Foods from black market at EU border as a neglected route of potential methicillin-resistant Staphylococcus aureus transmission

Methicillin-Resistant Staphylococcus aureus (MRSA) in Dairy Products and Bulk-Tank Milk (BTM)

In order to contribute to an assessment of the role of food in the risks of transmission of methicillin-resistant Staphylococcus aureus (MRSA), a review was undertaken of research on this microorganism in milk and dairy products published from January 2001 to February 2024. A total of 186 publications were selected, 125 for dairy products and 61 for bulk-tank milk (BTM). MRSA was detected in 68.8% of the research into dairy products and 73.8% of investigations relating to BTM, although in most studies the prevalence was less than 5%. Of the set of S. aureus strains isolated, approximately 30% corresponded to MRSA. The foods most extensively contaminated with this microorganism were raw milk and some types of soft cheese. Determination of the mecA gene on its own is known not to suffice for the detection of all MRSA strains. The great diversity of techniques used to study MRSA in milk and dairy products made it difficult to draw comparisons between studies. It would thus be advisable to develop a standardized protocol for the study of this microorganism in foods.

Residues of Veterinary Drugs in Animal Products Commercialized in the Border Region of Brazil, Argentina, and Uruguay

ABSTRACT

The traffic in international animal products can become a public health hazard when legal import sanitary procedures are not followed. In Brazil, due to its extensive border area, the importation of animal products is a common practice in many areas, especially in Rio Grande do Sul, a state that borders Argentina and Uruguay. The objective of this study was to evaluate the presence of veterinary drug residues (antibiotics and antiparasitics) in animal products consumed in Rio Grande do Sul. The presence of residues of veterinary antibiotics and antiparasitics was assessed in 189 meat (beef, pork, and chicken), processed dairy, and meat product samples bought in Argentina (n = 90) and Uruguay (n = 99). Residues of these veterinary drugs were detected in 50 (26.45%) of the samples; 28 samples (14.81%) had antibiotic residues, and 22 samples (11.64%) had antiparasitic residues. Of the 50 positive samples, 40% (15 from Argentina and 5 from Uruguay) had residues above the maximum residue limits (MRLs). Of these 20 samples, 12 had antiparasitic residues above the MRLs (11 beef samples had ivermectin and 1 pork sample had ivermectin and doramectin) and 8 had antibiotic residues above the MRLs (2 pork and 2 sausage samples had doxycycline, 2 cheese samples had doxycycline and chlortetracycline, 1 poultry meat sample had chloramphenicol, and 1 cheese sample had monensin). Because of the potential toxic effects on humans and the potential for pathogens to develop antibiotic resistance, the presence of these residues above the MRLs is a potential risk to public health. The negative impact of consumption of imported animal products can be reduced by implementation of an effective surveillance system and educational campaigns for the general population.

HIGHLIGHTS

Multidrug Resistant Coagulase-Positive Staphylococcus aureus and Their Enterotoxins Detection in Traditional Cheeses Marketed in Banat Region, Romania

