Risk Assessment and Management of Listeria Monocytogenes in Ready-to-Eat Lettuce Salads

A Critical Review of Risk Assessment Models for Listeria monocytogenes in Produce

A review of quantitative risk assessment (QRA) models of Listeria monocytogenes in produce was carried out, with the objective of appraising and contrasting the effectiveness of the control strategies placed along the food chains. Despite nine of the thirteen QRA models recovered being focused on fresh or RTE leafy greens, none of them represented important factors or sources of contamination in the primary production, such as the type of cultivation, water, fertilisers or irrigation method/practices. Cross-contamination at processing and during consumer's handling was modelled using transfer rates, which were shown to moderately drive the final risk of listeriosis, therefore highlighting the importance of accurately representing the transfer coefficient parameters. Many QRA models coincided in the fact that temperature fluctuations at retail or temperature abuse at home were key factors contributing to increasing the risk of listeriosis. In addition to a primary module that could help assess current on-farm practices and potential control measures, future QRA models for minimally processed produce should also contain a refined sanitisation module able to estimate the effectiveness of various sanitisers as a function of type, concentration and exposure time. Finally, L. monocytogenes growth in the products down the supply chain should be estimated by using realistic time-temperature trajectories, and validated microbial kinetic parameters, both of them currently available in the literature.

A Critical Review of Risk Assessment Models for Listeria monocytogenes in Meat and Meat Products

A review of the published quantitative risk assessment (QRA) models of L. monocytogenes in meat and meat products was performed, with the objective of appraising the intervention strategies deemed suitable for implementation along the food chain as well as their relative effectiveness. A systematic review retrieved 23 QRA models; most of them (87%) focused on ready-to-eat meat products and the majority (78%) also covered short supply chains (end processing/retail to consumption, or consumption only). The processing-to-table scope was the choice of models for processed meats such as chorizo, bulk-cooked meat, fermented sausage and dry-cured pork, in which the effects of processing were simulated. Sensitivity analysis demonstrated the importance of obtaining accurate estimates for lag time, growth rate and maximum microbial density, in particular when affected by growth inhibitors and lactic acid bacteria. In the case of deli meats, QRA models showed that delicatessen meats sliced at retail were associated with a higher risk of listeriosis than manufacture pre-packed deli meats. Many models converged on the fact that (1) controlling cold storage temperature led to greater reductions in the final risk than decreasing the time to consumption and, furthermore, that (2) lower numbers and less prevalence of L. monocytogenes at the end of processing were far more effective than keeping low temperatures and/or short times during retail and/or home storage. Therefore, future listeriosis QRA models for meat products should encompass a processing module in order to assess the intervention strategies that lead to lower numbers and prevalence, such as the use of bio-preservation and novel technologies. Future models should be built upon accurate microbial kinetic parameters, and should realistically represent cross-contamination events along the food chain.

Listeriosis Risk Model for Cancer Patients Who Consume Ready-to-Eat Salad

The foodborne pathogen Listeria monocytogenes generally infects immunocompromised individuals, such as cancer patients, more frequently and with higher morbidity and mortality than the general population. Because of the anticipated risk associated with L. monocytogenes and other pathogens in produce, immunocompromised individuals are often placed on neutropenic diets that exclude fresh produce, though these risks have not been quantified. Therefore, this study developed a data-driven risk model for listeriosis in cancer patients who consume ready-to-eat (RTE) salads, consisting of leafy greens, cucumbers, and tomatoes, as influenced by kitchen-scale treatments and storage practices. Monte Carlo simulations were used to model the risk of invasive listeriosis during one chemotherapy cycle. Refrigerating all salad components decreased median risk by approximately one-half log. For refrigerated salads with no treatment, the predicted median risk was ≤ 4.3 × 10^-08. When salad ingredients were surface blanched with greens rinsed, the predicted risk decreased to 5.4 × 10^-10. Predicted risk was lowest (1.4 × 10^-13) for a blanched "salad" consisting of solely cucumbers and tomatoes. Interestingly, rinsing, as recommended by FDA only decreased median risk by 1 log. A sensitivity analysis revealed that the highly variable dose-response parameter k strongly influenced risk, indicating that reducing uncertainty in this variable may improve model accuracy. Overall, this study demonstrates that kitchen-scale pathogen reduction approaches have high risk-reduction efficacy and could be considered as an alternative to diets that exclude produce when making risk management decisions.

