Risk factors for listeriosis

Effect of Bacterial Endophytes Isolated from Tropical Fruits against Listeria monocytogenes and Cronobacter sakazakii in Model Food Products

Listeria monocytogenes and Cronobacter sakazakii are two important foodborne bacterial pathogens. Bacterial endophytes, which reside in plant cells, can produce antimicrobial compounds to protect the host organism or inhibit pathogens. This study investigated the bacterial community of tropical fruits for their potential to inactivate L. monocytogenes or C. sakazakii in cantaloupe and liquid infant formula, respectively. Tropical fruits including papayas, dragon fruits, and sugar apples, were sourced from several countries. Candidate bacterial endophytes were recovered from these tropical fruits using blood agar and Reasoner's 2A (R2A) agar and tested for potential inhibition against L. monocytogenes and C. sakazakii. A total of 196 bacterial endophytes were recovered from papayas, dragon fruits, and sugar apples. Among these bacterial endophytes, 33 (16.8%) and 13 (6.6%) of them demonstrated an inhibition zone against L. monocytogenes and C. sakazakii, respectively. The inhibitory strains were identified using 16S rRNA sequencing as Bacillus spp., Enterobacter spp., Klebsiella spp., Microbacterium spp., Pantoea spp., and Pseudomonas spp. A cocktail of Pantoea spp. and Enterobacter spp. was used in challenge studies with cantaloupe and significantly reduced the number of L. monocytogenes by approximately 2.5 log10 CFU/g. In addition, P. stewartii demonstrated antagonistic activity against C. sakazakii in liquid infant formula, i.e., it significantly decreased the number of C. sakazakii by at least 1 log10 CFU/mL. Thus, the use of bacterial endophytes recovered from fruits and vegetables could be a promising area of research. Their use as potential biocontrol agents to control bacterial pathogens in ready-to-eat foods warrants further investigation.

Cell Envelope Modifications Generating Resistance to Hop Beta Acids and Collateral Sensitivity to Cationic Antimicrobials in Listeria monocytogenes

Hop beta acids (HBAs) are characteristic compounds from the hop plant that are of interest for their strong antimicrobial activity. In this work, we report a resistance mechanism against HBA in the foodborne pathogen Listeria monocytogenes. Using an evolution experiment, we isolated two HBA-resistant mutants with mutations in the mprF gene, which codes for the Multiple Peptide Resistance Factor, an enzyme that confers resistance to cationic peptides and antibiotics in several Gram-positive bacteria by lysinylating membrane phospholipids. Besides the deletion of mprF, the deletion of dltA, which mediates the alanylation of teichoic acids, resulted in increased HBA resistance, suggesting that resistance may be caused by a reduction in positive charges on the cell surface. Additionally, we found that this resistance is maintained at low pH, indicating that the resistance mechanism is not solely based on electrostatic interactions of HBA with the cell surface. Finally, we showed that the HBA-resistant mutants display collateral sensitivity to the cationic antimicrobials polymyxin B and nisin, which may open perspectives for combining antimicrobials to prevent resistance development.

Listeriosis in Pregnancy: Practitioners' Food Safety Counselling Practices to Pregnant Women

OBJECTIVE

The relative risk of invasive listeriosis in pregnant women is approximately 20 times greater than the general population, and listeriosis during pregnancy can have negative consequences for pregnant women, their fetuses, and their newborns. Health care providers are valuable sources of information, but published data suggest that most providers are unaware of the risk factors for listeriosis or its propensity for pregnant women, and they do not counsel their pregnant patients about risks. The objective of this study was to determine knowledge and practices of Canadian perinatal care providers on food safety counselling to pregnant women.

METHODS

An anonymous bilingual online questionnaire that sought information about awareness, knowledge of risk factors, practices for counselling pregnant women, and practitioners' learning needs with regard to listeriosis was sent to 3199 nurses, midwives, family physicians, and obstetrician/gynaecologists in Canada, with a response rate of 24.4%.

RESULTS

Most respondents had heard of listeriosis, provided prenatal care, and attended deliveries. Rates of awareness of listeriosis were the same among professions and were independent of years in practice, whether practice was urban or rural, and province. One third of the respondents (35.7%) were aware that listeriosis was more common in pregnant women; a minority (18.7%) correctly identified the incubation period for listeriosis and the stage in pregnancy in which women are at highest risk (30.4%). Those respondents who did not counsel women about the risks of listeriosis during pregnancy reported a lack of information or knowledge as the main reason.

CONCLUSION

Advising pregnant women about behaviours and lifestyle habits to prevent infectious diseases remains important, and information about preventive practices needs to be complete and adequate. The health care providers who participated in this study did express a clear need for information related to food safety during pregnancy and listeriosis, as supported by their lack of knowledge in some areas. If that lack is remedied, the knowledge gained could improve counselling practices.

Detection of Listeria Spp. and Listeria Monocytogenes in Biological Samples by SYBR Green I and TaqMan Probe-based Real-time PCRs

INTRODUCTION

The aim of the study was the application and comparison of real-time PCR methods based on the fluorescence of SYBR Green I intercalating dye and TaqMan probes for the detection of the 23S rDNA gene of Listeria spp. and the hlyA gene of Listeria monocytogenes in biological samples of the liver, brain, and blood.

MATERIAL AND METHODS

Five strains of L. monocytogenes and single strains of each species L. ivanovii, L. innocua,L. grayi, L. welshimeri, and L. seeligeri were used for the experiments. Additionally, five strains of other species of bacteria were used for evaluation of the specificity of tests. In the first stage of the study SYBR Green I real-time PCRs, one allowing detection of the 23S rDNA gene and two based on the amplification the hlyA gene, were performed. In the next part, three TaqMan probe-based real-time PCRs allowing confirmation of belonging to Listeria spp. and L. monocytogenes were conducted.