The main objectives of the present study were to determine the occurrence of coagulase positive staphylococci (CPS) and to assess the presence and antimicrobial susceptibility profile of Staphylococcus aureus isolates in different raw milk origin (cow and sheep) traditional cheeses marketed in Banat region, Romania. Additionally, the presence of mecA gene in S. aureus isolates and the staphylococcal enterotoxins (SEs) in cheese samples were evaluated. A total of 81.6% (138/169) of the screened samples were positive for CPS. Furthermore, 35.5% (49/138) of the investigated CPS positive cheese samples were contaminated with S. aureus, with an isolation frequency of 46.6% (14/30) in caș, 33.3% (32/96) in telemea, 25% (2/8) in burduf, and 25% (1/4) in urdă assortments, respectively. From the total number of S. aureus isolates, 6.1% (3/49) harbored the mecA gene. Detectable levels of SEs were identified in 4.3% (4/94) of cheese samples with a CPS contamination level higher than 10⁵ log CFU g⁻¹. The expressed antimicrobial susceptibility profile of the tested cheese-origin S. aureus isolates, with the automated Vitek 2 equipment, showed resistance towards amikacin (90.1%, 10 out from 11 tested), enrofloxacin (86.2%, 25/29), ceftiofur (72.7%, 8/11), neomycin (63.6%, 7/11), benzylpenicillin (53.1%, 26/49), kanamycin (41.4%, 12/29), rifampicin (39.5%, 15/38), tetracycline (38.8%, 19/49), tilmicosin (36.4%, 4/11), clindamycin (30.6%, 15/49), ciprofloxacin (30%, 6/20), erythromycin (22.4%, 11/49), tylosin (18.2%, 2/11), oxacillin (16.3%, 8/49), linezolid (15%, 3/20), teicoplanin (15%, 3/20), fusidic acid (13.1%), imipenem (10.5%, 4/38), vancomycin (7.9%, 3/38), ampicillin (5.5%, 1/18), mupirocin (5.5%, 1/18), fosfomycin (5%, 1/20), and gentamicin (4.1%, 2/49). Twenty-four (49%) S. aureus isolates exhibited multidrug resistance. The investigation highlighted a common occurrence of multidrug-resistant S. aureus strains in the monitored cheese assortments, which can constitute a potential risk for consumers’ health.

Scientific Achievements in the Study of the Occurrence and Antimicrobial Susceptibility Profile of Major Foodborne Pathogenic Bacteria in Foods and Food Processing Environments in Romania: Review of the Last Decade

Pathogenic bacteria are recognized as a major cause of foodborne diseases in humans, globally, with negative impact on the economy of each country. The aim of the present review was to obtain a comprehensive understanding about the frequency of isolation, diversity, and antimicrobial susceptibility profile of the six major foodborne pathogenic bacteria in food matrices and food processing environment, in Romania. In this regard, results of relevant epidemiological studies, published during the last decade and retrieved from the Web of Science Core Collection database, were analyzed, with special emphasis on scientific achievements, main knowledge gaps, and future perspectives. The summarized and harmonized results offer useful insight, especially for public health authorities and researchers, having a reference effect in stimulating further opportunities for studies to be carried out to address some of the limitations of the current status.

The Genomic Context for the Evolution and Transmission of Community-Associated Staphylococcus aureus ST59 Through the Food Chain

Sequence type 59 (ST59) is a predominant clonal lineage of community-acquired, methicillin-resistant Staphylococcus aureus (CA-MRSA) in Asia. Despite its increasing clinical relevance in China, the evolution and geographic expansion of ST59 has been relatively uncared for. Previous study has shown that ST59 was the predominant clone in food-related MRSA in China. This study compared the genomes of 87 clonal complex (CC) 59 S. aureus isolates sourced from food chain and infection cases to reconstruct the molecular evolution and geographical spread of ST59. Accordingly, three major sub-clades of ST59 were identified and these did not correlate with isolation source or location. Phylogenetic analysis estimated that ST59 in mainland China diverged from a most common recent ancestor around 1974, and most of the cases of cross-country transmission occurred between 1987 and 2000. Notably, two recent events of cross-country transmission through the food chain were observed, the isolates from these events diverged within relatively short time intervals. These isolates also showed high similarity in terms of their core genome, accessory genes, and antibiotic resistance patterns. These findings provide a valuable insight into the potential route of ST59 expansion in China and indicate a need for robust food chain surveillance to prevent the spread of this pathogen.

Methicillin-resistant Staphylococcus aureus in food and the prevalence in Brazil: a review

Foodborne diseases (FBD) occur worldwide and affect a large part of the population, being a cause of international concern among health authorities. Staphylococcus aureus can be transmitted by contaminated food, and it is one of the pathogens that most cause foodborne outbreaks in Brazil. Currently, this organism's ability in developing resistance to antibiotics is notorious; methicillin-resistant Staphylococcus aureus-MRSA-is known for its resistance to methicillin, oxacillin, and others. MRSA is one of the leading causes of infections, becoming a major threat to human health worldwide due to the numerous toxins that can produce. At first, the transmission of MRSA occurred in clinical environments; but in recent decades, its presence has been reported in the community, outside the hospital environment, including food and food-producing animals around the world. In this review, information about MRSA was gathered to verify MRSA incidence in the world but especially in Brazil in food samples, food handlers, food-producing animals, and food processing environments. The studies show that MRSA is easily found and in certain cases with high frequency, thus representing a potential risk to public health.