Incidence, Enumeration and Confirmation of Listeria and its Species in Ready-to-eat Street Vended Salads Sold at Various Outlets of Faisalabad City, Pakistan

The desire for a healthy lifestyle and faster mode of preparation has supported the consumption of ready to eat fresh salad. Street vended salads are recognized as a source of pathogenic transamination in different parts of the world. The present study was designed to evaluate the safety status of fresh vegetable and Russian salads being sold at various food outlets of Faisalabad. Samples of freshly prepared salads were collected from representative selected different areas of Faisalabad city divided into four different zones (zone 1, zone 2, zone 3 and zone 4). Prevalence and enumeration of Listeria was done through microbial testing via the spread plate method. Among samples of vegetable salad, highest prevalence of Listeria was found in the zone 2 (75%) whereas Russian salad samples from zones 1 and 3 exhibited 62% prevalence, the highest among all 4 zones of study. On the whole, the lowest prevalence of Listeria was found in zone 4 (50% vegetable salad and 58% Russian salad). Biochemical conformation of Listeria done through different tests for the identification of various Listeria species, exhibited that Listeria monocytogenes and Listeria innocua were highly prevalent in samples from zones 1 and 3 respectively. The results will help to improve safety concerns associated with street vended foods.

Estimating Listeria monocytogenes Growth in Ready-to-Eat Chicken Salad Using a Challenge Test for Quantitative Microbial Risk Assessment

Currently, there is a growing preference for convenience food products, such as ready-to-eat (RTE) foods, associated with long refrigerated shelf-lives, not requiring a heat treatment prior to consumption. Because Listeria monocytogenes is able to grow at refrigeration temperatures, inconsistent temperatures during production, distribution, and at consumer's household may allow for the pathogen to thrive, reaching unsafe limits. L. monocytogenes is the causative agent of listeriosis, a rare but severe human illness, with high fatality rates, transmitted almost exclusively by food consumption. With the aim of assessing the quantitative microbial risk of L. monocytogenes in RTE chicken salads, a challenge test was performed. Salads were inoculated with a three-strain mixture of cold-adapted L. monocytogenes and stored at 4, 12, and 16 °C for eight days. Results revealed that the salad was able to support L. monocytogenes' growth, even at refrigeration temperatures. The Baranyi primary model was fitted to microbiological data to estimate the pathogen's growth kinetic parameters. Temperature effect on the maximum specific growth rate (μ_max ) was modeled using a square-root-type model. Storage temperature significantly influenced μ_max of L. monocytogenes (p < 0.05). These predicted growth models for L. monocytogenes were subsequently used to develop a quantitative microbial risk assessment, estimating a median number of 0.00008726 listeriosis cases per year linked to the consumption of these RTE salads. Sensitivity analysis considering different time-temperature scenarios indicated a very low median risk per portion (<-7 log), even if the assessed RTE chicken salad was kept in abuse storage conditions.

Growth of Listeria monocytogenes in ready-to-eat "shrimp cocktail": Risk assessment and possible preventive interventions

The present study investigated the presence, growth potential, and public health risk posed by Listeria monocytogenes in a ready-to-eat "shrimp cocktail". The pathogen was detected in 4 out of the 104 samples, and there were no counts above the enumeration limit (1 Log colony-forming unit (CFU)/g); the product was a suitable substrate for pathogen growth owing to its chemical/physical properties. A stochastic quantitative microbial risk assessment (QMRA) was performed to estimate the expected number of invasive listeriosis cases caused by the consumption of 10,000 servings of the product on the last day of its shelf life, considering a population comprising healthy consumers, those susceptible, and transplant recipients. The model predicted no cases for this scenario. Uncertainties were included by considering alternative scenarios; even when considering an increased mean bacterial concentration (up to 3-4 Log CFU/g), no cases were estimated. Following a producer's demand, the exposure assessment model was also used to estimate the probability of the product exceeding the threshold of 2 log CFU/g during the shelf life. The possibility of Listeria growth in the product could not be avoided. Therefore, a modification of the production process was tested to re-classify the product as unsuitable for Listeria growth (EC Reg. 2073/2005). The shrimps were conditioned in three different organic acid solutions comprising: acetic acid (1500 ppm) (A); benzoic acid (1500 ppm) + acetic acid (500 ppm) + lactic acid (750 ppm) (BLA); and lactic acid (4500 ppm) + sodium acetate (2500 ppm) (LSA). Testing was conducted over various treatment durations (1 day-5 days). Treatment for 2 days in the LSA solution was selected based on efficacy, the absence of consumer-perceptible sensorial modifications, and the producers' production rate requirements. The concentration of L. monocytogenes decreased when the new process was applied, which confirmed the usefulness and effectiveness of the treatment relative to the traditional process. Thus, the product obtained by the modified production process did not support the growth of L. monocytogenes.

