Sarcoidosis, Mycobacterium paratuberculosis and Noncaseating Granulomas: Who Moved My Cheese

Clinical and histological similarities between sarcoidosis and tuberculosis have driven repeated investigations looking for a mycobacterial cause of sarcoidosis. Over 50 years ago, "anonymous mycobacteria" were suggested to have a role in the etiology of sarcoidosis. Both tuberculosis and sarcoidosis have a predilection for lung involvement, though each can be found in any area of the body. A key histopathologic feature of both sarcoidosis and tuberculosis is the granuloma-while the tuberculous caseating granuloma has an area of caseous necrosis with a cheesy consistency; the non-caseating granuloma of sarcoidosis does not have this feature. This article reviews and reiterates the complicity of the infectious agent, Mycobacterium avium subsp. paratuberculosis (MAP) as a cause of sarcoidosis. MAP is involved in a parallel story as the putative cause of Crohn's disease, another disease featuring noncaseating granulomas. MAP is a zoonotic agent infecting ruminant animals and is found in dairy products and in environmental contamination of water and air. Despite increasing evidence tying MAP to several human diseases, there is a continued resistance to embracing its pleiotropic roles. "Who Moved My Cheese" is a simple yet powerful book that explores the ways in which individuals react to change. Extending the metaphor, the "non-cheesy" granuloma of sarcoidosis actually contains the difficult-to-detect "cheese", MAP; MAP did not move, it was there all along.

State of the art of breeding, milking, and milk processing for the production of curdled milk and Wagashi Gassirè in Benin: Practices favoring the contamination of its dairy products

Introduction

This study aimed to identify the factors favoring the contamination of raw cow's milk, curdled milk, and Wagashi Gassirè cheese during their production and preservation in order to develop strategies to improve their quality.

Methods

A cross-sectional survey of 401 randomly selected stakeholders encompassing all levels of the dairy production chain in the Nikki and Dassa-Zoumé communes of Benin was conducted. The data obtained were analyzed using the SAS software for the calculation of frequencies and the R software for classifying the stakeholders based on the hygiene practices they adopted during the production and conservation of raw cow's milk, curdled milk, and Wagashi Gassirè.

Results and discussion

The study identified three types of dairy farmers based on how they medically treated their cattle and implemented hygiene practices, including farmers who (1) relied on themselves or received help from veterinarians trained in animal husbandry and milking to monitor the animals on their farms; (2) relied only on veterinarians; and (3) relied only on themselves. The majority of these dairy farmers felt that hygienic milking practices were very restrictive and difficult to implement. In addition, three groups of Wagashi Gassirè producers were identified: (1) producers trained in good hygiene practices who did not boil or sundry the cheese; (2) producers lacking the infrastructure to protect from weather exposure who used all parts of Calotropis procera for colored Wagashi Gassirè production; and (3) producers who did not often filter the milk and boiled the Wagashi Gassirè in bags before immersion in simple water or whey. The sanitary quality of milk and milk products is influenced by the diverse handling practices employed by producers. These practices must be considered according to the types of farmers and processors when suggesting improved intervention policies.

Isothermal inactivation of Mycobacterium avium subsp. paratuberculosis in curd simulating the stretching phase in pasta-filata cheese process