Oxacillin-susceptible mecA-positive Staphylococcus aureus associated with processed food in Europe

We report for the first time an oxacillin-susceptible mecA-positive Staphylococcus aureus (OS-MRSA) associated with a processed food product in Europe. One isolate (MRSA-ST5-type V SCCmec) was found in cheese among 600 food samples confiscated from air passengers from international flights in Vienna Airport (Austria). Type V SCCmec strains do not harbor functional mecI-mecR1 genes and in such strains mecA expression is regulated by the bla system (blaI-blaR1-blaZ). It has been recently reported that malfunctions in the bla system lead to the constitutive expression of mecA. The OS-MRSA reported in this study harbored the bla system on a plasmid and one deletion occurred in the blaR1 gene causing a frameshift variant that lead to an incomplete BlaR1 protein. This finding highlights the potential role of food as a neglected route of dissemination of emerging MRSA variants.

Inactivation of multidrug-resistant pathogens and Yersinia enterocolitica with cold atmospheric-pressure plasma on stainless-steel surfaces

The objective of this study was to investigate the impact of cold atmospheric-pressure plasma (CAP) produced by a surface micro-discharge plasma source as a new strategy to combat the transmission of five multidrug-resistant (MDR) pathogens and Yersinia enterocolitica on typical hospital- and food-producing surfaces, e.g. stainless-steel. Approximately 10⁶ CFU/cm² of vancomycin-resistant Enterococcus faecium, methicillin-resistant Staphylococcus aureus, Klebsiella pneumoniae, Acinetobacter baumannii, extended-spectrum β-lactamase (ESBL)-producing Escherichia coli and Y. enterocolitica were inoculated on a 3.14-cm² stainless-steel surface. Bovine serum albumin (BSA) (3%) was used as a disruptive factor simulating natural organic material. The inoculated surfaces were subsequently exposed to CAP, generated by a peak-to-peak voltage of 10 kV with sinusoidal waveform and a frequency of 2 kHz, for 5, 10 and 20 min, respectively. Fluorescent staining with propidium iodide and SYTO^TM 9 was used to demonstrate the manner of bacterial cell damage. Significant (P < 0.05) inactivation of 1.68 ± 0.17 up to 2.80 ± 0.17 log steps was achieved after 5 min of CAP treatment. However, bacterial reduction could be increased to 3.35 ± 0.1 up to 5.17 ± 0.67 log steps after 20 min of CAP treatment. Bacterial cells covered with BSA were statistically significantly less inactivated by CAP. Fluorescent staining showed a predominant level of orange-stained, sublethally damaged bacterial cells after 10 min of CAP treatment. In conclusion, CAP has the ability to inactivate MDR bacterial pathogens on stainless-steel surfaces. Further research is required to investigate the clinical features of CAP.

Profile of the Illegal Import of Products of Animal Origin to Brazilian Cities at the Border with Argentina and Uruguay

International food transit is a risk to public and animal health when not subject to legal importation sanitation procedures. Due to the extensive border area, illegal food import in Brazil is a common practice, especially in Rio Grande do Sul (RS), a state that borders with Argentina and Uruguay. The objective of this study was to evaluate the profile of Brazilians living in cities in RS that border with Argentina (BR-AR) or Uruguay (BR-UR) regarding the practice of illegal import of products of animal origin and to determine associations between the population characteristics and illegal import. A questionnaire with information related to the personal profile, habits of acquisition of imported food, and knowledge of health risks deriving from the consumption of the imported products was elaborated. The questionnaire was administered in six cities in RS (three cities bordering Argentina and three cities bordering Uruguay) and responses were obtained from 744 individuals. The variables city, sex, level of education, and knowledge were subjected to the chi-square test to verify the association between these variables and food import. Part of the interviewees admitted to illegally importing products of animal origin at both BR-AR (65.17%) and BR-UR (76.28%) borders. Dairy products were the main imported goods, followed by raw and processed meat. The study revealed that illegal import is common at the frontier region of RS, especially that of products of animal origin, dairy, and raw and processed meat. Although illegal importation occurs at all the cities under study, it was higher at the BR-UR border. Also, knowledge of the health risks influences the decision to import food or not.

