Restaurant Cooking Trends and Increased Risk for Campylobacter Infection

Applications and safety aspects of bioactives obtained from by-products/wastes

Due to the negative impacts of food loss and food waste on the environment, economy, and social contexts, it is a necessity to take action in order to reduce these wastes from post-harvest to distribution. In addition to waste reduction, bioactives obtained from by-products or wastes can be utilized by new end-users by considering the safety aspects. It has been reported that physical, biological, and chemical safety features of raw materials, instruments, environment, and processing methods should be assessed before and during valorization. It has also been indicated that meat by-products/wastes including collagen, gelatin, polysaccharides, proteins, amino acids, lipids, enzymes and chitosan; dairy by-products/wastes including whey products, buttermilk and ghee residue; fruit and vegetable by-products/wastes such as pomace, leaves, skins, seeds, stems, seed oils, gums, fiber, polyphenols, starch, cellulose, galactomannan, pectin; cereal by-products/wastes like vitamins, dietary fibers, fats, proteins, starch, husk, and trub have been utilized as animal feed, food supplements, edible coating, bio-based active packaging systems, emulsifiers, water binders, gelling, stabilizing, foaming or whipping agents. This chapter will explain the safety aspects of bioactives obtained from various by-products/wastes. Additionally, applications of bioactives obtained from by-products/wastes have been included in detail by emphasizing the source, form of bioactive compound as well as the effect of said bioactive compound.

Persistence of Campylobacter spp. in Poultry Flocks after Disinfection, Virulence, and Antimicrobial Resistance Traits of Recovered Isolates

To investigate the persistence risk of Campylobacter spp. in poultry farms, and to study the virulence and antimicrobial resistance characteristics in the recovered strains, we collected 362 samples from breeding hen flocks, before and after disinfection. The virulence factors were investigated by targeting the genes; flaA, cadF, racR, virB11, pldA, dnaJ, cdtA, cdtB, cdtC, ciaB, wlaN, cgtB, and ceuE by PCR. Antimicrobial susceptibility was tested and genes encoding antibiotic resistance were investigated by PCR and MAMA-PCR. Among the analyzed samples, 167 (46.13%) were positive for Campylobacter. They were detected in 38.7% (38/98) and 3% (3/98) of environment samples before and after disinfection, respectively, and in 126 (75.9%) out of 166 feces samples. In total, 78 C. jejuni and 89 C. coli isolates were identified and further studied. All isolates were resistant to macrolids, tetracycline, quinolones, and chloramphenicol. However, lower rates were observed for beta-lactams [ampicillin (62.87%), amoxicillin-clavulanic acid (47.3%)] and gentamicin (0.6%). The tet(O) and the cmeB genes were detected in 90% of resistant isolates. The bla_OXA-61 gene and the specific mutations in the 23S rRNA were detected in 87% and 73.5% of isolates, respectively. The A2075G and the Thr-86-Ile mutations were detected in 85% and 73.5% of macrolide and quinolone-resistant isolates, respectively. All isolates carried the flaA, cadF, CiaB, cdtA, cdtB, and cdtC genes. The virB11, pldA, and racR genes were frequent in both C. jejuni (89%, 89%, and 90%, respectively) and C. coli (89%, 84%, and 90%). Our findings highlight the high occurrence of Campylobacter strains exhibiting antimicrobial resistance with potential virulence traits in the avian environment. Thus, the improvement of biosecurity measures in poultry farms is essential to control bacterial infection persistence and to prevent the spread of virulent and resistant strains.

Experimentally observed Campylobacter jejuni survival kinetics in chicken meat products during model gastric digestion tended to be lower than model predictions

Campylobacter jejuni-related foodborne diseases are mainly attributed to the consumption of undercooked chicken meat and cross-contaminated produce. This study aimed to develop a survival kinetics model, based on the Weibull model, for predicting foodborne C. jejuni survival during gastric digestion in a model stomach. We previously confirmed that C. jejuni can survive temperatures up to 62 °C; therefore, certain types of grilled chicken skewers (yakitori) were examined for C. jejuni survival during simulated gastric digestion. C. jejuni survival on a chicken thigh following grilling was examined to confirm the foods for digestion experiments. Further, C. jejuni survival during model digestion was investigated through simultaneous digestion of raw chicken and cross-contaminated iceberg lettuce. The model stomach pH increased from 1.5 to 6.0 immediately after yakitori ingestion and did not decrease below 4.0 within 3 h of digestion. Gastric digestion did not significantly contribute to C. jejuni inactivation (<1.5 log reduction after 3 h digestion). Our model could predict C. jejuni survival kinetics in simulated gastric fluid under varying pH during model digestion. This approach can be used to predict C. jejuni survival rates following digestion to improve food safety and reduce Campylobacter-related disease outbreaks.

Quality changes in chicken livers during cooking

Raw chicken livers are often contaminated with Campylobacter and Salmonella. Cooking is considered the last defense of pathogen control for meals containing chicken livers. However, consumers' preference for pink color and a creamy texture as desired attributes in preparing liver pâté may lead to inadequate cooking, thereby increasing the risk of foodborne illness. This study aimed to investigate the effects of different cooking conditions (60-90°C, 0-65 min) on quality changes in frozen and fresh chicken livers and develop cooking recommendations to produce safe liver products with desired qualities. Frozen storage reduced the water holding capacity of raw chicken livers and led to more cooking loss (reduction in the weight of liver pieces during cooking) and area shrinkage after heating. The cooking loss and area shrinkage increased with increasing heating time and temperature, following the first-order fractional model. Compared with fresh livers, the shear resistance for cutting through the cooked livers increased after heating at 73.9°C to 90°C and decreased at 60°C, whereas the livers heated at 70°C had shear resistance (~4.5 N/g) similar to the fresh liver, regardless of the heating times used in this study. Heating resulted in color changes in livers, shifting from red hue (0°) toward yellow hue (90°), as characterized by the increased hue angles after heating. Cooking livers to an internal temperature of 70°C to 73.9°C and hold for 101 to 26 s is recommended for food processing plants or restaurants to prepare ready-to-eat meals containing chicken livers to achieve microbial safety with respect to Salmonella and provide cooked livers with desired texture and pink color.