RESULTS

The observation of amplification curves in real-time PCRs enabled the detection of both genes. A high regression coefficient of 0.99 was found for all reactions. Specific amplification products were obtained for the 23S rDNA and hlyA genes which confirm their belonging to Listeria spp. and L. monocytogenes, respectively. Other microbial species did not reveal real-time PCR products.

CONCLUSION

Both real-time PCR methods for the detection of Listeria spp. and L. monocytogenes in biological samples demonstrated a significant sensitivity and high specificity.

Changing US Population Demographics: What Does This Mean for Listeriosis Incidence and Exposure?

Listeria monocytogenes is an important cause of foodborne illness hospitalization, fetal loss, and death in the United States. Listeriosis incidence rate varies significantly among population subgroups with pregnant women, older persons, and the Hispanic population having increased relative risks compared with the other subpopulations. Using estimated rates of listeriosis per subpopulation based on FoodNet data from 2004 to 2009, we evaluate the expected number of cases and incidence rates of listeriosis in the US population and the pregnant women subpopulation as the demographic composition changes over time with respect to ethnicity, pregnancy status, and age distribution. If the incidence rate per subpopulation is held constant, the overall US population listeriosis incidence rate would increase from 0.25 per 100,000 (95% confidence interval [CI]: 0.19-0.34) in 2010 to 0.28 (95% CI: 0.22-0.38) in 2020 and 0.32 (95% CI: 0.25-0.43) in 2030, because of the changes in the population structure. Similarly, the pregnancy-associated incidence rate is expected to increase from 4.0 per 100,000 pregnant women (95% CI: 2.5-6.5) in 2010 to 4.1 (95% CI: 2.6-6.7) in 2020 and 4.4 (95% CI: 2.7-7.2) in 2030 as the proportion of Hispanic pregnant women increases. We further estimate that a reduction of 12% in the exposure of the US population to L. monocytogenes would be needed to maintain a constant incidence rate from 2010 to 2020 (current trend), assuming infectivity (strain virulence distribution and individual susceptibility) is unchanged. To reduce the overall US population incidence rate by one-third (Healthy People 2020 goal) would require a reduction in exposure (or infectivity) to L. monocytogenes of 48% over the same time period. Reduction/elimination in exposure of pregnant and Hispanic subpopulations alone could not meet this target. This information may be useful in setting public health targets, developing risk management options, and in interpreting trends in the public health burden of foodborne listeriosis in the United States.

Meat Safety—I Foodborne Pathogens and Other Biological Issues

This chapter presents information pertinent to foodborne pathogens (bacteria and bacterial toxins, viruses, parasites) and other biological issues (prions) with importance to the safety of meat and meat products. Aspects covered refer mainly to the characteristics of the most important pathogenic organisms, their distribution in the environment, their transmission routes to humans, as well as their epidemiology and association with sporadic or epidemic foodborne illness. Current and emerging challenges to meat safety management also are discussed.

Impact of environmental factors on the culturability and viability of Listeria monocytogenes under conditions encountered in food processing plants

The ability of Listeria monocytogenes to adhere to and persist on surfaces for months or even years may be responsible for its transmission from contaminated surfaces to food products. Hence the necessity to find effective means to prevent the establishment of L. monocytogenes in food processing environments. The aim of this study was to assess, through a fractional experimental design, the environmental factors that could affect the survival of L. monocytogenes cells on surfaces to thereby prevent the persistence of this pathogen in conditions mimicking those encountered in food processing plants: culture with smoked salmon juice or meat exudate, use of two materials with different hygiene status, biofilm of L. monocytogenes in pure-culture or dual-culture with a Pseudomonas fluorescens strain, application of a drying step after cleaning and disinfection (C&D) and comparison of two strains of L. monocytogenes. Bacterial survival was assessed by culture, qPCR to quantify total cells, and propidium monoazide coupled with qPCR to quantify viable cells and highlight viable but non-culturable (VBNC) cells. Our results showed that failure to apply C&D causes cell persistence on surfaces. Moreover, the sanitation procedure leads only to a loss of culturability and appearance of VBNC populations. However, an additional daily drying step after C&D optimises the effectiveness of these procedures to reduce culturable populations. Our results reinforce the importance to use molecular tools to monitor viable pathogens in food processing plants to avoid underestimating the amounts of cells using only methods based on cell culture.

Development of synthetic media mimicking food soils to study the behaviour of Listeria monocytogenes on stainless steel surfaces

Listeria monocytogenes is one of the main targets of hygiene procedures in the ready-to-eat food industry due to its ability to persist for months or even years in processing plants, where it can contaminate food during processing. The factors associated with persistence are often those that foster growth, which itself depends on food contamination of surfaces. It is therefore essential to experiment by using food soils or media modelling these soils to understand the behaviour of L. monocytogenes on surfaces of food processing plants. Thus, we set up an experimental plan including three physiological parameters characteristic of the behaviour of cells on surfaces, namely spatial distribution, adhesion forces and the physiological state of sessile L. monocytogenes. These were recorded in two food soils: smoked salmon juice and meat exudate. According to our results, the behaviour of L. monocytogenes on stainless steel surfaces is highly dependent on the food soil used. The presence of viable but non-culturable (VBNC) cells was demonstrated using meat exudate, while all viable cells were recovered using smoked salmon juice. Moreover, on the basis of our criteria and after validation with three strains of L. monocytogenes, we showed that smoked salmon juice can be substituted by a modified culture medium, demonstrating that drawbacks associated with the use of food soils can be overcome.

