An outbreak of febrile gastroenteritis associated with delicatessen meat contaminated with Listeria monocytogenes

Dose-response model for Listeria monocytogenes-induced stillbirths in nonhuman primates

A dose-response model using rhesus monkeys as a surrogate for pregnant women indicates that oral exposure to 10(7) CFU of Listeria monocytogenes results in about 50% stillbirths. Ten of 33 pregnant rhesus monkeys exposed orally to a single dose of 10(2) to 10(10) CFU of L. monocytogenes had stillbirths. A log-logistic model predicts a dose affecting 50% of animals at 10(7) CFU, comparable to an estimated 10(6) CFU based on an outbreak among pregnant women but much less than the extrapolated estimate (10(13) CFU) from the FDA-U.S. Department of Agriculture-CDC risk assessment using an exponential curve based on mouse data. Exposure and etiology of the disease are the same in humans and primates but not in mice. This information will aid in risk assessment, assist policy makers, and provide a model for mechanistic studies of L. monocytogenes-induced stillbirths.

Antimicrobial susceptibility of Listeria monocytogenes from food products

This study was conducted to determine the susceptibility of Listeria monocytogenes isolated from food products to antimicrobial agents commonly used for treatment of infections with gram-positive bacteria, and to disinfectants. A total of 114 L. monocytogenes retail isolates were tested for susceptibility to ceftiofur, chloramphenicol, ciprofloxacin, erythromycin, florfenicol, penicillin, spectinomycin, streptomycin, tetracycline, tiamulin, trimethoprim, and co-trimoxazole, and the disinfectants benzalkonium chloride and triclosan, by determination of minimum inhibitory concentrations (MICs). All isolates were resistant to ceftiofur, but susceptible to the other antibiotics. A single isolate had a MIC of 4 mg/L for ciprofloxacin. For tiamulin. the MIC values were around the breakpoint used. Most isolates had MICs for triclosan at 16 mg/L. The MICs for benzalkonium chloride formed a bimodal distribution, with 105 isolates having a MIC of 4 mg/L and 9 isolates MICs of 16 and 32 mg/L. This study showed that Danish isolates of L. monocytogenes have not developed or acquired resistance to antimicrobial agents used for treatment or disinfection, except for benzalkonium chloride. The MICs for triclosan was high compared to other gram-positive bacteria, suggesting that triclosan might not be useful against L. monocytogenes if incorporated in materials in the food industry.

The epidemiology of human listeriosis

Listeriosis is a serious invasive disease that primarily afflicts pregnant women, neonates and immunocompromised adults. The causative organism, Listeria monocytogenes, is primarily transmitted to humans through contaminated foods. Outbreaks of listeriosis have been reported in North America, Europe and Japan. Soft cheeses made from raw milk and ready-to-eat meats are high risk foods for susceptible individuals. Efforts by food processors and food regulatory agencies to aggressively control L. monocytogenes in the high risk foods have resulted in significant decreases in the incidence of sporadic listeriosis.

Effectiveness of cell-adsorbed bacteriocin produced by Lactobacillus curvatus CWBI-B28 and selected essential oils to control Listeria monocytogenes in pork meat during cold storage

AIMS

To study the effectiveness of a combination of cell-adsorbed bacteriocin (CAB; a suspension of producer cells on which maximum bacteriocin has been immobilized by pH adjustments) of a Lactobacillus curvatus strain with oregano or savory essential oil to control Listeria monocytogenes in pork meat at 4 degrees C.

METHODS AND RESULTS

The antimicrobial activity of the CAB and six different essential oils was tested by the well diffusion assay against L. monocytogenes M, Escherichia coli 10536 and Salmonella serotype Typhi CWBI-H1. The anti-Listeria activity of the CAB and oregano or savory essential oils was also investigated in pork meat. The results of the well diffusion assay showed that CAB was only inhibitory to L. monocytogenes while savory and oregano essential oils were the most active against the three indicator bacteria. In pork meat, Listeria counts have declined from c. 10(2) CFU g(-1) to below the detectable limit during the first week of storage in samples treated with CAB or oregano essential oil and in those treated with CAB combined with oregano or savory essential oil. However, the counts of L. monocytogenes have increased after the third week of storage in all samples with the exception of those treated with the combination of CAB and oregano essential oil. The combination of CAB with savory essential oil resulted in a 2-week delay of the growth rebound compared with samples treated with CAB alone.