Raw milk and dairy products are usually considered the major sources of Mycobacterium avium subsp. paratuberculosis (MAP) exposure for humans. During the production process of mozzarella cheese, as well as of other pasta-filata cheeses made with pasteurized or raw milk, curd is heated and stretched by addition of hot or boiling water. This step is the critical point for the inactivation of MAP during the production process, but, to our knowledge, no studies have been published about the thermal death time values of MAP in curd. The aim of this study was to determine the inactivation kinetics of MAP in curd used to produce pasta-filata cheese in six independent experiments. The milk was inoculated with a mix of MAP strains (field and registered strains) and, with the aim to simulate the thermal treatment of the curd during the stretching step, samples of 10 g of contaminated curd were vacuum packed and treated separately at six different temperatures from 60°C to 75°C in a water bath. MAP survival was then evaluated by plate count method and inactivation parameters were estimated for determining the thermal resistance of the pathogen directly in the curd. D-values increased from 0.15 min (D75-value) to 4.22 min (D60-value) and the calculated z-value was 10.2°C. These data aid: (i) to design food thermal process treatments defining acceptance limits of critical control points to ensure safety against MAP; (ii) to predict the time/temperature combinations needed to obtain a certain MAP log reduction during the curd stretching step; (iii) to optimize or validate pasta-filata cheese process.

Mycobacterium avium subsp. paratuberculosis Proteome Changes Profoundly in Milk

Mycobacterium avium subspecies paratuberculosis (MAP) are detectable viable in milk and other dairy products. The molecular mechanisms allowing the adaptation of MAP in these products are still poorly understood. To obtain information about respective adaptation of MAP in milk, we differentially analyzed the proteomes of MAP cultivated for 48 h in either milk at 37 °C or 4 °C or Middlebrook 7H9 broth as a control. From a total of 2197 MAP proteins identified, 242 proteins were at least fivefold higher in abundance in milk. MAP responded to the nutritional shortage in milk with upregulation of 32% of proteins with function in metabolism and 17% in fatty acid metabolism/synthesis. Additionally, MAP upregulated clusters of 19% proteins with roles in stress responses and immune evasion, 19% in transcription/translation, and 13% in bacterial cell wall synthesis. Dut, MmpL4_1, and RecA were only detected in MAP incubated in milk, pointing to very important roles of these proteins for MAP coping with a stressful environment. Dut is essential and plays an exclusive role for growth, MmpL4_1 for virulence through secretion of specific lipids, and RecA for SOS response of mycobacteria. Further, 35 candidates with stable expression in all conditions were detected, which could serve as targets for detection. Data are available via ProteomeXchange with identifier PXD027444.

Standardization of a rapid quadruplex PCR method for the simultaneous detection of bovine, buffalo, Salmonella spp., and Listeria monocytogenes DNA in milk

ABSTRACT The objective of the present study was to Standardize a Polymerase Chain Reaction (PCR) protocol for the authentication of bovine and buffalo milk, and to detect the presence of Salmonella spp. and Listeria monocytogenes. For this, the target DNA was extracted, mixed, and subjected to a PCR assay. Milk samples were defrauded and experimentally contaminated with microorganisms to assess the detection of target DNA at different times of cultivation, bacterial titers, and concentration of genetic material. In addition, the protocol was tested with DNA extracted directly from food, without a pre-enrichment step. The proposed quadruplex PCR showed good accuracy in identifying target DNA sequences. It was possible to simultaneously identify all DNA sequences at the time of inoculation (0h), when the samples were contaminated with 2 CFU/250mL and with 6h of culture when the initial inoculum was 1 CFU/250mL. It was also possible to directly detect DNA sequences from the food when it was inoculated with 3 CFU/mL bacteria. Thus, the proposed methodology showed satisfactory performance, optimization of the analysis time, and a potential for the detection of microorganisms at low titers, which can be used for the detection of fraud and contamination.

Growth interferences between bacterial strains from raw cow's milk and their impact on growth of Listeria monocytogenes and Staphylococcus aureus

AIMS

The purpose of this study was to detect growth enhancing or inhibiting activity between bacterial populations from raw milk under different conditions (temperature, medium).

METHODS AND RESULTS

The interference of 24 raw milk isolates on growth of each other and on Listeria monocytogenes, Staphylococcus aureus, Bacillus subtilis and Micrococcus luteus was screened by drop assay and for selected pairs in co-cultivation experiments. By drop assay, antibacterial activity was observed for 40% of the strains. About 30% of the strains showed growth-enhancing activity on other strains. Most of the isolates were well adapted to cold temperatures and showed consistent or even increased inhibiting or enhancing effects on growth of other strains at 10°C. The growth of L. monocytogenes DSM 20600^T and S. aureus DSM 1104^T was significantly (P < 0·05) reduced in co-cultivation with Pseudomonas protegens JZ R-192.