Comparing listeriosis risks in at-risk populations using a user-friendly quantitative microbial risk assessment tool and epidemiological data

Although infection by the pathogenic bacterium Listeria monocytogenes is relatively rare, consequences can be severe, with a high case-fatality rate in vulnerable populations. A quantitative, probabilistic risk assessment tool was developed to compare estimates of the number of invasive listeriosis cases in vulnerable Canadian subpopulations given consumption of contaminated ready-to-eat delicatessen meats and hot dogs, under various user-defined scenarios. The model incorporates variability and uncertainty through Monte Carlo simulation. Processes considered within the model include cross-contamination, growth, risk factor prevalence, subpopulation susceptibilities, and thermal inactivation. Hypothetical contamination events were simulated. Results demonstrated varying risk depending on the consumer risk factors and implicated product (turkey delicatessen meat without growth inhibitors ranked highest for this scenario). The majority (80%) of listeriosis cases were predicted in at-risk subpopulations comprising only 20% of the total Canadian population, with the greatest number of predicted cases in the subpopulation with dialysis and/or liver disease. This tool can be used to simulate conditions and outcomes under different scenarios, such as a contamination event and/or outbreak, to inform public health interventions.

Listeria monocytogenes dose response revisited--incorporating adjustments for variability in strain virulence and host susceptibility

Evaluations of Listeria monocytogenes dose-response relationships are crucially important for risk assessment and risk management, but are complicated by considerable variability across population subgroups and L. monocytogenes strains. Despite difficulties associated with the collection of adequate data from outbreak investigations or sporadic cases, the limitations of currently available animal models, and the inability to conduct human volunteer studies, some of the available data now allow refinements of the well-established exponential L. monocytogenes dose response to more adequately represent extremely susceptible population subgroups and highly virulent L. monocytogenes strains. Here, a model incorporating adjustments for variability in L. monocytogenes strain virulence and host susceptibility was derived for 11 population subgroups with similar underlying comorbidities using data from multiple sources, including human surveillance and food survey data. In light of the unique inherent properties of L. monocytogenes dose response, a lognormal-Poisson dose-response model was chosen, and proved able to reconcile dose-response relationships developed based on surveillance data with outbreak data. This model was compared to a classical beta-Poisson dose-response model, which was insufficiently flexible for modeling the specific case of L. monocytogenes dose-response relationships, especially in outbreak situations. Overall, the modeling results suggest that most listeriosis cases are linked to the ingestion of food contaminated with medium to high concentrations of L. monocytogenes. While additional data are needed to refine the derived model and to better characterize and quantify the variability in L. monocytogenes strain virulence and individual host susceptibility, the framework derived here represents a promising approach to more adequately characterize the risk of listeriosis in highly susceptible population subgroups.

Systematic review of human listeriosis in China, 1964-2010

OBJECTIVES

Listeria is an important foodborne pathogen with severe manifestations and high case-fatality rate. However, listeriosis is not yet a notifiable disease in China, and there is no national monitoring system for cases. We conducted a systematic review to better understand the clinical and epidemiologic features of listeriosis in China.

METHODS

Both electronic and manual retrieval systems were used to search Chinese literature for cases and isolates of human listeriosis reported between 1964 and 2010. We recorded and analysed demographic, clinical and laboratory information available for reported cases.

RESULTS

A total of 147 clinical cases, 479 Listeria isolates and 82 outbreak-related cases were reported in 28 (90%) provinces in China from January 1964 to December 2010. Of the clinical cases, 45 (31%) were central nervous system infections, 68 (46%) were septicaemia and 34 (23%) were focal infections or gastroenteritis. The overall case-fatality rate was 26% (34/130) among clinical cases with known outcomes and 46% (21/46) among neonatal cases.

CONCLUSION

Listeriosis cases occurred in China throughout the study period between 1964 and 2010. Case-fatality was similar to published data from other countries. China should consider requiring notification of listeriosis cases to improve estimates of incidence, identification of risk factors and design of preventive measures.

New data, strategies, and insights for Listeria monocytogenes dose-response models: summary of an interagency workshop, 2011

Listeria monocytogenes is a leading cause of hospitalization, fetal loss, and death due to foodborne illnesses in the United States. A quantitative assessment of the relative risk of listeriosis associated with the consumption of 23 selected categories of ready-to-eat foods, published by the U.S. Department of Health and Human Services and the U.S. Department of Agriculture in 2003, has been instrumental in identifying the food products and practices that pose the greatest listeriosis risk and has guided the evaluation of potential intervention strategies. Dose-response models, which quantify the relationship between an exposure dose and the probability of adverse health outcomes, were essential components of the risk assessment. However, because of data gaps and limitations in the available data and modeling approaches, considerable uncertainty existed. Since publication of the risk assessment, new data have become available for modeling L. monocytogenes dose-response. At the same time, recent advances in the understanding of L. monocytogenes pathophysiology and strain diversity have warranted a critical reevaluation of the published dose-response models. To discuss strategies for modeling L. monocytogenes dose-response, the Interagency Risk Assessment Consortium (IRAC) and the Joint Institute for Food Safety and Applied Nutrition (JIFSAN) held a scientific workshop in 2011 (details available at http://foodrisk.org/irac/events/). The main findings of the workshop and the most current and relevant data identified during the workshop are summarized and presented in the context of L. monocytogenes dose-response. This article also discusses new insights on dose-response modeling for L. monocytogenes and research opportunities to meet future needs.