CONCLUSIONS

Addition of oregano or savory essential oil exhibited a synergistic effect with CAB to control L. monocytogenes in pork meat during storage at 4 degrees C.

SIGNIFICANCE AND IMPACT OF THE STUDY

The combination of CAB with oregano or savory essential oil may be effectively used in meat industry to enhance the safety and stability of meat products.

Microbiological safety of retail vacuum-packed and modified-atmosphere-packed cooked meats at end of shelf life

A study of retail modified-atmosphere-packed and vacuum-packed cooked ready-to-eat meats was undertaken from September through mid-November 2003 to determine the microbiological quality at the end of shelf life and to establish any risk factors in the production, storage, and display of this product. Examination of 2,981 samples using Microbiological Guidelines criteria revealed that 66% were of satisfactory or acceptable microbiology quality, 33% were of unsatisfactory quality mainly due to high aerobic colony counts and Enterobacteriaceae concentrations, and 1% were of unacceptable quality due to the presence of Listeria monocytogenes at 100 CFU/g or higher (27 samples; range of 10(2) to 106 CFU/g) and Campylobacter jejuni (1 sample), indicating a risk to health. All samples at the end of the shelf life had satisfactory (<20 CFU/g) and/or acceptable (<102 CFU/g) levels of Staphylococcus aureus and Clostridium perfringens, four samples (<1%) had unsatisfactory levels of Escherichia coli (range of 102 to 106 CFU/g) and 5.5% of the samples contained L. monocytogenes at <20 CFU/g (4.8%) or between 20 and 100 CFU/g (0.7%). More samples of chicken (45%; 224 of 495 samples), beef (43%; 160 of 371 samples), and turkey (41%; 219 of 523 samples) were of unsatisfactory or unacceptable quality compared with ham (23%; 317 of 1,351 samples) or pork (32%; 67 of 206 samples). Twelve different L. monocytogenes typing characters (serotype-amplified fragment length polymorphism type-phage type) were evaluated for isolates recovered from samples of unacceptable quality, and the 1/2-IX-NT type was recovered from almost half (48%) of these samples. Salmonella was not detected in any samples examined. Risk factors identified for cooked meats that were microbiologically contaminated more frequently included vacuum packaging, packaging on retail premises, slicing, temperature not monitored in display units, and no hazard analysis system in place. Results from this study also suggest that the shelf life assigned to some modified-atmosphere-packed and vacuum-packed meats may not be appropriate.

Listeria monocytogenes infection from foods prepared in a commercial establishment: a case-control study of potential sources of sporadic illness in the United States

BACKGROUND

Listeria monocytogenes has been estimated to cause >2500 illnesses and 500 deaths annually in the United States. Efforts to reduce foodborne listeriosis have focused on foods frequently implicated in outbreaks. Potential sources for L. monocytogenes infection not associated with outbreaks remain poorly understood.

METHODS

The Foodborne Diseases Active Surveillance Network conducts surveillance for culture-confirmed listeriosis at clinical laboratories in 9 states. After excluding outbreak-associated cases, we attempted to enroll eligible case patients with L. monocytogenes infection in a case-control study from 2000 through 2003. Control subjects were recruited through health care providers and were matched to case patients by state, age, and immunosuppression status. Data were collected about exposures occurring in the 4 weeks before specimen collection from the case patients.

RESULTS

Of the 249 case patients with L. monocytogenes infection, only 12 (5%) had cases that were associated with outbreaks; 6 other patients were ineligible for other reasons. Of 231 eligible case patients, 169 (73%) were enrolled in the study. We classified 28 case patients as having pregnancy-associated cases. We enrolled 376 control subjects. In multivariable analysis, L. monocytogenes infection was associated with eating melons at a commercial establishment (odds ratio, 2.6; 95% confidence interval, 1.4-5.0) and eating hummus prepared in a commercial establishment (odds ratio, 5.7; 95% confidence interval, 1.7-19.1).

CONCLUSIONS

Most cases of L. monocytogenes infection were not associated with outbreaks. Reducing the burden of foodborne listeriosis may require interventions directed at retail environments and at foods, such as melons and hummus, that are not commonly recognized as high risk. Because of the severity of listeriosis, pregnant women and other persons at risk may wish to avoid eating these newly implicated foods.

