1
|
Microbiological analysis and characterization of Salmonella and ciprofloxacin-resistant Escherichia coli isolates recovered from retail fresh vegetables in Shaanxi Province, China. Int J Food Microbiol 2023; 387:110053. [PMID: 36521241 DOI: 10.1016/j.ijfoodmicro.2022.110053] [Citation(s) in RCA: 5] [Impact Index Per Article: 5.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/24/2022] [Revised: 11/20/2022] [Accepted: 12/02/2022] [Indexed: 12/12/2022]
Abstract
Fresh vegetables are closely associated with foodborne disease outbreaks; however, systematic analysis of the microbiological quality of fresh vegetables and molecular information on foodborne pathogens in fresh produce are poorly reported in China. Here, we evaluated the epidemiological prevalence of coliforms via the most probable number method and characterized Salmonella and ciprofloxacin-resistant (CIPR) Escherichia coli isolates recovered from retail fresh vegetables in Shaanxi Province, China. Antimicrobial susceptibility testing, serotype determination, multilocus sequence typing (MLST), core genome multilocus sequence typing (cgMLST), antibiotic resistance encoding gene (ARG) annotation, virulence factor prediction, and functional classification were performed. Between October 2020 and September 2021, 576 samples (i.e., tomatoes, lettuces, spinaches, and cabbages) were found to be positive for coliforms, and the prevalence of coliforms showed a seasonal trend. Coliform counts of vegetables in supermarkets in Xi'an were significantly lower (P < 0.01) than that in other cities. The detection rates of Salmonella and CIPRE. coli-positive vegetables were 1 % (6/576) and 0.7 % (4/576), respectively. All isolates exhibited resistance to ≥1 antibiotics, and 92.9 % (13/14) were multidrug-resistant. One extended spectrum β-lactamase (ESBL)-producing CIPRE. coli isolate in spinach was resistant to not only three third-generation cephalosporins but also to two polymyxins. Among nine Salmonella isolates, five different serovars (S. Enteritidis, S. Indiana, monophasic variant of S. Typhimurium, S. Agona, and S. Gallinarum), four sequence types (STs; ST11, ST13, ST17, and ST34), and seven core genome STs (cgSTs) were identified. Five CIPRE. coli strains were assigned to three serovars (O101:H4, O8:H18, and O11:H25), three STs (ST44, ST48, and ST457), and four cgSTs. Coexisting amino acid mutations of Thr57Ser/Ser80Arg in ParC and Ser83Phe/Asp87Gly in GyrA in quinolone resistance-determining regions (QRDRs) might be causes for nalidixic acid resistance. Eight definite virulence profiles in eight serovars were identified. Notably, cdtB and pltA only encoded typhoid toxins and were just detected from S. Typhoid isolates were also detected from S. Indiana and monophasic S. Typhimurium, which are closely associated with swine food chain were first detected in fresh vegetables. In conclusion, our findings suggest that coliform contamination on fresh vegetables is prevalent in this province. Most Salmonella and CIPRE. coli isolates were phenotypically and genetically diverse and could resist multiple antibiotics by carrying multiple ARGs and virulence genes.
Collapse
|
2
|
György É, Laslo É, Salamon B. Antimicrobial impacts of selected Lamiaceae plants on bacteria isolated from vegetables and their application in edible films. FOOD BIOSCI 2023. [DOI: 10.1016/j.fbio.2022.102280] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
|
3
|
Molecular Methods for Identification and Quantification of Foodborne Pathogens. Molecules 2022; 27:molecules27238262. [PMID: 36500353 PMCID: PMC9737419 DOI: 10.3390/molecules27238262] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/24/2022] [Revised: 11/12/2022] [Accepted: 11/21/2022] [Indexed: 11/29/2022] Open
Abstract
Foodborne pathogens that enter the human food chain are a significant threat worldwide to human health. Timely and cost-effective detection of them became challenging for many countries that want to improve their detection and control of foodborne illness. We summarize simple, rapid, specific, and highly effective molecular technology that is used to detect and identify foodborne pathogens, including polymerase chain reaction, isothermal amplification, loop-mediated isothermal amplification, nucleic acid sequence-based amplification, as well as gene chip and gene probe technology. The principles of their operation, the research supporting their application, and the advantages and disadvantages of each technology are summarized.