Modeling time to inactivation of Listeria monocytogenes in response to high pressure, sodium chloride, and sodium lactate

A mathematical model was developed to predict time to inactivation (TTI) by high pressure processing of Listeria monocytogenes in a broth system (pH 6.3) as a function of pressure (450 to 700 MPa), inoculum level (2 to 6 log CFU/ml), sodium chloride (1 or 2%), and sodium lactate (0 or 2.5%) from a 4°C initial temperature. Ten L. monocytogenes isolates from various sources, including processed meats, were evaluated for pressure resistance. The five most resistant strains were used as a cocktail to determine TTI and for model validation. Complete inactivation of L. monocytogenes in all treatments was demonstrated with an enrichment method. The TTI increased with increasing inoculum level and decreasing pressure magnitude, from 1.5 min at 700 MPa and 2 log CFU/ml, to 15 min at 450 MPa and 6 log CFU/ml. Neither NaCl nor sodium lactate significantly influenced TTI. The model was validated with ready-to-eat, uncured, Australian retail poultry products, and with product specially made at a U.S. Department of Agriculture, Food Safety and Inspection Service (FSIS)-inspected pilot plant in the United States. Data from the 210 individual product samples used for validation indicate that the model gives "fail-safe" predictions (58% with response as expected, 39% with no survivors where survivors expected, and only 3% with survivors where none were expected). This model can help manufacturers of refrigerated ready-to-eat meats establish effective processing criteria for the use of high pressure processing as a postlethality treatment for L. monocytogenes in accordance with FSIS regulations.

Improving Foodborne Illness Prevention Among Transplant Recipients

The U.S. Department of Agriculture developed a food safety brochure to educate transplant recipients and their caregivers about the risk of contracting foodborne illnesses and safe food-handling prevention practices. Qualitative research was conducted with transplant recipients and caregivers to collect information on participants’ food safety concerns, knowledge, and practices; changes in food safety knowledge and practices after receiving the food safety brochure; preferred communication channels and dissemination strategies for delivering the brochure; and evaluation of the brochure. Many participants received food safety information from a health care provider, but the content and format varied by institution. Most participants are not following recommended practices to cook and chill food safely, and many participants consume high-risk foods associated with foodborne illnesses. After reading the brochure, many participants made or plan to make at least one food safety recommendation. The research findings were used to refine the brochure before nationwide distribution.

Dynamic modeling of Listeria monocytogenes growth in pasteurized vanilla cream after postprocessing contamination

A product-specific model was developed and validated under dynamic temperature conditions for predicting the growth of Listeria monocytogenes in pasteurized vanilla cream, a traditional milk-based product. Model performance was also compared with Growth Predictor and Sym'Previus predictive microbiology software packages. Commercially prepared vanilla cream samples were artificially inoculated with a five-strain cocktail of L. monocytogenes, with an initial concentration of 102 CFU g(-1), and stored at 3, 5, 10, and 15 degrees C for 36 days. The growth kinetic parameters at each temperature were determined by the primary model of Baranyi and Roberts. The maximum specific growth rate (mu(max)) was further modeled as a function of temperature by means of a square root-type model. The performance of the model in predicting the growth of the pathogen under dynamic temperature conditions was based on two different temperature scenarios with periodic changes from 4 to 15 degrees C. Growth prediction for dynamic temperature profiles was based on the square root model and the differential equations of the Baranyi and Roberts model, which were numerically integrated with respect to time. Model performance was based on the bias factor (B(f)), the accuracy factor (A(f)), the goodness-of-fit index (GoF), and the percent relative errors between observed and predicted growth. The product-specific model developed in the present study accurately predicted the growth of L. monocytogenes under dynamic temperature conditions. The average values for the performance indices were 1.038, 1.068, and 0.397 for B(f), A(f), and GoF, respectively for both temperature scenarios assayed. Predictions from Growth Predictor and Sym'Previus overestimated pathogen growth. The average values of B(f), A(f), and GoF were 1.173, 1.174, 1.162, and 0.956, 1.115, 0.713 for [corrected] Growth Predictor and Sym'Previus, respectively.

A processing plant persistent strain of Listeria monocytogenes crosses the fetoplacental barrier in a pregnant guinea pig model

The foodborne pathogen Listeria monocytogenes can cause infection in immunocompromised humans and in the fetuses of pregnant women. We have demonstrated that one group of genetically similar L. monocytogenes strains (random amplified polymorphic DNA [RAPD] type 9) dominate and persist in several independent fish processing plants. The purpose of the present study was to determine the virulence potential of one RAPD type 9 strain (La111), one human clinical strain (Scott A), and one monkey clinical strain (12443) in a pregnant guinea pig model. Animals were orally exposed to 10(8) CFU of L. monocytogenes in whipping cream on gestation day (GD) 36 and euthanized on GD 42, 45, or 56. Strains 12443 and Scott A were shed from treated animals for 20 days, whereas La111 was shed only in the first 10 days. Strains 12443 and Scott A were recovered from maternal liver, spleen, and gallbladder on all 3 days of euthanization, whereas La111 was recovered only at GD 45 and 56. Scott A was not isolated from any placentas or fetuses. For dams treated with 12443, 22% of the fetuses were positive for L. monocytogenes, and surprisingly, treatment of dams with La111 resulted in 56% infected fetuses. L. monocytogenes was isolated from 16 and 20% of placentas for 12443 and La111, respectively. The study demonstrates that a food processing plant persistent strain of L. monocytogenes is able to cross the fetoplacental barrier in pregnant guinea pigs. Furthermore, we demonstrate that although information can be gained from model virulence assays, assessment of the virulence potential of a strain may require more complex hosts.