CONCLUSIONS

Growth interferences between bacterial populations have an impact on the structure of raw milk microbiota, especially when it develops under cold storage, and it may have an effect on the prevalence of certain foodborne pathogens.

SIGNIFICANCE AND IMPACT OF THE STUDY

This study demonstrates growth-inhibiting and also growth-enhancing interactions between raw milk bacteria, which must be considered when predicting bacterial growth and spoilage in food. A Ps. protegens strain isolated from raw milk showed an antagonistic effect on growth of L. monocytogenes in refrigerated raw milk.

Prevalence and Survival of Stenotrophomonas Species in Milk and Dairy Products in Egypt

Stenotrophomonas maltophilia is a nosocomial, multidrug-resistant pathogen that causes significant economic losses in milk production and deterioration of dairy product quality. This study investigates the prevalence and the survival of S. maltophilia under different food preservation conditions. A total of 240 samples, including farm-sourced milk, dairy shop purchased milk, Kareish cheese, Domiati cheese, ice cream, yoghurt, cooking butter, and unpasteurized cream were collected from various locations in Beni-Suef Governorate, Egypt. Thirty samples of each product were analyzed by standard biochemical tests for the presence of Stenotrophomonas spp., which was isolated from 36% (87/240) of the examined samples. The highest prevalence was observed in ice cream (80%), followed by unpasteurized cream (67%), whereas the lowest incidence was in Domiati cheese (3.3%). S. maltophilia, identified by PCR, was found only in unpasteurized cream (13%), cooking butter (10%), ice cream (6.7%), and dairy shop milk (3.3%). We also studied the viability of S. maltophilia in laboratory manufactured cream, butter, and cheese under different preservation conditions. S. maltophilia was able to survive for 30, 30, 28, 30, and 8 d in the inoculated cream, butter 0% salt, butter 3% salt, cheese 0% salt, and cheese 6% salt, respectively. Thus, S. maltophilia was able to survive more than predicted in all products in this study. This suggests that strains of S. maltophilia may develop adaptive strategies that enable survival under different food preservation conditions, which contradicts previous knowledge about the sensitivity of this microbe to environmental stress conditions. Our overall aim was to draw attention to the prevalence and future potential for increased public health significance of Stenotrophomonas spp.

Putting Crohn's on the MAP: Five Common Questions on the Contribution of Mycobacterium avium subspecies paratuberculosis to the Pathophysiology of Crohn's Disease

For decades, Mycobacterium avium subspecies paratuberculosis (MAP) has been linked to the pathogenesis of Crohn's disease. Despite many investigations and research efforts, there remains no clear unifying explanation of its pathogenicity to humans. Proponents argue Crohn's disease shares many identical features with a granulomatous infection in ruminants termed Johne's disease and similarities with ileo-cecal tuberculosis. Both are caused by species within the Mycobacterium genus. Sceptics assert that since MAP is found in individuals diagnosed with Crohn's disease as well as in healthy population controls, any association with CD is coincidental. This view is supported by the uncertain response of patients to antimicrobial therapy. This report aims to address the controversial aspects of this proposition with information and knowledge gathered from several disciplines, including microbiology and veterinary medicine. The authors hope that this discussion will stimulate further research aimed at confirming or refuting the contribution of MAP to the pathogenesis of Crohn's disease and ultimately lead to advanced targeted clinical therapies.