Collapse
|
4
|
Jung J, Jin H, Seo S, Jeong M, Kim B, Ryu K, Oh K. Short Communication: Enterotoxin Genes and Antibiotic Susceptibility of Bacillus cereus Isolated from Garlic Chives and Agricultural Environment. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:12159. [PMID: 36231461 PMCID: PMC9564537 DOI: 10.3390/ijerph191912159] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Revised: 09/17/2022] [Accepted: 09/24/2022] [Indexed: 06/16/2023]
Abstract
This study aims to investigate the enterotoxin profiles and antibiotic susceptibility of Bacillus cereus isolated from garlic chives and environmental samples. A total of 103 B. cereus isolates were used to identify enterotoxin genes, including hblA, hblC, hblD, nheA, nheB, and nheC. The hemolysin BL enterotoxin complex (hblACD) was detected in 38 isolates (36.9%), and the non-hemolytic enterotoxin complex (nheABC) was detected in 8 (7.8%) isolates. Forty-five isolates (43.7%) had hblACD and nheABC genes. B. cereus was resistant to β-lactam antibiotics and susceptible to non-β-lactam antibiotics. However, some B. cereus strains showed intermediate resistance to β-lactam and non-β-lactam antibiotics. B. cereus isolated from garlic chives showed intermediate resistance to cefotaxime (7.7%), rifampin (15.4%), clindamycin (30.8%), erythromycin (7.7%), and tetracycline (7.7%). B. cereus isolates from the agricultural environment were moderately resistant to cefotaxime (18.9%), rifampin (15.6%), clindamycin (12.2%), erythromycin (4.4%), and tetracycline (5.6%). Moreover, B. cereus isolates from garlic chives and cultivation environments could change their antibiotic resistance profile from susceptible to intermediate-resistant to rifampin, clindamycin, erythromycin, and tetracycline and exhibit multidrug resistance. These results indicate that continuous monitoring of B. cereus contamination in the produce and agricultural environment might be needed to ensure the safety of consuming fresh vegetables.
Collapse
Affiliation(s)
- Jieun Jung
- Functional Food Division, Department of Agro-Food Resources, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeolloabuk-do, Korea
| | - Hyeonsuk Jin
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| | - Seungmi Seo
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| | - Myeongin Jeong
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| | - Boeun Kim
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| | - Kyoungyul Ryu
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| | - Kwangkyo Oh
- Microbial Safety Division, Department of Agro-food Safety and Crop Protection, National Institute of Agricultural Sciences, Rural Development Administration, Wanju-gun 55365, Jeollabuk-do, Korea
| |
Collapse
|
5
|
Kayode AJ, Okoh AI. Incidence and genetic diversity of multi-drug resistant Listeria monocytogenes isolates recovered from fruits and vegetables in the Eastern Cape Province, South Africa. Int J Food Microbiol 2021; 363:109513. [PMID: 34971880 DOI: 10.1016/j.ijfoodmicro.2021.109513] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Revised: 12/02/2021] [Accepted: 12/19/2021] [Indexed: 11/24/2022]
Abstract
We investigated the prevalence, genetic diversity and antibiogram profiles of Listeria monocytogenes (Lm) recovered from fruits and vegetables sourced from three District Municipalities in the Eastern Cape Province, South Africa after the recent listeriosis outbreak in the country. The procedure outlined by the International Organization for Standardization EN ISO 11290:2017 Parts 1 and 2 was adopted for the isolation of Lm from 140 vegetable samples. Molecular detection of the pathogen and the presence of 10 virulence-associated markers were assessed. Lm was detected in 42.86% of all the vegetable samples tested. Highest prevalence was recorded in tomato (65.52%) followed by spinach (56.67%), cabbage (38.10%), apple (36.84%), mushroom (29.41%) and carrot (10%). The virulence determinants including the inlA, inlC, prfA and plcA, hly, plcB genes were detected in all Lm isolates whereas, inlJ (88.35%), inlB (86.41%), mpl (92.23%) and actA (84.55%) respectively. High susceptibility (> 50) was observed to all antibiotics tested except for sulfamethoxazole (17.48%), streptomycin (38.84%), amoxicillin (41.75%) and erythromycin (43.69%). However, high resistance against sulfamethoxazole (80.58%), amoxicillin (58.25%) and erythromycin (49.52%) were observed. About 85.44% of Lm isolates showed multidrug-resistance phenotypes against the test antibiotics. Furthermore, twenty (20) resistance genes encoding tetracyclines, sulphonamides, phenicols, aminoglycosides, β-lactamases, and variants of the extended-spectrum of β-lactamases (ESBLs) resistance were detected among the Lm isolates. The sul2 (90.81), tetM (68.42%) sul1 (45.98%) were more prevalent among the resistant strains. The dendrogram signatures generating seven clades is an indication of the high genetic diversity among the isolates. We conclude that the presence of Lm in fruits and vegetables is a potential threat to the consumers and a potential public health hazard, particularly to the high-risk group of the population.
Collapse
Affiliation(s)
- Adeoye John Kayode
- SAMRC Microbial Water Quality Monitoring Center, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa; Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa.