Modelling the combined effect of chlorine, benzyl isothiocyanate, exposure time and cut size on the reduction of Salmonella in fresh-cut lettuce during washing process

This work aimed to study the effect of the combination of Sodium hypochlorite, the most used disinfectant by the vegetable industry, with a natural antimicrobial, benzyl-isothiocyanate (BITC), considering cutting surface and contact time, on the reduction of Salmonella in fresh-cut produce in washing operations under typical industrial conditions. Overall, the combinations of disinfectant and process parameters resulted in a mean reduction of Salmonella of 2.5 log CFU/g. According to statistical analysis, free chlorine and BITC concentrations, contact time and cut size exerted a significant effect on the Salmonella reduction (p ≤ 0.05). The optimum combination of process parameter values yielding the highest Salmonella reduction was a lettuce cut size of 15 cm2 washed for 110 s in industrial water containing 160 mg/L free chlorine and 40 mg/L BITC. A predictive model was also derived, which, as illustrated, could be applied to optimize industrial disinfection and develop probabilistic Exposure Assessments considering the effect of washing process parameters on the levels of Salmonella contamination in leafy green products. The present study demonstrated the efficacy of chlorine to reduce Salmonella populations in fresh-cut lettuce while highlighting the importance of controlling the washing process parameters, such as, contact time, cut size and concentration of the disinfectant to increase disinfectant efficacy and improve food safety.

Listeria monocytogenes contamination of ready-to-eat foods and the risk for human health in the EU

Food safety criteria for Listeria monocytogenes in ready-to-eat (RTE) foods have been applied from 2006 onwards (Commission Regulation (EC) 2073/2005). Still, human invasive listeriosis was reported to increase over the period 2009-2013 in the European Union and European Economic Area (EU/EEA). Time series analysis for the 2008-2015 period in the EU/EEA indicated an increasing trend of the monthly notified incidence rate of confirmed human invasive listeriosis of the over 75 age groups and female age group between 25 and 44 years old (probably related to pregnancies). A conceptual model was used to identify factors in the food chain as potential drivers for L. monocytogenes contamination of RTE foods and listeriosis. Factors were related to the host (i. population size of the elderly and/or susceptible people; ii. underlying condition rate), the food (iii. L. monocytogenes prevalence in RTE food at retail; iv. L. monocytogenes concentration in RTE food at retail; v. storage conditions after retail; vi. consumption), the national surveillance systems (vii. improved surveillance), and/or the bacterium (viii. virulence). Factors considered likely to be responsible for the increasing trend in cases are the increased population size of the elderly and susceptible population except for the 25-44 female age group. For the increased incidence rates and cases, the likely factor is the increased proportion of susceptible persons in the age groups over 45 years old for both genders. Quantitative modelling suggests that more than 90% of invasive listeriosis is caused by ingestion of RTE food containing > 2,000 colony forming units (CFU)/g, and that one-third of cases are due to growth in the consumer phase. Awareness should be increased among stakeholders, especially in relation to susceptible risk groups. Innovative methodologies including whole genome sequencing (WGS) for strain identification and monitoring of trends are recommended.