Detection and Characterization of Staphylococcus aureus and Methicillin-Resistant S. aureus in Foods Confiscated in EU Borders

The aim of the study was to evaluate the potential role of the illegal entry of food in UE in the Methicillin-resistant S. aureus (MRSA) spread. We studied the prevalence and characteristics of Staphylococcus aureus and MRSA isolated from foods of animal origin confiscated from passengers on flights from 45 non-EU countries from 2012 to 2015 by the Border Authorities at Bilbao International Airport (Spain) and Vienna International Airport (Austria), as well as foods from open markets close to EU land borders. Of 868 food samples tested (diverse meat samples including antelope, duck, guinea pig, pork, rodents, turkey, dairy products, and eggs), 136 (15.7%) were positive for S. aureus and 26 (3.0%) for MRSA. All MRSA strains were mecA-positive. The prevalence of S. aureus-positive dairy samples among food confiscated at Bilbao International Airport was 64.6%, and this airport also had the highest value (11.8%) for MRSA-positive samples. The predominant sequence type was ST5 (30.8%), followed by ST8, ST1649, ST1, and other lineages were found to a lesser extent (ST7, ST22, ST72, ST97, and ST398). Six isolates tested positive for luk-PVL genes (SCCmec IV subtypes IVc and IVe). Enterotoxin profiling revealed that 19 MRSA strains were enterotoxigenic, harboring one or more se genes. The MRSA isolates positive for luk-PVL genes were not enterotoxigenic, and none of the isolates tested positive for enterotoxin E. We found 14 resistance profiles, and more than 69% of the MRSA isolates were resistant to three or more types of antimicrobial agents. This finding reveals both the wide diversity of the antimicrobial resistance found in the strains and the capacity to resist not only to beta-lactam drugs. One MRSA strain showed unusual characteristics: it was oxacillin-susceptible, harbored SCCmec V, and was positive for sed, seg, and sej but negative for PVL virulence factors. This study shows the presence of enterotoxigenic HA-, CA-, and LA-MRSA in foods illegally entering the EU, and highlights illegal importation of food as route of enterotoxigenic MRSA spread. Uncontrolled entry of food stuffs into the EU can be a relevant neglected route of MRSA dissemination.

Recent government regulations in the United States seek to ensure the effectiveness of antibiotics by limiting their agricultural use

The development of bacteria resistant to antibiotics is viewed as a medical health threat. Because thousands of people die every year due to antibiotic-resistant bacteria, efforts are underway to reduce antibiotic usage which in turn will reduce the development of antibiotic-resistant bacteria. In the United States, the use of antibiotics in the production of food animals to enhance animal growth has been identified as contributing to resistance. In 2015, a veterinary feed directive was adopted by the U.S. federal government prohibiting nontherapeutic uses of antibiotics in food animals that should reduce usage. The continued usage of antibiotics by producers for preventing disease may mean the directive is insufficient to reduce nontherapeutic antibiotic administration. This may lead some consumers to seek meat products from animals raised without antibiotics. A governmentally-sponsored labeling program could encourage reduction in antibiotic usage.

Compositional Analysis of Biofilms Formed by Staphylococcus aureus Isolated from Food Sources

Sixteen Staphylococcus aureus isolates originating from foods (eight from dairy products, five from fish and fish products and three from meat and meat products) were evaluated regarding their biofilms formation ability. Six strains (E2, E6, E8, E10, E16, and E23) distinguished as strong biofilm formers, either in standard Tryptic Soy Broth or in Tryptic Soy Broth supplemented with 0.4% glucose or with 4% NaCl. The composition of the biofilms formed by these S. aureus strains on polystyrene surfaces was first inferred using enzymatic and chemical treatments. Later on, biofilms were characterized by confocal laser scanning microscope (CLSM). Our experiments proved that protein-based matrices are of prime importance for the structure of biofilms formed by S. aureus strains isolated from food sources. These biofilm matrix compositions are similar to those put into evidence for coagulase negative staphylococci. This is a new finding having in view that scientific literature mentions exopolysaccharide abundance in biofilms produced by clinical isolates and food processing environment isolates of S. aureus.