A review of the incidence and transmission of Listeria monocytogenes in ready-to-eat products in retail and food service environments

Contamination of ready-to-eat products with Listeria monocytogenes may occur at several stages before consumption. Accessibility to the public and relatively limited control interventions at retail and food service establishments (compared with the processing sector of the food industry) and the lack of a specific regulatory framework increase the likelihood of introduction of this pathogen into some foods in these establishments. This review is a compilation of available information on the incidence and transmission of L. monocytogenes through ready-to-eat products at the retail and food service level. The potential transmission of L. monocytogenes within retail and food service operations has been indicated in epidemiological investigations and by survey data. Potential sources of the organism in these operations include the environment, food handlers, and incoming raw ingredients or processed products that have become contaminated after the lethality treatment at the manufacturing facility. L. monocytogenes may be present at retail and food service establishments in various ready-to-eat products, both prepackaged and those packaged in the store, and occasionally at high concentrations. This issue dictates the need for development and application of effective control measures, and potential control approaches are discussed here. Good manufacturing practices, appropriate cleaning, sanitation and hygiene programs, and temperature control required for prevention or inhibition of growth of the pathogen to high levels are critical for control of L. monocytogenes in the retail and food service sector. A comprehensive food safety system designed to be functional in retail and food service operations and based on the philosophy of hazard analysis and critical control point systems and a series of sound prerequisite programs can provide effective control of L. monocytogenes in these environments. However, competent delivery of food safety education and training to retail and food service managers and food handlers must be in place for successful implementation of such a system.

Consumer home refrigeration practices: results of a web-based survey

To reduce bacterial growth and to ensure the quality and safety of food products, the U.S. Department of Agriculture and the U.S. Food and Drug Administration advise consumers to clean their refrigerators regularly, use a refrigerator thermometer, and keep refrigerator temperatures at 40 degrees F (4.4 degrees C) or below. We conducted a nationally representative Web-enabled survey (n = 2,060) to collect data on refrigerator thermometer ownership, home refrigerator temperatures, and the frequency of home refrigerator cleaning. We stratified the sample to provide results for pregnant women, older adults (60 years or older), and the remaining population. About half of all respondents had cleaned their refrigerators at least 1 month before the survey. Only 11% of all respondents had a thermometer in their refrigerator before the survey. Older adults (77.5%) were more likely than the remaining population (70.4%) to have their refrigerators at the recommended temperature (P < 0.01). Older adults who were not married and who lived alone were less likely to have refrigerator thermometers and to have their refrigerators at a recommended temperature (P < 0.05). For all respondents, those who had previously owned a refrigerator thermometer were more likely to have their refrigerators at the recommended temperature than were respondents who did not previously own a thermometer (P < 0.01). Food safety educators can use the survey findings and results of previous research to target educational materials and help consumers, especially those at risk for listeriosis, to safely store refrigerated foods at home.

Evaluation of the international reference methods NF EN ISO 11290-1 and 11290-2 and an in-house method for the isolation of Listeria monocytogenes from retail seafood products in france

Retail seafood products were analyzed on their use-by date using the international reference methods NF EN ISO 11290-1 and 11290-2 (collectively method R) or an in-house method (method B) for the isolation of Listeria monocytogenes. The sensitivity of the methods was about 78%. Method R detected more positive samples of smoked salmon and herb-flavored slices of smoked salmon than did method B, whereas the reverse was true for samples of carpaccio-like salmon, herb-flavored slices of raw salmon, and smoked trout. Most products produced a positive result after the first of two enrichments, and little difference was observed after changing the isolation medium (Listeria selective agar, L. monocytogenes blood agar, agar for Listeria according to Ottaviani and Agosti, Oxford agar, and Palcam agar). L. monocytogenes was isolated from 151 (27.8%) of the 543 samples, with concentrations mostly below 100 CFU/g. The pathogen prevalence and concentration in these seafood products varied greatly depending on the producer and the nature of the product. In certain cases, these differences could be explained by problems in cleaning and disinfection operations in the food-processing environment. The identities of L. monocytogenes isolates were confirmed by PCR, and isolates were characterized by random amplification of polymorphic DNA and pulsed-field gel electrophoresis (PFGE). PFGE patterns obtained with the enzymes Apal and AscI produced 26 different pulsotypes. In general, different pulsotypes were present in the different categories of seafood products and were not specific to one producer. The genetic diversity observed in the products was not related to the prevalence found at the manufacturing site. It is therefore important for producers to determine the source(s) of contamination of their product so the risks linked to the presence of L. monocytogenes can be reduced.

Sodium chloride enhances adherence and aggregation and strain variation influences invasiveness of Listeria monocytogenes strains

Some subtypes of Listeria monocytogenes can persist in the food-processing industry, but the reasons for such persistence are not known. In the present study, 10 strains of L. monocytogenes representing known persistent randomly amplified polymorphic DNA (RAPD) types from fish processing plants were compared to eight strains of different RAPD type and origin (clinical, food, and animal). All 18 strains of L. monocytogenes had similar growth patterns at different temperatures (5 or 37 degrees C) or different salinities (0.5 or 5% NaCl), and all strains formed a thin layer of adhered cells on a plastic surface when cultured in tryptone soya broth (TSB) with a total of 1% glucose. Many ready-to-eat foods, such as cold-smoked fish, contain NaCl at concentrations of 2 to 5%, and NaCl is present in the processing environment. Adding NaCl to TSB changed the adhesion patterns of all strains, and all adhered better when NaCl was added. Also, the addition of NaCl caused a marked aggregation of 13 of the strains; however, 5 of the 18 strains did not aggregate in the presence of up to 5% NaCl. The aggregates stuck to the plastic surface, and this occurred in all but one of the persistent RAPD types. Four strains represented one particular RAPD type that has been isolated as a persistent RAPD type in several fish processing plants for up to 10 years. Because this RAPD type often can contaminate fish products, it is important to address its potential virulence. The 18 strains differed markedly in their ability to invade Caco-2 cells, and the four strains representing the universal persistent RAPD type were the least invasive (10(2) to 10(3) CFU/ml), whereas other strains invaded Caco-2 cells at levels of 10(4) to 10(5) CFU/ml. Five of the 18 strains belonged to the genetic lineage 1 and were the most invasive. Although the most commonly isolated persistent RAPD type was low invasive, it is important to understand why moderate salinity facilitates aggregation and biofilm formation, for this understanding can be beneficial in developing procedures to reduce processing plant contamination.