| | - Anthony Ifeanyi Okoh
- Department of Environmental Health Sciences, College of Health Sciences, University of Sharjah, Sharjah, United Arab Emirates; SAMRC Microbial Water Quality Monitoring Center, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa; Applied and Environmental Microbiology Research Group (AEMREG), Department of Biochemistry and Microbiology, University of Fort Hare, Private Bag X1314, Alice 5700, South Africa
| |
Collapse
|
6
|
Listeria monocytogenes: health risk and a challenge for food processing establishments. Arch Microbiol 2021; 203:5907-5919. [DOI: 10.1007/s00203-021-02590-2] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/25/2021] [Revised: 09/06/2021] [Accepted: 09/20/2021] [Indexed: 12/19/2022]
|
7
|
Wilczyńska A, Kukułowicz A, Lewandowska A. Preliminary assessment of microbial quality of edible flowers. Lebensm Wiss Technol 2021. [DOI: 10.1016/j.lwt.2021.111926] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/28/2022]
|
8
|
Das S, Vishakha K, Banerjee S, Mondal S, Ganguli A. Antibacterial and antibiofilm effectiveness of bioactive packaging materials from edible sodium alginate and vanillin: Assessment on lettuce. J FOOD PROCESS PRES 2021. [DOI: 10.1111/jfpp.15668] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/14/2022]
Affiliation(s)
- Shatabdi Das
- Department of Microbiology Techno India University Kolkata India
| | - Kumari Vishakha
- Department of Microbiology Techno India University Kolkata India
| | | | | | - Arnab Ganguli
- Department of Microbiology Techno India University Kolkata India
| |
Collapse
|
9
|
Cristiano D, Peruzy MF, Aponte M, Mancusi A, Proroga YTR, Capuano F, Murru N. Comparison of droplet digital PCR vs real-time PCR for Yersinia enterocolitica detection in vegetables. Int J Food Microbiol 2021; 354:109321. [PMID: 34225034 DOI: 10.1016/j.ijfoodmicro.2021.109321] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/23/2021] [Revised: 06/18/2021] [Accepted: 06/21/2021] [Indexed: 11/30/2022]
Abstract
Yersiniosis - the 4th most commonly reported zoonosis in the European Union - is caused by the consumption of food contaminated with the bacterium Yersinia enterocolitica. The number of human cases and contaminated food samples is probably underestimated since conventional molecular methods currently proposed for Yersinia enterocolitica detection proved to have several limitations. Critical issues associated with the detection of Yersinia enterocolitica in meat and/or meat product has already been investigated, whereas data on the possible limits of the molecular methods for Yersinia enterocolitica detection in vegetables are still lacking. According to ISO method (ISO 18867:2015), real-time polymerase chain reaction (rtPCR) should be adopted for Yersinia enterocolitica detection, even if it proved to be affected by some biases. Recently, Droplet Digital PCR (ddPCR) has been introduced as a useful tool to detect and quantify different pathogenic bacteria in complex food matrices. However, its potential application for Yersinia enterocolitica detection in vegetables has never been investigated before. In the present study two molecular platforms (rtPCR and ddPCR) were used to evaluate the pathogen's behaviour in experimentally contaminated leafy greens (Lactuca sativa L.) and to assess the rate of detection achievable after the incubation for eleven days at different temperatures. By comparing, noticeable differences emerged between the two technical approaches: only ddPCR allowed the detection of the pathogen in leafy greens when contaminated at low levels. Moreover, results of the present work highlighted the importance of length and temperature of incubation on the survival and/or the growth of Yersinia enterocolitica in vegetables: at 18 and 25 °C the concentration of the pathogen considerably decreases along incubation. Based on data, the use of rtPCR leads to an underestimation of the true prevalence of pathogenic Y. enterocolitica in vegetables, while temperature and time currently proposed for Y. enterocolitica (25 °C for 24 h), allow optimizing detection. To conclude, ddPCR may be undoubtedly proposed as a reliable alternative strategy for the quick detection of the pathogen in food samples.
Collapse
Affiliation(s)
- D Cristiano
- Department of Food Microbiology, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute, 2, 8055 Portici, NA, Italy
| | - M F Peruzy
- Department of Veterinary Medicine and Animal Production, University of Naples "Federico II", Via Delpino 1, 80137 Napoli, Italy.
| | - M Aponte
- Department of Agricultural Sciences, University of Naples 'Federico II', Via Università 100, Portici, NA, Italy
| | - A Mancusi
- Department of Food Microbiology, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute, 2, 8055 Portici, NA, Italy
| | - Y T R Proroga
- Department of Food Microbiology, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute, 2, 8055 Portici, NA, Italy
| | - F Capuano
- Department of Food Microbiology, Istituto Zooprofilattico Sperimentale del Mezzogiorno, Via Salute, 2, 8055 Portici, NA, Italy
| | - N Murru
- Department of Veterinary Medicine and Animal Production, University of Naples "Federico II", Via Delpino 1, 80137 Napoli, Italy; Task Force on Microbiome Studies, University of Naples Federico II, Naples, Italy
| |
Collapse
|
10
|
Wang Q, Xu Y, Liu L, Li LY, Lin H, Wu XY, Bi WJ, Wang LT, Mao DQ, Luo Y. The prevalence of ampicillin-resistant opportunistic pathogenic bacteria undergoing selective stress of heavy metal pollutants in the Xiangjiang River, China. ENVIRONMENTAL POLLUTION (BARKING, ESSEX : 1987) 2021; 268:115362. [PMID: 33035873 DOI: 10.1016/j.envpol.2020.115362] [Citation(s) in RCA: 23] [Impact Index Per Article: 7.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 01/20/2020] [Revised: 07/06/2020] [Accepted: 08/02/2020] [Indexed: 05/11/2023]
Abstract
The emergence of clinically relevant β-lactam-resistant bacteria poses a serious threat to human health and presents a major challenge for medical treatment. How opportunistic pathogenic bacteria acquire antibiotic resistance and the prevalence of antibiotic-resistant opportunistic pathogenic bacteria in the environment are still unclear. In this study, we further confirmed that the selective pressure of heavy metals contributes to the increase in ampicillin-resistant opportunistic pathogens in the Xiangjiang River. Four ampicillin-resistant opportunistic pathogenic bacteria (Pseudomonas monteilii, Aeromonas hydrophila, Acinetobacter baumannii, and Staphylococcus epidermidis) were isolated on Luria-Bertani (LB) agar plates and identified by 16S rRNA sequencing. The abundance of these opportunistic pathogenic bacteria significantly increased in the sites downstream of the Xiangjiang River that were heavily influenced by metal mining activities. A microcosm experiment showed that the abundance of β-lactam resistance genes carried by opportunistic pathogenic bacteria in the heavy metal (Cu2+ and Zn2+) treatment group was 2-10 times higher than that in the control. Moreover, heavy metals (Cu2+ and Zn2+) significantly increased the horizontal transfer of plasmids in pathogenic bacteria. Of particular interest is that heavy metals facilitated the horizontal transfer of conjugative plasmids, which may lead to the prevalence of multidrug-resistant pathogenic bacteria in the Xiangjiang River.