Molecular characterization of antimicrobial resistance genes on farms and in commercial milk with emphasis on the effect of currently practiced heat treatments on viable but nonculturable formation

Despite the considerable advances that have been made to improve dairy food safety, there is rising concern that pasteurization is not sufficient for the destruction of plasmid-mediated antimicrobial resistance (AMR) genes of resistant bacteria and could stimulate bacteria to enter into a viable but nonculturable (VBNC) state. In the current study, we surveyed the prevalence of 1 genomic and 9 plasmid-mediated AMR genes in 100 samples (bulk tank milk and milk filter socks) at the farm level and 152 commercial milk samples (pasteurized and UHT milks) and assessed the VBNC state in dairy bacteria. Results revealed that sul2 was the most prevalent plasmid-mediated gene in milk filter socks (96%), bulk tank milk (48%), pasteurized milk (68%), and UHT (43%) milk; in contrast, mecA was not detected in any sample. Additionally, commercial pasteurization (as currently practiced) failed to decrease the prevalence of the bla_TEM-B1 (43%), tetK (30%), and tetA (55%) plasmid-mediated AMR genes; thus, commercial pasteurization may be one of the factors creating the VBNC state in some dairy bacteria. Continued research is necessary to identify bacterial species entering the VBNC state after pasteurization, to assess their potential hazard level and shed more light on the expression and possibility of horizontal gene transfer of those plasmid-mediated AMR genes.

"They've got to be testing and doing something about it": Farmer and veterinarian views on drivers for Johne's disease control in dairy herds in England

There needs to be an understanding of the reasons why key stakeholders engage in disease control efforts if disease is to be successfully and sustainably controlled. It is increasingly recognised within veterinary epidemiology and policy making in animal health that these 'people factors' are important influences on the success or otherwise of animal disease control programmes. Research methodologies adopted from the social sciences offer ways to understand this important dimension through investigating the attitudes and opinions of the key actors involved. The study reported in this paper, based on qualitative interview research, investigates the views of dairy farmers and cattle veterinarians on the drivers and incentives for controlling Johne's disease in English dairy herds. Twenty semi-structured interviews involving 17 dairy farmers and seven veterinarians were conducted in two dairy-intensive regions of England. The findings demonstrate the varied influences of veterinary advice and encouragement; appreciation of the economic cost of the disease at herd level; a voluntary national control plan; and fear of a future consumer food scare as the main reasons to engage in Johne's disease control on dairy farms. The study demonstrates how a combination of a voluntary industry-led control scheme, compulsory participation through retailer and processor contractual requirements, and threats of reputational harm and market loss have strongly influenced farmer and veterinary behaviour in relation to Johne's control without statutory involvement. The findings illustrate the importance of considering the political economy and societal impact of animal disease.

Fates of pathogenic bacteria in time-temperature-abused and Holder-pasteurized human donor-, infant formula-, and full cream cow's milk

This study was conducted to address the dearth in works that simultaneously compare the growth and inactivation behaviors of selected pathogens in different milk products. In worst-case scenarios where hygienic practices are absent and heavy microbiological contaminations occur, Salmonella enterica, Escherichia coli O157:H7, Listeria monocytogenes, Pseudomonas aeruginosa, and Staphylococcus aureus multiplied in all samples at room temperature (27 °C). Most organisms readily proliferated with growth lag (t_lag) values ranging from 0.00 to 5.95 h. Growth rates (K_G) ranged from 0.16 to 0.67 log CFU/h. Sanitary risk times (SRTs) for a 1-log population increase ranged from 1.85 to 6.27 h, while 3.69-12.55 h were the SRTs determined for 2-log population increase. Final populations (Pop_fin) ranged from 7.11 to 9.36 log CFU/mL. Inactivation in heavily contaminated milk during Holder pasteurization revealed biphasic inactivation behavior with total log reduction (TLR) after exposure to 62.5 °C for 30 min ranging from 1.91 (90.8%) to 6.00 (99.9999%). These results emphasize the importance food safety systems in the handling of milk and milk products during manufacture and preparation.