International Life Sciences Institute North America Listeria monocytogenes strain collection: development of standard Listeria monocytogenes strain sets for research and validation studies

Research and development efforts on bacterial foodborne pathogens, including the development of novel detection and subtyping methods, as well as validation studies for intervention strategies can greatly be enhanced through the availability and use of standardized strain collections. These types of strain collections are available for some foodborne pathogens, such as Salmonella and Escherichia coli. We have developed a standard Listeria monocytogenes strain collection that has not been previously available. The strain collection includes (i) a diversity set of 25 isolates chosen to represent a genetically diverse set of L. monocytogenes isolates as well as a single hemolytic Listeria innocua strain and (ii) an outbreak set, which includes 21 human and food isolates from nine major human listeriosis outbreaks that occurred between 1981 and 2002. The diversity set represents all three genetic L. monocytogenes lineages (I, n = 9; II, n = 9; and III, n = 6) as well as nine different serotypes. Molecular subtyping by EcoRI automated ribotyping and pulsed-field gel electrophoresis (PFGE) with AscI and ApaI separated the 25 isolates in the diversity set into 23 ribotypes and 25 PFGE types, confirming that this isolate set represents considerable genetic diversity. Molecular subtyping of isolates in the outbreak set confirmed that human and food isolates were identical by ribotype and PFGE, except for human and food isolates for two outbreaks, which displayed related but distinct PFGE patterns. Subtype and source data for all isolates in this strain collection are available on the Internet and are linked to the PathogenTracker database (www.pathogentracker.com), which allows the addition of new, relevant information on these isolates, including links to publications that have used isolates from this collection. We have thus developed a core L. monocytogenes strain collection, which will provide a resource for L. monocytogenes research and development efforts with centralized Internet-based data curation and integration.

Transfer of Listeria monocytogenes during slicing of turkey breast, bologna, and salami with simulated kitchen knives

In response to continued concerns regarding Listeria cross-contamination during the slicing of deli meats, a series of specially prepared grade 304 and 316 stainless steel kitchen knife blades was inoculated with a six-strain Listeria monocytogenes cocktail (10(8), 10(5), and 10(3) CFU per blade) composed of two weak, two medium, and two strong biofilm-forming strains. The blades were then attached to an Instron 5565 electromechanical compression analyzer and used to slice whole chubs of delicatessen turkey breast, bologna, and salami to entirety (30 slices) at a cutting speed of 8.3 mm/s. Homogenates of the slices in University of Vermont Medium were surface or pour plated with modified Oxford agar and then enriched. Listeria transfer from knife blades inoculated at 10(8) CFU per blade was logarithmic, with a 2-log decrease seen after 8 to 12 slices and direct counts obtained thereafter out to 30 slices. However, blades containing 10(5) and 10(3) CFU per blade typically yielded direct counts out to only 20 and 5 slices, respectively. Normalizing data on a log scale for the first 10 slices resulted in significantly greater Listeria transfer and "tailing" from grade 304 as opposed to grade 316 stainless (P < 0.05) for all three products. After 1 year of use, surface roughness values as determined by surface profilometry were significantly greater (P < 0.001) for grade 304 than for grade 316 stainless blades. Cutting force and blade sharpness were not significantly different (P > 0.05) within stainless steel grade (P < 0.05) for each product. However, significant differences in cutting force were seen between salami and turkey (P < 0.05) for grades 304 and 316 stainless, respectively. In addition to compositional differences in the deli meats and knife blades, wear and scoring on the blade likely affected Listeria transfer during slicing.

Intragastric inoculation with a cocktail of Listeria monocytogenes strains does not potentiate the severity of infection in A/J mice compared to inoculation with the individual strains comprising the cocktail

Although multistrain cocktails of Listeria monocytogenes are used in food inoculation experiments, no studies, to our knowledge, have been reported that use these cocktails in an intragastric mouse model. In this study, we used a five-strain L. monocytogenes cocktail consisting of strains Scott A, MFS108, 101M, V7, and 310 and a four-strain L. monocytogenes cocktail containing strains Scott A, EGD, H7738, and F2365. Here, we report that intragastric inoculation of anesthetized mice with approximately 106 CFU of a cocktail of L. monocytogenes strains does not result (P > 0.05) in a more severe infection (on the basis of the CFU of Listeria spp. recovered from the spleen, liver, and blood) than inoculation of mice with similar numbers of the individual strains comprising the cocktail. Nor did we observe any consistent relationship between susceptibility of L. monocytogenes strains to inactivation in synthetic gastric fluid in vitro and virulence in mice.