Collapse
Affiliation(s)
- Qing Wang
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China; College of Energy and Environmental Engineering, Hebei Key Laboratory of Air Pollution Cause and Impact (preparatory), Hebei University of Engineering, Handan, 056038, China
| | - Yan Xu
- Agro-Environmental Protection Institute, Ministry of Agriculture, Tianjin, 300191, China
| | - Lei Liu
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China
| | - Lin-Yun Li
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China
| | - Huai Lin
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China
| | - Xin-Yan Wu
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China; School of Medicine, Nankai University, Tianjin, 300071, China
| | - Wen-Jing Bi
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China; School of Medicine, Nankai University, Tianjin, 300071, China
| | - Li-Tao Wang
- College of Energy and Environmental Engineering, Hebei Key Laboratory of Air Pollution Cause and Impact (preparatory), Hebei University of Engineering, Handan, 056038, China
| | - Da-Qing Mao
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yi Luo
- College of Environmental Sciences and Engineering, Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, Nankai University, Tianjin, 300350, China.
| |
Collapse
|
11
|
Maćkiw E, Korsak D, Kowalska J, Felix B, Stasiak M, Kucharek K, Postupolski J. Incidence and genetic variability of Listeria monocytogenes isolated from vegetables in Poland. Int J Food Microbiol 2020; 339:109023. [PMID: 33341686 DOI: 10.1016/j.ijfoodmicro.2020.109023] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/21/2020] [Revised: 12/08/2020] [Accepted: 12/09/2020] [Indexed: 02/07/2023]
Abstract
The aim of the present study is to investigate the prevalence and genetic diversity of Listeria monocytogenes in various fresh and frozen vegetable products available in Poland. The samples were collected at retail market within the framework of national official control and monitoring program. In the years 2016-2019 a total of 49 samples out of 8712 collected vegetable samples were positive for L. monocytogenes. Our findings demonstrated that the occurrence of L. monocytogenes in various vegetable products was generally low, on average only 0.56% in the studied years. All isolates were susceptible to 11 antimicrobial agents: penicillin, ampicillin, meropenem, erythromycin, sulfamethoxazole-trimethoprim, amoxicillin-clavulanic acid, ciprofloxacin, chloramphenicol, gentamicin, vancomycin, and tetracycline. All of them harbored virulence-associated genes (inlA, inlC, and lmo2672), 82% harbored inlJ gene and few of them (22%) also possessed the llsX gene. The majority of collected isolates (65%) belonged to molecular serogroup 1/2a-3a, followed by 4ab-4b-4d-4e (33%), and only one to serogroup 1/2b-3b-7 (2%). Isolates yielded 18 different restriction profiles, revealing a large cluster of contamination linked to frozen corn (21 strains) and distributed in 3 pulsotypes. MLST analysis classified selected isolates into nine clonal complexes (CCs). The obtained results contribute to characterizing the diversity of L. monocytogenes isolated from various vegetable products in Poland and their impact on food safety and public health.
Collapse
Affiliation(s)
- Elżbieta Maćkiw
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland.
| | - Dorota Korsak
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Joanna Kowalska
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Benjamin Felix
- European Union Reference Laboratory for L. monocytogenes, ANSES, Laboratory for Food Safety, University of Paris-Est, 94700 Maisons-Alfort, France
| | - Monika Stasiak
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Katarzyna Kucharek
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| | - Jacek Postupolski
- Department of Food Safety, National Institute of Public Health - National Institute of Hygiene, Warsaw, Poland
| |
Collapse
|
12
|
Willis C, McLauchlin J, Aird H, Amar C, Barker C, Dallman T, Elviss N, Lai S, Sadler-Reeves L. Occurrence of Listeria and Escherichia coli in frozen fruit and vegetables collected from retail and catering premises in England 2018–2019. Int J Food Microbiol 2020; 334:108849. [DOI: 10.1016/j.ijfoodmicro.2020.108849] [Citation(s) in RCA: 12] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/18/2020] [Revised: 08/18/2020] [Accepted: 08/19/2020] [Indexed: 10/23/2022]
|
13
|
Colombe S, Jernberg C, Löf E, Angervall AL, Mellström-Dahlgren H, Dotevall L, Bengnér M, Hall I, Sundqvist L, Kühlmann-Berenzon S, Galanis I, Lindblad M, Hansen A, Rehn M. Outbreak of unusual H 2S-negative monophasic Salmonella Typhimurium strain likely associated with small tomatoes, Sweden, August to October 2019. ACTA ACUST UNITED AC 2020; 24. [PMID: 31771698 PMCID: PMC6885747 DOI: 10.2807/1560-7917.es.2019.24.47.1900643] [Citation(s) in RCA: 11] [Impact Index Per Article: 2.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/25/2022]
Abstract
Sweden is investigating an outbreak of monophasic Salmonella Typhimurium. Eighty-two nationally-distributed cases have been confirmed, with date of symptom onset between 28 August and 29 October. Cases were 51 years of age on average (range: 0–89) and the majority of cases were female (62%). A case–control study was conducted and suggested small tomatoes as source of the outbreak (adjusted odds ratio (OR): 10.8, 95% confidence interval (CI): 4.15-112.68, p value < 0.001), and a trace-back investigation led to a single, non-Swedish producer in Europe. Both the Salmonella strain and the source of the outbreak are rarely encountered in Europe. Results from investigation at the producer are pending.