Linking quantitative exposure assessment and risk management using the food safety objective concept: an example with Listeria monocytogenes in different cross-contamination scenarios

A practical approach was used to achieve specified food safety objectives (FSOs) by incorporating risk assessment methodology. A series of cross-contamination scenarios at the retail level were evaluated in a spreadsheet and ranked according to their level of risk, and the degree to which they exceeded an FSO for Listeria monocytogenes (100 CFU/g) was determined. Percentiles and analyses of variance were used to identify which scenarios would be most likely not to achieve the FSO. It was also possible to incorporate into the model the effect of additional risk management interventions (e.g., hand washing method) by using "what if" scenarios analysis. The highest risk corresponded to the use of the same gloves to handle contaminated meat and then sliced ham compared with the safer method of using different gloves to handle each product. Nevertheless, in all scenarios bacterial concentrations could be higher than 10(8) CFU/g. A significant lack of knowledge regarding the transfer rates of L. monocytogenes was revealed, which provided the model with an important uncertainty component. The "what if" scenarios analysis based on the scenario representing handling food with bare hands followed by hand washing (scenario 2) revealed that the hand washing procedure had less impact than expected. This study illustrates the use of scenarios to model the most effective food processes and thus provide risk managers with appropriate information on which to base their decisions.

Consumer knowledge, storage, and handling practices regarding Listeria in frankfurters and deli meats: results of a Web-based survey

Proper storage and handling of refrigerated ready-to-eat foods can help reduce the risk of listeriosis. A national Web-based survey was conducted to measure consumer awareness and knowledge of Listeria and to estimate the prevalence of the U.S. Department of Agriculture-recommended consumer storage and handling practices for frankfurters and deli meats. The demographic characteristics of consumers who are unaware of Listeria and who do not follow the recommended storage guidelines were also assessed. In addition, predictive models were developed to determine which consumers engage in risky storage practices. Less than half of the consumers surveyed were aware of Listeria, and most of those aware were unable to identify associated food vehicles. Awareness was lower among adults 60 years of age and older, an at-risk population for listeriosis, and individuals with relatively less education and lower incomes. Most households safely stored and prepared frankfurters. Most households stored unopened packages of vacuum-packed deli meats in the refrigerator within the U.S. Department of Agriculture-recommended storage guidelines (< or =14 days); however, many stored opened packages of vacuum-packed deli meats and freshly sliced deli meats for longer than the recommended time (< or =5 days). Men, more-educated individuals, and individuals living in metropolitan areas were more likely to engage in risky storage practices. This study identified the need to develop targeted educational initiatives on listeriosis prevention.

Food Safety Guidance for Older Adults

Aging is associated with loss of the physical barriers and immune efficiency that typically control pathogens' access to and multiplication within the body, thus making infection more likely in elderly persons. Chronic diseases and other health factors, such as malnutrition and immobility, may increase susceptibility to and severity of infections, including foodborne illnesses, in elderly persons, as well as associated morbidity and mortality. Prevention is the best way to avoid foodborne illnesses, but older adults have long-established food preparation and handling practices, some of which may increase the likelihood of illness. Elderly persons rely on physicians as trusted sources of health information. Physicians and other health care professionals can help prevent and control foodborne diseases by educating their patients about the risks of foodborne illness, providing sound advice on safe food-handling and consumption practices, making rapid appropriate diagnoses, and reporting cases promptly to public health authorities.

Effect of preincubation temperature and pH on the individual cell lag phase of Listeria monocytogenes, cultured at refrigeration temperatures

The impact of precultural temperature and pH on the distribution of the lag phase of individual Listeria monocytogenes cells was assessed during preincubation at 7 degrees C, using a dilution protocol to obtain single cells, and optical density measurements to estimate the individual lag phase. Firstly, the pure temperature effect (37, 15, 10, 7, 4 and 2 degrees C) was investigated on a subsequent growth at 7 degrees C and pH 7.4. Secondly, low precultural temperatures (10, 7 and 4 degrees C) were combined with a controlled pH at 7.4 and 5.7 with a subsequent growth at 7 degrees C and at different pH values (7.4, 6.0 and 5.5). For all temperature-pH combinations, the individual cell lag phase was determined using a three-phase linear growth model. It was observed that at low precultural temperatures (2, 4 and 7 degrees C), a high proportion of L. monocytogenes cells were able to grow at 7 degrees C with almost no lag phase, consequently, the resulting distributions were positively skewed. Beside this, the variability observed was lower than at higher precultural temperatures. Regarding the precultural pH effect, at pH 7.4 the mean values of the lag phases were shorter at lower preincubation temperatures; while at pH 5.7 small pH transitions produced shorter individual lag phases at all precultural temperatures. The quantification of the effect of precultural conditions on the individual cell lag phase duration would improve the accuracy of the existing growth models, especially when a series of processing and storage steps are linked together in a process model or exposure assessment. Distributions will be fitted to the data for every set of conditions, generating useful tools for further risk assessment purposes.