Detection of Listeria monocytogenes in food using a combined enrichment/real-time PCR method targeting the prfA gene

A combined enrichment/real-time PCR method for the detection of Listeria monocytogenes is presented. The method is based on a conventional PCR assay targeting the prfA gene, which has been validated and suggested as an international standard PCR method for identifying L. monocytogenes in food. This real-time PCR assay includes an internal amplification control. Inclusivity and exclusivity were 100% each when testing 100 L. monocytogenes isolates, 30 Listeria spp. isolates other than L. monocytogenes, and 29 non-Listeria isolates. The theoretical detection limit was one copy of the target gene per PCR reaction and the practical detection limit was about 5 copies per PCR. Using the combined enrichment/real-time PCR method, 7.5 CFU/25 ml of artificially contaminated raw milk, and 9, 1, and 1 CFU/15 g of artificially contaminated salmon, pâté, and green-veined cheese, respectively, were detected. When analyzing 76 naturally contaminated food samples of various types and comparing the results with the ISO 11290-1 standard method, the relative accuracy was 96%, the relative specificity 100%, and the relative sensitivity, 76.9%.

Invasive Listeria monocytogenes infections in the Netherlands, 1995-2003

In order to add to the limited data available about the incidence of invasive Listeria monocytogenes infection in the Netherlands, two studies were conducted. In the first study, data on hospital patients with listeriosis in the period 1995-2003 were obtained from the National Medical Registration (study 1). In the second study, hospital discharge letters for patients whose Listeria isolates were received by the Netherlands Reference Laboratory for Bacterial Meningitis (NRLBM) in the period 1999-2003 were retrieved (study 2). Serotyping and pulsed-field gel electrophoresis (PFGE) were used to subtype the various strains of Listeria. These reviews revealed 283 hospital patients and 159 patients with Listeria isolates. Discharge letters were received for 107 (67%) patients. The mean annual incidence of listeriosis in both studies was 2.0 per million inhabitants. The main clinical manifestations were meningitis (incidence: 0.9 and 1.0 per million in studies 1 and 2, respectively) and septicaemia (incidence: 0.08 and 1.0 per million, respectively). Listeriosis in pregnancy was rare (incidence: 1.3 and 2.4 per 100,000 pregnancies over 24 weeks of gestation, respectively). Predisposing conditions were present in 47 and 71% of the patients in studies 1 and 2, respectively. The mortality due to listeriosis was 18%. Serotypes 4b, 1/2a, and 1/2b were responsible for 96% of the cases of human listeriosis. Listeriosis is rare in the Netherlands, but its clinical course is severe and the resulting mortality is high. Therefore, the current recommendations for pregnant women to avoid high-risk foods should be continued. These dietary recommendations should also be given to individuals with predisposing conditions, since they, too, are at risk of Listeria infection.

Prevalence and genetic characterization of Listeria monocytogenes in retail broiler meat in Estonia

The prevalence and genetic diversity of Listeria monocytogenes in raw broiler legs at the retail level in Estonia were studied. A total of 240 raw broiler legs (120 from Estonia and 120 of foreign origin, which had been imported to Estonia from Denmark, Finland, Hungary, Sweden, and the United States) from 12 retail stores in the two largest cities in Estonia (Tallinn and Tartu) were investigated from January to December 2002. Of these, 70% were positive for L. monocytogenes. The prevalence of L. monocytogenes in broiler legs of Estonian origin (88%) was significantly higher than in broiler legs of foreign origin (53%) (P < 0.001). Altogether, 169 (106 Estonian and 63 imported) L. monocytogenes isolates were characterized by pulsed-field gel electrophoresis (PFGE) typing after treatment with the restriction enzyme AscI. The isolates showed a wide genetic diversity, with 35 different PFGE types obtained. Of these, 11 PFGE types came only from isolates of broiler legs of Estonian origin, 4 of Danish origin, 2 of Finnish origin, and 4 of Hungarian origin. Fourteen PFGE types came from isolates of broiler legs that originated from various countries. The strains that shared the same PFGE types from isolates of Estonian origin were recovered from broiler legs that came from different stores over the course of several months. Seventy-one L. monocytogenes isolates, including all PFGE types, were serotyped, and three serotypes (1/2a, 1/2b, and 4b) were obtained. Serotype 1/2a accounted for 96% of the isolates.