Collapse
Affiliation(s)
- Soledad Colombe
- European Programme for Intervention Epidemiology Training (EPIET), European Centre for Disease Prevention and Control (ECDC), Solna, Sweden.,Public Health Agency of Sweden, Solna, Sweden
| | | | - Emma Löf
- Public Health Agency of Sweden, Solna, Sweden
| | - Anna Lindqvist Angervall
- County Council Department of Communicable Disease Control and Prevention, Region Västra Götaland, Gothenburg, Sweden
| | - Henrik Mellström-Dahlgren
- County Council Department of Communicable Disease Control and Prevention, Region Västra Götaland, Gothenburg, Sweden
| | - Leif Dotevall
- County Council Department of Communicable Disease Control and Prevention, Region Västra Götaland, Gothenburg, Sweden
| | - Malin Bengnér
- County Council Department of Communicable Disease Control and Prevention, Region Jönköping, Jönköping, Sweden
| | - Ingela Hall
- County Council Department of Communicable Disease Control and Prevention, Region Jönköping, Jönköping, Sweden
| | | | | | | | | | | | - Moa Rehn
- Public Health Agency of Sweden, Solna, Sweden
| |
Collapse
|
14
|
Otto M, Pretorius B, Kritzinger Q, Schönfeldt H. Contamination of freshly harvested Bambara groundnut (
Vigna subterranea
) seed from Mpumalanga, South Africa, with mycotoxigenic fungi. J Food Saf 2020. [DOI: 10.1111/jfs.12846] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/30/2022]
Affiliation(s)
- Margot Otto
- Department of Animal and Wildlife Science, Institute of Food Nutrition and Well‐Being University of Pretoria Pretoria South Africa
| | - Beulah Pretorius
- Department of Animal and Wildlife Science, Institute of Food Nutrition and Well‐Being University of Pretoria Pretoria South Africa
| | - Quenton Kritzinger
- Department of Plant and Soil Sciences University of Pretoria Pretoria South Africa
| | - Hettie Schönfeldt
- Department of Animal and Wildlife Science, Institute of Food Nutrition and Well‐Being University of Pretoria Pretoria South Africa
| |
Collapse
|
15
|
Ali AA, Altemimi AB, Alhelfi N, Ibrahim SA. Application of Biosensors for Detection of Pathogenic Food Bacteria: A Review. BIOSENSORS 2020; 10:E58. [PMID: 32486225 PMCID: PMC7344754 DOI: 10.3390/bios10060058] [Citation(s) in RCA: 62] [Impact Index Per Article: 15.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Revised: 05/22/2020] [Accepted: 05/27/2020] [Indexed: 12/14/2022]
Abstract
The use of biosensors is considered a novel approach for the rapid detection of foodborne pathogens in food products. Biosensors, which can convert biological, chemical, or biochemical signals into measurable electrical signals, are systems containing a biological detection material combined with a chemical or physical transducer. The objective of this review was to present the effectiveness of various forms of sensing technologies for the detection of foodborne pathogens in food products, as well as the criteria for industrial use of this technology. In this article, the principle components and requirements for an ideal biosensor, types, and their applications in the food industry are summarized. This review also focuses in detail on the application of the most widely used biosensor types in food safety.
Collapse
Affiliation(s)
- Athmar A. Ali
- Department of Food Science, College of Agriculture, University of Basrah, Basrah 61001, Iraq; (A.A.A.); (A.B.A.); (N.A.)
| | - Ammar B. Altemimi
- Department of Food Science, College of Agriculture, University of Basrah, Basrah 61001, Iraq; (A.A.A.); (A.B.A.); (N.A.)
| | - Nawfal Alhelfi
- Department of Food Science, College of Agriculture, University of Basrah, Basrah 61001, Iraq; (A.A.A.); (A.B.A.); (N.A.)
