca. 10⁶ CFU/g) were inoculated, and the cell counts were enumerated on PALCAM agar. Among the hydrogels, the SR of hydrogel 1 increased with absorbing time, but other hydrogels showed no significant changes. Antimicrobial hydrogel 1 showed higher (p<0.05) antilisterial activity than other antimicrobial hydrogels, especially for the one absorbed the antimicrobial for 120 min. Thus, the antimicrobial hydrogel 1 absorbed antimicrobials for 120 min was applied on raw beef at 4℃, and reduced (p<0.05) more than 90% of L. monocytogenes on raw beef. These results indicate that antimicrobial hydrogel 1 formulated with 0.1% GSE or 0.1% CE is appropriate to improve the safety of Yukhoe by reducing psychrotrophic L. monocytogenes cell counts on raw beef.