Listeria monocytogenes in platelets: a case report

BACKGROUND

Efforts to reduce bacterial contamination in platelets (PLTs) have led to implementation of tests for bacterial detection before product release. Although relatively rare as a human pathogen, Listeria monocytogenes often causes serious illness and has a case-fatality rate of 20 percent.

CASE REPORT

PLTs from an asymptomatic 58- year-old Hispanic male with a long history of PLT donation were culture-positive for the presence of L. monocytogenes. The pulsed-field gel electrophoresis (PFGE) pattern of the isolate matched two other L. monocytogenes isolates in the CDC National PulseNet database. Public health investigation found no evidence that the other two isolates were epidemiologically related to the PLT donor, who remained asymptomatic.

CONCLUSION

A cluster of listeriosis cases was detected by PFGE but the significance is unknown. Organisms of public health significance should be reported to health departments. Better surveillance and reporting are needed in the efforts to improve blood product safety.

Prevalence of Listeria monocytogenes in 13 dried sausage processing plants and their products

The aims of the present study were: (i) to investigate the occurrence of Listeria monocytogenes in dried sausage processing plants on surfaces before and during processing, (ii) to study the contamination in meat and sausages at different stages of maturation, (iii) to assess the distribution of L. monocytogenes in the different plants and products studied. Thirteen dried sausage processing plants were sampled at two different times of the working day. The studies were repeated twice to evaluate the persistence of the pathogen. A total of 1029 samples were collected. Among swabbed samples, 15% were positive before the beginning of the working day and 47.3% during working day. Results showed that effectiveness of cleaning and disinfecting operations could be linked with the complexity of processing lines and machines used. The presence of L. monocytogenes in mixed meat amounted to 71.6% of the collected samples. A decrease of the contamination rate in dry sausage was noted, particularly during the drying stage. Nevertheless 3 sausages studied presented a low contamination rate (<3 cfu/g) when ready for consumption. A total of 996 strains of L. monocytogenes were characterised by biochemical tests and serotyping. A majority of isolates were 1/2a (49.5%), 1/2c (19.5%) and 1/2b (13%) strains. A high heterogeneity of serotypes was observed in all plants, raw meat and in sausages during maturation.

Does sporadic Listeria gastroenteritis exist? A 2-year population-based survey in Nova Scotia, Canada

BACKGROUND

Febrile gastroenteritis due to Listeria monocytogenes (LM) has been primarily described in foodborne outbreaks. We decided to determine the incidence of sporadic, febrile gastroenteritis due to LM in a large, well-defined North American population over a 2-year period and to compare these cases to sporadic cases of Campylobacter and Salmonella infections occurring concurrently in the community.

METHODS

From 1 September 2002 through 31 August 2004, all stool specimens submitted for evaluation of diarrheal illness to a public health laboratory and to a children's hospital serving a population of approximately 350,000 were examined for the presence of Listeria species. Patients identified as having LM in their stool samples were matched with 2 temporally-matched patients with cultures positive for Campylobacter and Salmonella species. Patients with LM and control patients were contacted by telephone, and they answered a questionnaire that examined clinical features and risk factors for diarrheal illness.

RESULTS

A total of 7775 stool specimens were submitted during the period 1 September 2002-31 August 2004. Thirty-nine Listeria species were recovered. Seventeen of the species were LM, 13 were Listeria innocua, 3 were Listeria welshimeri, 1 was Listeria grayi, and 4 were other species. Pulsed-field gel electrophoresis results demonstrated no temporal or other clusters, and no seasonality was noted for isolates of LM. Preexisting gastrointestinal problems were much more common in patients with LM (P=.001) than in patients with Campylobacter or Salmonella infections.

CONCLUSIONS

Sporadic gastroenteritis due to LM appears to be an uncommon illness, and routine screening of stool samples for LM remains unwarranted. Preexisting gastrointestinal disease may be a risk factor for infection of the gastrointestinal tract with LM.