| | - Salam A. Ibrahim
- Food and Nutritional Science Program, North Carolina A & T State University, Greensboro, NC 27411, USA
| |
Collapse
|
16
|
Koutsoumanis K, Alvarez‐Ordóñez A, Bolton D, Bover‐Cid S, Chemaly M, Davies R, De Cesare A, Herman L, Hilbert F, Lindqvist R, Nauta M, Peixe L, Ru G, Simmons M, Skandamis P, Suffredini E, Jordan K, Sampers I, Wagner M, Da Silva Felicio MT, Georgiadis M, Messens W, Mosbach‐Schulz O, Allende A. The public health risk posed by Listeria monocytogenes in frozen fruit and vegetables including herbs, blanched during processing. EFSA J 2020; 18:e06092. [PMID: 32874300 PMCID: PMC7448082 DOI: 10.2903/j.efsa.2020.6092] [Citation(s) in RCA: 24] [Impact Index Per Article: 6.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/06/2023] Open
Abstract
A multi-country outbreak of Listeria monocytogenes ST6 linked to blanched frozen vegetables (bfV) took place in the EU (2015-2018). Evidence of food-borne outbreaks shows that L. monocytogenes is the most relevant pathogen associated with bfV. The probability of illness per serving of uncooked bfV, for the elderly (65-74 years old) population, is up to 3,600 times greater than cooked bfV and very likely lower than any of the evaluated ready-to-eat food categories. The main factors affecting contamination and growth of L. monocytogenes in bfV during processing are the hygiene of the raw materials and process water; the hygienic conditions of the food processing environment (FPE); and the time/Temperature (t/T) combinations used for storage and processing (e.g. blanching, cooling). Relevant factors after processing are the intrinsic characteristics of the bfV, the t/T combinations used for thawing and storage and subsequent cooking conditions, unless eaten uncooked. Analysis of the possible control options suggests that application of a complete HACCP plan is either not possible or would not further enhance food safety. Instead, specific prerequisite programmes (PRP) and operational PRP activities should be applied such as cleaning and disinfection of the FPE, water control, t/T control and product information and consumer awareness. The occurrence of low levels of L. monocytogenes at the end of the production process (e.g. < 10 CFU/g) would be compatible with the limit of 100 CFU/g at the moment of consumption if any labelling recommendations are strictly followed (i.e. 24 h at 5°C). Under reasonably foreseeable conditions of use (i.e. 48 h at 12°C), L. monocytogenes levels need to be considerably lower (not detected in 25 g). Routine monitoring programmes for L. monocytogenes should be designed following a risk-based approach and regularly revised based on trend analysis, being FPE monitoring a key activity in the frozen vegetable industry.
Collapse
|
17
|
Wang Q, Duan YJ, Wang SP, Wang LT, Hou ZL, Cui YX, Hou J, Das R, Mao DQ, Luo Y. Occurrence and distribution of clinical and veterinary antibiotics in the faeces of a Chinese population. JOURNAL OF HAZARDOUS MATERIALS 2020; 383:121129. [PMID: 31546217 DOI: 10.1016/j.jhazmat.2019.121129] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Subscribe] [Scholar Register] [Received: 07/05/2019] [Revised: 08/26/2019] [Accepted: 08/30/2019] [Indexed: 05/21/2023]
Abstract
Antibiotics ingested in the human gut may create selective pressure to change the composition of the gut microbiota, which could adversely effect the immune system of the host. However, the occurrence and distribution of antibiotics in the human gut remains unclear. A total population of 180 individuals, across three Chinses regions with different economic development levels, including children, adults, and elders, were sampled in 2017. A total of 19 representative antibiotics, including both clinical and veterinary antibiotics, were investigated in human faeces. While clinical use and prescriptions were the main exposure pathways for children, environmental media were the exposure pathway to adults. In addition, significant differences (P < 0.05) in antibiotic residues in human faeces were observed amongst various economic development levels, where human faeces from underdeveloped areas were mostly associated with higher levels of antibiotics. This study first to investigate the occurrence and distribution of typical antibiotics in the faeces of a Chinese population and thereby provide a reference for the intensive study of the effects and mechanisms of antibiotics on human gut microbiota.
Collapse
Affiliation(s)
- Qing Wang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China; Hebei Key Laboratory of Air Pollution Cause and Impact (preparatory), College of Energy and Environmental Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Yu-Jing Duan
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Shao-Peng Wang
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Li-Tao Wang
- Hebei Key Laboratory of Air Pollution Cause and Impact (preparatory), College of Energy and Environmental Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Ze-Lin Hou
- Hebei Key Laboratory of Air Pollution Cause and Impact (preparatory), College of Energy and Environmental Engineering, Hebei University of Engineering, Handan, 056038, China
| | - Yu-Xiao Cui
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Jie Hou
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Ranjit Das
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China
| | - Da-Qing Mao
- School of Medicine, Nankai University, Tianjin, 300071, China
| | - Yi Luo
- Ministry of Education Key Laboratory of Pollution Processes and Environmental Criteria, College of Environmental Science and Engineering, Nankai University, Tianjin, 300071, China.