Tracking Foodborne Pathogenic Bacteria in Raw and Ready-to-Eat Food Illegally Sold at the Eastern EU Border

Food illegally brought into the European Union, mainly in the personal luggage of travelers, represents a potential threat to consumers' health. The aim of this study was to investigate the presence of five pathogens in food brought into the European Union by Moldavian citizens as personal goods and illegally sold in Romania in the vicinity of the border. The occurrence of Staphylococcus aureus and Listeria monocytogenes was 7.5% and 8%, while Campylobacter spp., Escherichia coli O157:H7, and Salmonella spp. were absent in all samples. L. monocytogenes sequence type 2, 9, 121, and 155, highly prevalent among foodstuffs worldwide, was also present among isolates from ready-to-eat food illegally sold in Romania, even at the same date of sampling, indicating cross-contamination during food handling. S. aureus spa types t449, t304, and t524 were most often isolated from raw-milk cheeses contaminated with 10(3)-10(5) colony-forming units per gram, evidencing a contamination at herd level or unhygienic conditions during processing. S. aureus t011 and t3625, both included in the livestock-associated CC398, were isolated from pork lard and poultry meat. This study shows that cross-border trade from nonmember states represents a neglected route of transmission of foodborne pathogens into the European Union that could lead to sporadic or family-associated cases of disease.

Evaluation of two commercially available chromogenic media for confirmation of methicillin-resistant Staphylococcus aureus from human, animal, and food samples

We compared the diagnostic performance of two chromogenic media, Brilliance MRSA 2 agar (Thermo Fisher Scientific) and ChromID MRSA agar (bioMérieux), for MRSA confirmation of 239 Staphylococcus aureus isolates from clinical, animal and food samples. Statistically significant differences were not observed between MRSA confirmation by mecA/mecC PCR, and by culture in both chromogenic media. However, a statistically significant difference was observed between the results obtained by both chromogenic media (p = 0.003). Segregated analysis of the results depending on the origin of the isolates (clinical, animal, and food) revealed a significant lower performance in the MRSA confirmation of food-derived isolates by using Brilliance MRSA 2 agar in comparison to PCR confirmation (p = 0.003) or ChromID MRSA agar (p<0.001). Both chromogenic media provided a good diagnostic performance for detection of MRSA isolates of human and animal origin. In conclusion, the use of chromogenic agar plates for MRSA confirmation of S. aureus isolates can provide a good diagnostic performance (sensitivity >92% and specificity >89%) regardless of the type of chromogenic media used or the origin of the S. aureus isolates. However, our results revealed a lower diagnostic performance for MRSA confirmation of S. aureus isolates from food samples by using Brilliance MRSA 2 agar.

Presence of pathogenic enteric viruses in illegally imported meat and meat products to EU by international air travelers

One hundred twenty two meat samples confiscated from passengers on flights from non-European countries at the International Airport of Bilbao (Spain) were tested for the presence of the main foodborne viral pathogens (human noroviruses genogroups I and II, hepatitis A and E viruses) during 2012 and 2013. A sample process control virus, murine norovirus, was used to evaluate the correct performance of the method. Overall, 67 samples were positive for at least one enteric viruses, 65 being positive for hepatitis E virus (53.3%), 3 for human norovirus genogroup I (2.5%) and 1 for human norovirus genogroup II (0.8%), whereas hepatitis A virus was not detected in any sample. The type of positive meat samples was diverse, but mainly was pork meat products (64.2%). The geographical origin of the positive samples was wide and diverse; samples from 15 out 19 countries tested were positive for at least one virus. However, the estimated virus load was low, ranging from 55 to 9.0 × 10(4) PDU per gram of product. The results obtained showed the potential introduction of viral agents in travelers' luggage, which constitute a neglected route of introduction and transmission.