Fate of Listeria monocytogenes in experimentally contaminated French sausages

Listeria monocytogenes has been recognized as one of the most important foodborne pathogens dealt with by the food. The bacterium has been found in every part along the pork processing industry from the slaughterhouse to the cutting room and the delicatessen factories. During the fermentation and drying of sausages, L. monocytogenes tends to decrease substantially. However, despite the various hurdles in the dry sausage manufacturing process, L. monocytogenes is able to survive and is detected in the final products. The present study has evaluated growth and survival of eight different L. monocytogenes strains (originating from sausage, sausage industry environment and from clinical cases of listeriosis) in experimentally inoculated French sausages with 10(4) cfu g(-1). This study points out the fact that the decrease of L. monocytogenes contamination rate during the manufacturing process of sausages is strain dependent (p < 0.001) and mainly due to the drying and maturation step than to the fermentation itself. Whatever the strains studied, almost no decrease of the contamination rate was noted during the fermentation step. However hurdle-adapted strains (those isolated from sausages or sausage industry environment) were more difficult to cure from sausages (decrease by 1.5 log10) than non-adapted strains (decrease by 3 log10) at the end of the drying period (day 35), when sausages were ready for consumption. These sausages became safe only at the best before date. As a consequence, L. monocytogenes and more particularly those "adapted" strains might represent a very important issue for hygienists since these strains originating from sausages or production environment themselves are likely to contaminate sausages during manufacturing and remain in the final products. However, the high inoculum levels used in the study (10(4) cfu g(-1)) are not representative of the natural contamination of L. monocytogenes commonly encountered in the raw material for sausages. If such contamination happened to be inferior to 100 cfu g(-1), then the manufacturing process used in this study would be able to produce "safe" sausages according to the European regulation requiring the absence of L. monocytogenes in 25 g of food with a tolerance of below 100 cfu g(-1) at the best before date.

Molecular and experimental virulence of Listeria monocytogenes strains isolated from cases with invasive listeriosis and febrile gastroenteritis

We analyzed 27 Listeria monocytogenes strains of serotypes 1/2b and 4b, from invasive and gastroenteric listeriosis, for molecular and experimental virulence. Molecular virulence was tested by PCR for the presence of 8 major virulence-associated genes and genetic polymorphisms through restriction enzyme analysis; genomic DNA typing using pulsed-field gel electrophoresis was also performed. Experimental virulence was evaluated through intra-peritoneal and intra-gastric mouse virulence assays. Our results showed no significant differences in the virulence-related molecular properties of the strains analyzed. All strains were equally pathogenic following intra-peritoneal inoculation of mice. In mice inoculated intra-gastric with 4 representative strains of the 2 types of listeriosis, there were no significant differences in the bacterial count when comparing invasive and gastroenteric strains, suggesting that the strains were comparable in terms of mean oral infectivity.

Multistate Outbreak ofListeria monocytogenesInfection Linked to Delicatessen Turkey Meat

BACKGROUND

Despite a decreasing incidence of listeriosis in the United States, molecular subtyping has increased the number of recognized outbreaks. In September 2000, the New York City Department of Health identified a cluster of infections caused by Listeria monocytogenes isolates with identical molecular subtypes by pulsed-field gel electrophoresis (PFGE) and ribotyping.

METHODS

To determine the magnitude of the outbreak and identify risk factors for infection, we notified state health departments and conducted a case-control study. A case was defined as a patient or mother-infant pair infected with Listeria monocytogenes whose isolate yielded the outbreak PFGE pattern. Controls were patients infected with Listeria monocytogenes whose isolate yielded a different PFGE pattern. Patients were asked about food and drink consumed during the 30 days before the onset of illness.

RESULTS

Between May and December 2000, there were 30 clinical isolates of Listeria monocytogenes with identical PFGE patterns identified in 11 US states. Cases of infection caused by these isolates were associated with 4 deaths and 3 miscarriages. A case-control study implicated sliced processed turkey from a delicatessen (Mantel-Haenszel odds ratio, 8.0; 95% confidence interval, 1.2-43.3). A traceback investigation identified a single processing plant as the likely source of the outbreak, and the company voluntarily recalled 16 million pounds of processed meat. The same plant had been identified in a Listeria contamination event that had occurred more than a decade previously.

CONCLUSIONS

Prevention of persistent L. monocytogenes contamination in food processing plants presents a critical challenge to food safety professionals.

Gastroenteritis due to Listeria monocytogenes

It has been known for a long time that many patients experience diarrhea antecedent to the development of bacteremia or meningoencephalitis due to Listeria monocytogenes, but it was only recently that convincing evidence was obtained that this organism can cause acute, self-limited, febrile gastroenteritis in healthy persons. At least 7 outbreaks of foodborne gastroenteritis due to L. monocytogenes have been reported. Illness typically occurs 24 h after ingestion of a large inoculum of bacteria and usually lasts 2 days. Common symptoms include fever, watery diarrhea, nausea, headache, and pains in joints and muscles. L. monocytogenes should be considered to be a possible etiology in outbreaks of febrile gastroenteritis when routine cultures fail to yield a pathogen.