Quantitative Microbial Risk Assessment for Escherichia coli O157:H7 in Fresh-Cut Lettuce

Leafy green vegetables, including lettuce, are recognized as potential vehicles for foodborne pathogens such as Escherichia coli O157:H7. Fresh-cut lettuce is potentially at high risk of causing foodborne illnesses, as it is generally consumed without cooking. Quantitative microbial risk assessments (QMRAs) are gaining more attention as an effective tool to assess and control potential risks associated with foodborne pathogens. This study developed a QMRA model for E. coli O157:H7 in fresh-cut lettuce and evaluated the effects of different potential intervention strategies on the reduction of public health risks. The fresh-cut lettuce production and supply chain was modeled from field production, with both irrigation water and soil as initial contamination sources, to consumption at home. The baseline model (with no interventions) predicted a mean probability of 1 illness per 10 million servings and a mean of 2,160 illness cases per year in the United States. All intervention strategies evaluated (chlorine, ultrasound and organic acid, irradiation, bacteriophage, and consumer washing) significantly reduced the estimated mean number of illness cases when compared with the baseline model prediction (from 11.4- to 17.9-fold reduction). Sensitivity analyses indicated that retail and home storage temperature were the most important factors affecting the predicted number of illness cases. The developed QMRA model provided a framework for estimating risk associated with consumption of E. coli O157:H7-contaminated fresh-cut lettuce and can guide the evaluation and development of intervention strategies aimed at reducing such risk.

Niksic M. Antimicrobial Activity of Chitosan Films With Essential Oils Against Listeria monocytogenes on Cabbage

BACKGROUND

The highest incidence of listeriosis, due to consumption of ready-to-eat foods and fresh, shredded, minimally processed vegetables, occurs among pregnant women and the elderly. In order to reduce the prevalence of listeriosis among consumers, better protective measures are recommended. Chitosan films, with or without added essential oils, represent a modern, safe method of preserving the quality of such vegetables and significantly reducing the incidence of Listeria monocytogenes in these foods.

OBJECTIVES

The present study was conducted to evaluate the antimicrobial properties of composite chitosan-gelatin films with and without essential oils against two strains of L. monocytogenes, ATCC 19115 and ATCC 19112, in fresh shredded cabbage.

METHODS

Shredded cabbage was inoculated with L. monocytogenes and packed between two layers of the chitosan composite film, then placed in Petri dishes. The prepared samples were stored at 4°C then analyzed for total viable count on PALCAM agar while incubated at 37°C, every 24 hours for 7 days.

RESULTS

Average L. monocytogenes content ranged from 4.2 - 5.4 log CFU/g, reaching values of 7.2 - 8.6 log CFU/g in samples of untreated cabbage. A complete reduction of L. monocytogenes ATCC 19115 on cabbage was achieved after 120 hours in the presence of 0.5% chitosan film, whereas reduction of L. monocytogenes ATCC 19112 was achieved after 144 hours. In the presence of 1% chitosan film, the bacteria withered more quickly and complete reduction of both species of L. monocytogenes was achieved after 96 hours.

CONCLUSIONS

All tested formulations of chitosan films exhibited strong antimicrobial activity on the growth of both strains of L. monocytogenes on cabbage. The best effect was achieved with a 1% chitosan concentration. The addition of essential oils increased the antimicrobial activity of all tested films.

Belgian and Spanish consumption data and consumer handling practices for fresh fruits and vegetables useful for further microbiological and chemical exposure assessment

A consumer survey was organized in Spain and Belgium to obtain consumption data and to gain insight into consumer handling practices for fresh vegetables consumed raw or minimally processed (i.e., heads of leafy greens, bell peppers, tomatoes, fresh herbs, and precut and packed leafy greens) and fruits to be consumed without peeling (i.e., apples, grapes, strawberries, raspberries, other berries, fresh juices, and precut mixed fruit). This information can be used for microbiological and/or chemical food safety research. After extensive cleanup of rough databases for missing and extreme values and age correction, information from 583 respondents from Spain and 1,605 respondents from Belgium (18 to 65 years of age) was retained. Daily intake (grams per day) was calculated taking into account frequency and seasonality of consumption, and distributions were obtained that can be used in quantitative risk assessment for chemical hazards with chronic effects on human health. Data also were recalculated to obtain discrete distributions of consumption per portion and the corresponding frequency of consumption, which can be used in acute microbiological risk assessment or outbreak investigations. The ranked median daily consumption of fruits and vegetables was similar in Spain and Belgium: apple > strawberry > grapes > strawberries and raspberries; and tomatoes > leafy greens > bell peppers > fresh herbs. However, vegetable consumption was higher (in terms of both portion and frequency of consumption) in Spain than in Belgium, whereas the opposite was found for fruit consumption. Regarding consumer handling practices related to storage time and method, Belgian consumers less frequently stored their fresh produce in a refrigerator and did so for shorter times compared with Spanish consumers. Washing practices for lettuce heads and packed leafy greens also were different. The survey revealed differences between these two countries in consumption and consumer handling practices, which can have an impact on outcomes of future microbiological or chemical risk assessment studies.