| |
Collapse
|
18
|
Jung D, Rubin JE. Identification of antimicrobial resistant bacteria from plant-based food products imported into Canada. Int J Food Microbiol 2020; 319:108509. [PMID: 31945714 DOI: 10.1016/j.ijfoodmicro.2020.108509] [Citation(s) in RCA: 10] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2019] [Revised: 12/22/2019] [Accepted: 01/06/2020] [Indexed: 02/08/2023]
Abstract
The role of plant-based foods in the epidemiology of antimicrobial resistance has been inadequately studied. In this investigation, resistant organisms from vegetables, fruits and spices imported into Canada were identified and characterized. A total of 143 products imported from primarily Asian and African countries were purchased from international markets in Saskatoon, Saskatchewan. Samples were selectively cultured for bacterial species where resistance is known to be emerging. The proportions of samples positive for each organism were as follows: E. coli (n = 13, 9.1%), Salmonella spp. (n = 2, 1.4%), ESBL producing Enterobacter spp. (n = 2, 1.4%) and K. pneumoniae (n = 2, 1.4%), S. aureus (n = 7, 4.9%) and Enterococcus spp. (n = 66, 46.2%). Antimicrobial minimum inhibitory concentrations were determined by broth micro-dilution and agar-dilution. Based on the susceptibility of each organism, isolates were screened for resistance genes (β-lactamases and plasmid mediated quinolones resistance determinants) by PCR. Extended-spectrum β-lactamase producing Enterobacteriaceae and methicillin resistant S. aureus (MRSA) were identified from 6/143 (4.2%) and 2/143 (1.4%) of samples respectively. The qnrB, qnrS and aac(6')-Ib-cr plasmid mediated quinolone resistance determinants were identified in 2/143 (1.4%) of samples tested. None of the Enterobacteriaceae isolates were resistant to meropenem or colistin. Similarly, all Enterococcus isolates remained susceptible to ampicillin, penicillin and vancomycin. Finding multi-drug resistant bacteria which are frequently isolated from human infections is concerning, although the contribution of the global food trade to the dissemination of resistance remains cryptic. These results suggest that imported plant-based foods may be an underappreciated source of clinically relevant resistant organisms. Further study is required to address these gaps in our understanding of the epidemiology of resistance, and the magnitude of the risk posed to human health by these organisms.
Collapse
Affiliation(s)
- Dongyun Jung
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada
| | - Joseph E Rubin
- Department of Veterinary Microbiology, University of Saskatchewan, Saskatoon, Saskatchewan, Canada.
| |
Collapse
|
19
|
Verma P, Saharan VV, Nimesh S, Singh AP. Phenotypic and virulence traits of Escherichia coli and Salmonella strains isolated from vegetables and fruits from India. J Appl Microbiol 2018. [PMID: 29512849 DOI: 10.1111/jam.13754] [Citation(s) in RCA: 12] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
AIMS The present study was designed to assess the phenotypic traits and virulence determinants of vegetable-/fruit-origin Escherichia coli and Salmonella strains. METHODS AND RESULTS A total of 520 fresh vegetables/fruits samples were analysed for the presence of E. coli, including Shiga toxin-producing E. coli (STEC), and Salmonella. The vegetable-/fruit-origin E. coli and Salmonella strains were further assessed for antimicrobial resistance, biofilm formation, extracellular matrix production and in vitro invasion/intracellular survivability assays. A total of 73 E. coli, including four STEC, and 26 Salmonella strains were recovered from vegetables/fruits in the present study. Most of the E. coli and Salmonella isolates were able to form biofilm with higher production of cellulose/curli-fimbriae. Furthermore, more resistance was observed in E. coli isolates (61·6%) than in Salmonella isolates (38·5%) against tested antimicrobials. Additionally, invasion/intracellular survival results showed that majority of the E. coli and Salmonella isolates were able to efficiently invade/replicate intracellularly in the human epithelial cells. CONCLUSIONS Our results demonstrate that vegetable-/fruit-origin E. coli and Salmonella significantly exhibited distinct phenotypic/virulence traits which could be linked to their plant-associated lifestyle with food safety issues. SIGNIFICANCE AND IMPACT OF THE STUDY The present study provides valuable baseline information that E. coli and Salmonella may use plants as an alternative host with significant clinical importance.
Collapse
Affiliation(s)
- P Verma
- Department of Microbiology, School of Life Science, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - V V Saharan
- Department of Microbiology, School of Life Science, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - S Nimesh
- Department of Biotechnology, School of Life Science, Central University of Rajasthan, Ajmer, Rajasthan, India
| | - A P Singh
- Department of Microbiology, School of Life Science, Central University of Rajasthan, Ajmer, Rajasthan, India
| |
Collapse
|
20
|
Jordan K, McAuliffe O. Listeria monocytogenes in Foods. ADVANCES IN FOOD AND NUTRITION RESEARCH 2018; 86:181-213. [PMID: 30077222 DOI: 10.1016/bs.afnr.2018.02.006] [Citation(s) in RCA: 65] [Impact Index Per Article: 10.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Indexed: 12/03/2022]
Abstract
Listeria monocytogenes causes listeriosis, a rare foodborne disease with a mortality rate of 20%-30%. The elderly and immunocompromised are particularly susceptible to listeriosis. L. monocytogenes is ubiquitous in nature and can contaminate food-processing environments, posing a threat to the food chain. This is particularly important for ready-to-eat foods as there is no heat treatment or other antimicrobial step between production and consumption. Thus, occurrence and control of L. monocytogenes are important for industry and public health. Advances in whole-genome sequence technology are facilitating the investigation of disease outbreaks, linking sporadic cases to outbreaks, and linking outbreaks internationally. Novel control methods, such as bacteriophage and bacteriocins, can contribute to a reduction in the occurrence of L. monocytogenes in the food-processing environment, thereby reducing the risk of food contamination and contributing to a reduction in public health issues.