Construction and analysis of fractional multifactorial designs to study attachment strength and transfer of Listeria monocytogenes from pure or mixed biofilms after contact with a solid model food

The aim of this study was to establish which of seven factors influence the adhesion strength and hence bacterial transfer between biofilms containing Listeria monocytogenes (pure and two-species biofilms) and tryptone soya agar (TSA) as a solid organic surface. The two-species biofilms were made of L. monocytogenes and one of the following species of bacteria: the nonpathogenic organisms Kocuria varians, Pseudomonas fluorescens, and Staphylococcus sciuri and CCL 63, an unidentified gram-negative bacterium isolated from the processing plant environment. We used biofilms prepared under conditions simulating open surfaces in meat-processing sites. The biofilm's adhesion strength and population were evaluated by making 12 contacts on a given whole biofilm (4.5 cm(2)), using a new slice of a sterilized TSA cylinder for each contact, and plotting the logarithm CFU . cm(-2) detached by each contact against the contact number. Three types of detachment kinetics were observed: biphasic kinetics, where the first slope may be either positive or negative, and monophasic kinetics. The bacteria that resisted a chlorinated alkaline product and a glutaraldehyde- and quaternary ammonium-based disinfectant had greater adhesion strengths than those determined for untreated biofilms. One of the four non-Listeria strains studied, Kocuria varians CCL 56, favored both the attachment and detachment of L. monocytogenes. The stainless steel had smaller bacterial populations than polymer materials, and non-Listeria bacteria adhered to it less strongly. Our results helped to evaluate measures aimed at controlling the immediate risk, linked to the presence of a large number of CFU in a foodstuff, and the delayed risk, linked to the persistence of L. monocytogenes and the occurrence of slightly contaminated foods that may become dangerous if L. monocytogenes multiplies during storage. Cleaning and disinfection reduce the immediate risk, while reducing the delayed risk should be achieved by lowering the adhesion strength, which the sanitizers used here cannot do at low concentrations.

Interactions in biofilms between Listeria monocytogenes and resident microorganisms from food industry premises

Twenty nine bacterial strains were grown as binary culture biofilms with Listeria monocytogenes to assess their influence on the settlement of the latter on stainless steel coupons. Most of the strains had been isolated from food processing plants after cleaning and disinfection and were tentatively identified by the APILAB Plus 3.3.3 database (bioMerieux). Sixteen of them decreased L. monocytogenes biofilm colony forming units (CFU) counts. Three strains, Bacillus sp. CCL 9 an unidentified Gram-positive strain CCL 59 and Pseudomonas fluorescens E9. 1, led to a 3-log difference in CFU counts between the pure L. monocytogenes biofilms and the mixed biofilms. Eleven strains had no effect and only four, Kocuria varians CCL 73, Staphylococcus capitis CCL 54, Stenotrophomonas maltophilia CCL 47 and Comamonas testosteroni CCL 24, had a positive effect, with a 0.5- to 1.0-log increase in the L. monocytogenes biofilm CFU counts. On its own, L. monocytogenes settled as single cells, but in binary biofilms, different spatial arrangements were observed: (i) with K. varians CCL 73, K. varians CCL 56 and S. capitis CCL 54, L. monocytogenes cells gathered around the microcolonies of the partner strain; (ii) with the two Gram-negative strains, C. testosteroni CCL 24 and CCL 25, L. monocytogenes cells formed its own microcolonies. No link could be found between the exopolysaccharide production capacity of the bacterial strains in pure-culture biofilms and their effect on the L. monocytogenes population in mixed biofilms. With one strain, C. testosteroni CCL 24, adding filter-sterilized supernatant from a pure-culture biofilm to a pure culture of L. monocytogenes increased the number of L. monocytogenes cells adhering to the stainless steel coupons and forming microcolonies. This study suggests that the "house flora" can have a strong effect on the likelihood of finding L. monocytogenes on inert surfaces.

Evaluation of chromogenic media for the detection of Listeria species in food

AIMS

The aim of this study was to evaluate the performance of chromogenic agars, Agar Listeria according to Ottaviani and Agosti (ALOA) and Rapid L. mono agar, compared with Oxford agar for the enumeration and detection of Listeria species in food.

METHODS AND RESULTS

A total of 170 food samples were examined using the three plating media. Listeria species were isolated from 63 samples. In contrast to Oxford agar, detection of Listeria colonies on chromogenic media was as good after 24 h of incubation of plates as after 48 h. While there was no significant difference in recovery of Listeria monocytogenes on the three media, recovery of other Listeria species was significantly poorer on Rapid L. mono agar compared with Oxford and ALOA agars. Recovery of species other than L. monocytogenes was significantly improved by including a secondary enrichment stage in the detection method.

CONCLUSIONS

Using chromogenic agars, presumptive identification of L. monocytogenes is possible after 24 h, compared with 3-4 days using Oxford agar. However, the poor detection of species other than L. monocytogenes on Rapid L. mono agar is a disadvantage of this medium.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study provides new information regarding the isolation of Listeria species other than L. monocytogenes from food using chromogenic plating media. This is important, as non-pathogenic Listeria species act as markers for the likelihood of presence of L. monocytogenes and allow preventive action to be taken to avoid its presence.

Pregnant women and listeriosis: preferred educational messages and delivery mechanisms

OBJECTIVE

To characterize pregnant women's food safety practices, to evaluate the impact of existing educational messages on the risks and prevention of listeriosis, and to identify preferred delivery methods for educational initiatives.