A quantitative exposure model simulating human norovirus transmission during preparation of deli sandwiches

Human noroviruses (HuNoVs) are a major cause of food borne gastroenteritis worldwide. They are often transmitted via infected and shedding food handlers manipulating foods such as deli sandwiches. The presented study aimed to simulate HuNoV transmission during the preparation of deli sandwiches in a sandwich bar. A quantitative exposure model was developed by combining the GoldSim® and @Risk® software packages. Input data were collected from scientific literature and from a two week observational study performed at two sandwich bars. The model included three food handlers working during a three hour shift on a shared working surface where deli sandwiches are prepared. The model consisted of three components. The first component simulated the preparation of the deli sandwiches and contained the HuNoV reservoirs, locations within the model allowing the accumulation of NoV and the working of intervention measures. The second component covered the contamination sources being (1) the initial HuNoV contaminated lettuce used on the sandwiches and (2) HuNoV originating from a shedding food handler. The third component included four possible intervention measures to reduce HuNoV transmission: hand and surface disinfection during preparation of the sandwiches, hand gloving and hand washing after a restroom visit. A single HuNoV shedding food handler could cause mean levels of 43±18, 81±37 and 18±7 HuNoV particles present on the deli sandwiches, hands and working surfaces, respectively. Introduction of contaminated lettuce as the only source of HuNoV resulted in the presence of 6.4±0.8 and 4.3±0.4 HuNoV on the food and hand reservoirs. The inclusion of hand and surface disinfection and hand gloving as a single intervention measure was not effective in the model as only marginal reductions of HuNoV levels were noticeable in the different reservoirs. High compliance of hand washing after a restroom visit did reduce HuNoV presence substantially on all reservoirs. The model showed that good handling practices such as washing hands after a restroom visit, hand gloving, hand disinfection and surface disinfection in deli sandwich bars were an effective way to prevent HuNoV contamination of the prepared foods, but it also demonstrated that further research is needed to ensure a better assessment of the risk of HuNoV transmission during preparation of foods.

Growth of Escherichia coli O157:H7 and Listeria monocytogenes in packaged fresh-cut romaine mix at fluctuating temperatures during commercial transport, retail storage, and display

Temperature abuse during commercial transport and retail sale of leafy greens negatively impacts both microbial safety and product quality. Consequently, the effect of fluctuating temperatures on Escherichia coli O157:H7 and Listeria monocytogenes growth in commercially-bagged salad greens was assessed during transport, retail storage, and display. Over a 16-month period, a series of time-temperature profiles for bagged salads were obtained from five transportation routes covering four geographic regions (432 profiles), as well as during retail storage (4,867 profiles) and display (3,799 profiles). Five different time-temperature profiles collected during 2 to 3 days of transport, 1 and 3 days of retail storage, and 3 days of retail display were then duplicated in a programmable incubator to assess E. coli O157:H7 and L. monocytogenes growth in commercial bags of romaine lettuce mix. Microbial growth predictions using the Koseki-Isobe and McKellar-Delaquis models were validated by comparing the root mean square error (RMSE), bias, and the acceptable prediction zone between the laboratory growth data and model predictions. Monte Carlo simulations were performed to calculate the probability distribution of microbial growth from 8,122,127,472 scenarios during transport, cold room storage, and retail display. Using inoculated bags of retail salad, E. coli O157:H7 and L. monocytogenes populations increased a maximum of 3.1 and 3.0 log CFU/g at retail storage. Both models yielded acceptable RMSEs and biases within the acceptable prediction zone for E. coli O157:H7. Based on the simulation, both pathogens generally increased <2 log CFU/g during transport, storage, and display. However, retail storage duration can significantly impact pathogen growth. This large-scale U.S. study-the first using commercial time/temperature profiles to assess the microbial risk of leafy greens-should be useful in filling some of the data gaps in current risk assessments for leafy greens.