Effects of suspension in emulsified wiener or incubation in wiener packages on the virulence of Listeria monocytogenes Scott A in intragastrically inoculated A/J mice

Several outbreaks of listeriosis have been associated with contamination of wieners and other ready-to-eat meat products. In this study, we addressed the question of whether emulsification in, or growth on, wieners triggers a response in the listerial cells that makes them more virulent or protects them against the harsh environment of the gastrointestinal tract in mice. Our results indicate that Listeria monocytogenes Scott A grows poorly, if at all, in one brand of commercially prepared wieners inoculated with 5 x 10(3) to 5 x 10(6) CFU per package and incubated at 15 degrees C. Neither L. monocytogenes Scott A emulsified in a slurry of homogenized wieners nor recovered from wiener package fluid after a 7-day incubation at 15 degrees C were more virulent when inoculated into the stomachs of A/J mice than L. monocytogenes Scott A grown in brain heart infusion broth. These findings suggest that the ability of L. monocytogenes Scott A to cause systemic infection following introduction into the gastrointestinal tract was not improved by incubation with wieners or suspension in a meat matrix.

Listeria monocytogenes isolates from foods and humans form distinct but overlapping populations

A total of 502 Listeria monocytogenes isolates from food and 492 from humans were subtyped by EcoRI ribotyping and PCR-restriction fragment length polymorphism analysis of the virulence gene hly. Isolates were further classified into genetic lineages based on subtyping results. Food isolates were obtained through a survey of selected ready-to-eat food products in Maryland and California in 2000 and 2001. Human isolates comprised 42 isolates from invasive listeriosis cases reported in Maryland and California during 2000 and 2001 as well as an additional 450 isolates from cases that had occurred throughout the United States, predominantly from 1997 to 2001. Assignment of isolates to lineages and to the majority of L. monocytogenes subtypes was significantly associated with the isolate source (food or human), although most subtypes and lineages included both human and food isolates. Some subtypes were also significantly associated with isolation from specific food types. Tissue culture plaque assay characterization of the 42 human isolates from Maryland and California and of 91 representative food isolates revealed significantly higher average infectivity and cell-to-cell spread for the human isolates, further supporting the hypothesis that food and human isolates form distinct populations. Combined analysis of subtype and cytopathogenicity data showed that strains classified into specific ribotypes previously linked to multiple human listeriosis outbreaks, as well as those classified into lineage I, are more common among human cases and generate larger plaques than other subtypes, suggesting that these subtypes may represent particularly virulent clonal groups. These data will provide a framework for prediction of the public health risk associated with specific L. monocytogenes subtypes.

Characteristics of the gastritis induced by Listeria monocytogenes in mice: microbiology, histopathology, and mRNA expression of inflammatory mediators with time course of infection

Listeria monocytogenes induces the suppurative gastritis in some mice strains. In this study, characteristics of the gastritis caused by L. monocytogenes infection in mice were examined with time course of infection. Mice were administered intragastrically with 1.8 x 10(8) CFU of L. monocytogenes. Each three mice were sacrificed by cervical dislocation at 1, 3, 5, 7, 10, 14, 17, 21, and 28 days postinoculation (pi), respectively. Bacterial colonization in the stomachs reached the peak at 3 days pi, maintained over 4.3 log10 CFU/g tissue until 14 days pi, and was cleared by 28 days pi. However, in the spleens and livers, the bacteria could not be detected after 7 days pi. The gastric lesions were the most prominent at between 3 and 7 days pi. The lesions consisted of marked neutrophilic infiltration, edema, vacuolar degeneration and necrosis of muscle cells and were more severe in the nonglandular region and fundus than in the pylorus, and were in submucosa, lamina muscularis, and serosa than in mucosa. mRNA expression of several cytokines (INF-gamma, IL-1beta, IL-5, IL-6, IL-12, and TNF-alpha) and chemokines (KC, MCP-1) increased in the gastric tissue of infected mice at 1-7 days pi and slightly decreased at 14 days pi. These findings would be useful for studying the pathological mechanism of human febrile gastroenteritis due to L. monocytogenes infection.