DESIGN

Eight focus group discussions conducted with pregnant women in 4 locations.

SETTING

Focus group discussions led by moderators using a prepared moderator guide.

PARTICIPANTS

Purposeful sampling was used to select the 63 pregnant women who participated in this study. The focus groups were segmented by location and education level.

PHENOMENON OF INTEREST

Food safety knowledge and food-handling practices, food safety practices during pregnancy, attitudes toward listeriosis brochure, and preferred delivery methods.

ANALYSIS

Focus group discussions were videotaped and audiorecorded. Detailed summaries of each discussion were prepared and systematically analyzed to identify common themes within and across groups.

RESULTS

Participants were not aware of the risks of listeriosis and recommended practices for listeriosis prevention; thus, they were not taking precautions during their pregnancy to prevent listeriosis.

CONCLUSIONS AND IMPLICATIONS

The study identified the need to develop educational materials on listeriosis targeted specifically to pregnant women and to partner with obstetricians and other health care providers to deliver these materials to pregnant women.

Transfer of microorganisms, including Listeria monocytogenes, from various materials to beef

The quantity of microorganisms that may be transferred to a food that comes into contact with a contaminated surface depends on the density of microorganisms on the surface and on the attachment strengths of the microorganisms on the materials. We made repeated contacts between pieces of meat and various surfaces (stainless steel and conveyor belt materials [polyvinyl chloride and polyurethane]), which were conditioned with meat exudate and then were contaminated with Listeria monocytogenes, Staphylococcus sciuri, Pseudomonas putida, or Comamonas sp. Attachment strengths were assessed by the slopes of the two-phase curves obtained by plotting the logarithm of the number of microorganisms transferred against the order number of the contact. These curves were also used to estimate the microbial population on the surface by using the equation of A. Veulemans, E. Jacqmain, and D. Jacqmain (Rev. Ferment. Ind. Aliment. 25:58-65, 1970). The biofilms were characterized according to their physicochemical surface properties and structures. Their exopolysaccharide-producing capacities were assessed from biofilms grown on polystyrene. The L. monocytogenes biofilms attached more strongly to polymers than did the other strains, and attachment strength proved to be weaker on stainless steel than on the two polymers. However, in most cases, it was the population of the biofilms that had the strongest influence on the total number of CFU detached. Although attachment strengths were weaker on stainless steel, this material, carrying a smaller population of bacteria, had a weaker contaminating capacity. In most cases the equation of Veulemans et al. revealed more bacteria than did swabbing the biofilms, and it provided a better assessment of the contaminating potential of the polymeric materials studied here.

Listeria pathogenesis and molecular virulence determinants

The gram-positive bacterium Listeria monocytogenes is the causative agent of listeriosis, a highly fatal opportunistic foodborne infection. Pregnant women, neonates, the elderly, and debilitated or immunocompromised patients in general are predominantly affected, although the disease can also develop in normal individuals. Clinical manifestations of invasive listeriosis are usually severe and include abortion, sepsis, and meningoencephalitis. Listeriosis can also manifest as a febrile gastroenteritis syndrome. In addition to humans, L. monocytogenes affects many vertebrate species, including birds. Listeria ivanovii, a second pathogenic species of the genus, is specific for ruminants. Our current view of the pathophysiology of listeriosis derives largely from studies with the mouse infection model. Pathogenic listeriae enter the host primarily through the intestine. The liver is thought to be their first target organ after intestinal translocation. In the liver, listeriae actively multiply until the infection is controlled by a cell-mediated immune response. This initial, subclinical step of listeriosis is thought to be common due to the frequent presence of pathogenic L. monocytogenes in food. In normal individuals, the continual exposure to listerial antigens probably contributes to the maintenance of anti-Listeria memory T cells. However, in debilitated and immunocompromised patients, the unrestricted proliferation of listeriae in the liver may result in prolonged low-level bacteremia, leading to invasion of the preferred secondary target organs (the brain and the gravid uterus) and to overt clinical disease. L. monocytogenes and L. ivanovii are facultative intracellular parasites able to survive in macrophages and to invade a variety of normally nonphagocytic cells, such as epithelial cells, hepatocytes, and endothelial cells. In all these cell types, pathogenic listeriae go through an intracellular life cycle involving early escape from the phagocytic vacuole, rapid intracytoplasmic multiplication, bacterially induced actin-based motility, and direct spread to neighboring cells, in which they reinitiate the cycle. In this way, listeriae disseminate in host tissues sheltered from the humoral arm of the immune system. Over the last 15 years, a number of virulence factors involved in key steps of this intracellular life cycle have been identified. This review describes in detail the molecular determinants of Listeria virulence and their mechanism of action and summarizes the current knowledge on the pathophysiology of listeriosis and the cell biology and host cell responses to Listeria infection. This article provides an updated perspective of the development of our understanding of Listeria pathogenesis from the first molecular genetic analyses of virulence mechanisms reported in 1985 until the start of the genomic era of Listeria research.

Maillard reaction causes suppression of virulence gene expression in Listeria monocytogenes

Many environmental signals affect the expression of virulence genes of the food borne pathogen Listeria monocytogenes. In addition media composition has been shown to suppress levels of haemolytic activity. Using a Pr(plcA)::luxAB reporter gene fusion it was observed that the heat processing of media also reduces the level of virulence gene expression in L. monocytogenes without affecting its growth. Physicochemical factors that are considered to enhance the Maillard reaction were also found to increase the levels of suppression. The results indicate that heat treatment of a multicomponent matrix gives rise to specific inhibitors of the Listeria virulence gene operon.