Collapse
|
21
|
|
22
|
Meta-analysis of the incidence of foodborne pathogens in vegetables and fruits from retail establishments in Europe. Curr Opin Food Sci 2017. [DOI: 10.1016/j.cofs.2017.10.001] [Citation(s) in RCA: 18] [Impact Index Per Article: 2.6] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/22/2022]
|
23
|
Wang W, Baloch Z, Jiang T, Zhang C, Peng Z, Li F, Fanning S, Ma A, Xu J. Enterotoxigenicity and Antimicrobial Resistance of Staphylococcus aureus Isolated from Retail Food in China. Front Microbiol 2017; 8:2256. [PMID: 29209290 PMCID: PMC5702451 DOI: 10.3389/fmicb.2017.02256] [Citation(s) in RCA: 39] [Impact Index Per Article: 5.6] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/12/2017] [Accepted: 10/31/2017] [Indexed: 11/17/2022] Open
Abstract
Staphylococcus aureus is one of the most common causes of zoonotic agent in the world, which are attributable to the contamination of food with enterotoxins. In this study, a total of 1,150 S. aureus isolates were cultured from 27,000 retail foods items from 203 cities of 24 provinces in China in 2015 and were test for antimicrobial susceptibility. Additionally, the role of the genes responsible for the staphylococcal enterotoxins (SEA to SEE), methicillin resistance (mecA) and the toxigenic capabilities were also assessed. The results showed that 4.3% retail foods were contaminated with S. aureus, and 7.9% retail foods isolates were mecA positive. Some 97.6% of S. aureus isolates were resistant to at least one antimicrobial compound, and 57.5% of these were multi drug resistant (MDR). Resistance to penicillin (83.7%, 963/1,150), was common, followed by linezolid (67.7%, 778/1,150) and erythromycin (52.1%, 599/1,150). The isolates cultured from raw meats showed high levels of resistant to tetracycline (42.8%), ciprofloxacin (17.4%), and chloramphenicol (12.0%) and expressed a MDR phenotype (62.4%). A total of 29.7% S. aureus isolates harbored the classical SEs genes (sea, seb, sec, and sed). The sea and seb genes were the most frequent SEs genes detected. Of note, 22% of the SEs genes positive S. aureus harbored two or three SEs genes, and 16 isolates were confirmed with the capacity to simultaneously produce two or three enterotoxin types. Moreover, nearly 50% of the MRSA isolates were positive for at least one SE gene in this study. Therefore, it is important to monitor the antimicrobial susceptibility and enterotoxigenicity of MDR S. aureus and MRSA in the food chain and to use these data to develop food safety measures, designed to reduce the contamination and transmission of this bacterium.
Collapse
Affiliation(s)
- Wei Wang
- School of Public Health, Qingdao University, Qingdao, China.,Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Zulqarnain Baloch
- College of Veterinary Medicine, South China Agricultural University, Guangzhou, China
| | - Tao Jiang
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Cunshan Zhang
- Kuiwen District Center for Disease Control and Prevention, Weifang, China
| | - Zixin Peng
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Fengqin Li
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| | - Séamus Fanning
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China.,UCD-Centre for Food Safety, School of Public Health, Physiotherapy and Sports Science, University College Dublin, Dublin, Ireland.,Institute for Global Food Security, School of Biological Sciences, Queen's University Belfast, Belfast, United Kingdom
| | - Aiguo Ma
- School of Public Health, Qingdao University, Qingdao, China
| | - Jin Xu
- Key Laboratory of Food Safety Risk Assessment, Ministry of Health, China National Center for Food Safety Risk Assessment, Beijing, China
| |
Collapse
|
24
|
Kwon JH, Reske KA, Hink T, Seiler SM, Wallace MA, Bommarito KM, Burnham CAD, Dubberke ER. An Evaluation of the Prevalence of Vancomycin-Resistant Enterococci (VRE) and Methicillin-Resistant Staphylococcus aureus (MRSA) in Hospital Food. Infect Control Hosp Epidemiol 2017; 38:1373-1375. [PMID: 28950921 PMCID: PMC6261362 DOI: 10.1017/ice.2017.207] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/06/2022]
Abstract
This prospective cohort study evaluated the presence of MRSA and VRE in the food of hospitalized patients. 149 patients were enrolled and 910 food specimens cultured; 3.2% were positive for MRSA and 2.4% positive for VRE, from a variety of food types.
Collapse
Affiliation(s)
- Jennie H. Kwon
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Kimberly A. Reske
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Tiffany Hink
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Sondra M. Seiler
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Meghan A. Wallace
- Department of Pathology & Immunology, Washington University School of Medicine, St. Louis, MO, USA
| | - Kerry M. Bommarito
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| | - Carey-Ann D. Burnham
- Departments of Pathology & Immunology, Molecular Microbiology, and Pediatrics, Washington University School of Medicine, St. Louis, MO, USA
| | - Erik R. Dubberke
- Division of Infectious Diseases, Washington University School of Medicine, St. Louis, MO, USA
| |
Collapse
|