Detection of low levels of Listeria monocytogenes cells by using a fiber-optic immunosensor

Biosensor technology has a great potential to meet the need for sensitive and nearly real-time microbial detection from foods. An antibody-based fiber-optic biosensor to detect low levels of Listeria monocytogenes cells following an enrichment step was developed. The principle of the sensor is a sandwich immunoassay where a rabbit polyclonal antibody was first immobilized on polystyrene fiber waveguides through a biotin-streptavidin reaction to capture Listeria cells on the fiber. Capture of cells on the fibers was confirmed by scanning electron microscopy. A cyanine 5-labeled murine monoclonal antibody, C11E9, was used to generate a specific fluorescent signal, which was acquired by launching a 635-nm laser light from an Analyte 2000 and collected by a photodetector at 670 to 710 nm. This immunosensor was specific for L. monocytogenes and showed a significantly higher signal strength than for other Listeria species or other microorganisms, including Escherichia coli, Enterococcus faecalis, Salmonella enterica, Lactobacillus plantarum, Carnobacterium gallinarum, Hafnia alvei, Corynebacterium glutamicum, Enterobacter aerogenes, Pseudomonas aeruginosa, and Serratia marcescens, in pure or in mixed-culture setup. Fiber-optic results could be obtained within 2.5 h of sampling. The sensitivity threshold was about 4.3 x 10(3) CFU/ml for a pure culture of L. monocytogenes grown at 37 degrees C. When L. monocytogenes was mixed with lactic acid bacteria or grown at 10 degrees C with 3.5% NaCl, the detection threshold was 4.1 x 10(4) or 2.8 x 10(7) CFU/ml, respectively. In less than 24 h, this method could detect L. monocytogenes in hot dog or bologna naturally contaminated or artificially inoculated with 10 to 1,000 CFU/g after enrichment in buffered Listeria enrichment broth.

Microbiological examination of ready-to-eat cold sliced meats and pate from catering and retail premises in the UK

AIMS

To establish the microbiological quality of cold ready-to-eat sliced meats and pâté from catering and retail premises, and investigate links hypothesized between foodborne Campylobacter infection and the consumption of cold sliced meats.

METHODS AND RESULTS

A total of 4078 cold meat and pâté samples were collected and examined according to a standardized protocol. Comparison with published microbiological guidelines revealed that most ready-to-eat meat and pâté samples (75%) were of satisfactory/acceptable microbiological quality and 25% were of unsatisfactory/unacceptable quality. Two cold meat samples (<1%) were of unacceptable microbiological quality because of the presence of Campylobacter jejuni in 25 g and Listeria monocytogenes at 3.4 x 104 CFU g-1.

CONCLUSIONS

Acceptable microbiological quality was associated with premises where the management was trained in food hygiene and those that had hazard analysis in place. Poor microbiological quality was associated with storage above 8 degrees C, presliced meats, infrequent cleaning of slicing equipment and poor control of practices that may lead to cross contamination.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides important information about the microbiological quality of cold ready-to-eat meats and pâté. It also assists caterers, retailers, enforcement officers and policy makers to understand how different food safety practices affect microbiological quality.

Controlling healthcare-associated infections: the role of infection control and antimicrobial use practices

Healthcare-associated infections are a major cause of morbidity and mortality in pediatric patients in the United States and throughout the world. Overall rates of infection range widely depending on the pediatric population, with the highest rates being in patients in neonatal intensive care units, followed by those in pediatric intensive care units, immunocompromised patients, and those undergoing surgical procedures. Risk factors for healthcare-associated infection include intrinsic and extrinsic factors. The major intrinsic factors are age, birth weight, underlying diseases, and immune status. The major extrinsic factors are presence of invasive devices and procedures. The major risk factors for healthcare-associated infection caused by antimicrobial-resistant pathogens are either the transmission of pathogens from person to person (directly or indirectly, usually via the hands of healthcare workers) or the emergence of resistance after exposure to antimicrobials. Preventing healthcare-associated infections caused by antimicrobial-resistant pathogens requires a comprehensive approach that includes: 1) preventing infections through the use of vaccines and prophylaxis; 2) minimizing the use of invasive devices; 3) understanding and fully implementing (and complying with) current guideline recommendations for the prevention of infections; and 4) using antimicrobials judiciously. Implementing such a comprehensive program will reduce healthcare-associated infections, reduce the prevalence of antimicrobial-resistant pathogens, improve patient outcomes, and reduce health care costs.