Survey of New Zealand Poultry Consumers' Handling of Raw Poultry and Food Safety Awareness To Provide Insight into Risk Factors for Campylobacteriosis

ABSTRACT

New Zealand (NZ) has a high rate of reported campylobacteriosis cases. Cross-contamination in home kitchens during poultry handling is considered the main factor in campylobacteriosis transmission. The main aim of this study was to measure NZ consumers' food safety awareness and self-reported food safety practices associated with handling raw poultry. This study will contribute to the existing knowledge to explain the reasons behind the increase of campylobacteriosis incidents. Findings can help inform future consumer education campaigns to help reduce the incidence of campylobacteriosis in NZ. A cross-sectional survey composed of 31 multiple-choice questions was designed, piloted, and used to collect information about the last time consumers purchased and prepared raw poultry at home. A street-intercept survey in public places, such as supermarkets in the Canterbury region, was used to recruit respondents for this study. A descriptive and inferential data analysis was performed, including a one-way analysis of variance test used to compare the mean scored responses of the respondents among different sociodemographics. Overall, 301 valid responses were obtained. Scores representing reported safe food practices ranged between 2 and 19 (maximum 21), with a mean score of 9.83 (standard deviation of 3.50 with a standard error of 0.20). There was some variation in correctly answered questions by respondents for food hygiene (25%), cross-contamination prevention (55%), temperature control and storage practices (49%), and food safety (52%). Approximately 30% of the respondents reported symptoms of a foodborne disease experienced once to four times during the past 12 months. The study identified low adherence to current recommended food safety practices, including safe food storage and temperature control. The findings can be used to inform a communication campaign regarding food safety needs to be designed urgently in NZ to reduce the rate of campylobacteriosis.

HIGHLIGHTS

Prevalence of Multidrug-Resistant Foodborne Pathogens and Indicator Bacteria from Edible Offal and Muscle Meats in Nashville, Tennessee

This study investigated the prevalence of antimicrobial-resistant bacteria in retail edible offal and muscle meats in Nashville, Tennessee. A total of 348 retail meats (160 edible offal and 188 muscle) were analyzed for Salmonella enterica serovar, Campylobacter, Escherichia coli, E. coli O157:H7, and enterococci. Bacteria was identified using biochemical and PCR methods. Salmonella enterica serovar (4.4% and 4.3%), Campylobacter (1.9% and 1.1%), E. coli (79.4% and 89.4%), and enterococci (88.1% and 95.7%) was detected in offal and muscle meats, respectively. Chicken liver (9.7%) was most frequently contaminated with Salmonella enterica serovar, followed by ground chicken (6.9%) and chicken wings (4.2%). No Salmonella enterica serovar was detected in beef liver, beef tripe, and ground beef. The prevalence of Campylobacter was 6.9%, 2.3%, and 1.4% in beef liver, ground beef, and ground chicken, respectively. None of the meats were positive for E. coli O157:H7. Resistance of isolates was significantly (p < 0.05) highest in erythromycin (98.3%; 99.1%), followed by tetracycline (94%; 98.3%), vancomycin (88.8%; 92.2%) as compared to chloramphenicol (43.1%; 53.9%), amoxicillin/clavulanic (43.5%; 45.7%), and ciprofloxacin (45.7%; 55.7%) in offal and muscle meats, respectively. Imipenem showed the lowest resistance (0%; 0.9%). A total of 41 multidrug-resistant patterns were displayed. Edible offal could be a source of antibiotic-resistant bacteria.

Molecular characterization of megaplasmids encoding the type VI secretion system in Campylobacter jejuni isolated from chicken livers and gizzards

Megaplasmids in Campylobacter spp. likely play important roles in antibiotic resistance, virulence, and horizontal gene transfer. In this study, megaplasmids pCJDM202 (119 kb) and pCJDM67L (116 kb) from C. jejuni strains WP2-202 and OD2-67, respectively, were sequenced and characterized. These megaplasmids contained genes for tetracycline resistance [tet(O)], the Type IV secretion system, conjugative transfer and the Type VI secretion system (T6SS). The T6SS genes in Campylobacter plasmids encoded genes and proteins that were similar to those identified in Campylobacter chromosomal DNA. When the megaplasmid pCJDM202 from C. jejuni WP2-202 was transferred via conjugation to C. jejuni NCTC11168 Nal⁺, transconconjugants acquired tetracycline resistance and enhanced cytotoxicity towards red blood cells. A T6SS mutant of strain WP2-202 was generated and designated Δhcp3; the mutant was significantly impaired in its ability to lyse red blood cells and survive in defibrinated blood. The cytotoxicity of Campylobacter strains towards the human embryonic kidney cell line HEK 293 was not impacted by the T6SS. In summary, the T6SS encoded by Campylobacter megaplasmids mediates lysis of RBCs and likely contributes to survival on retail meats where blood cells are abundant.

Methicillin-resistant Staphylococcus aureus (MRSA) isolated from chicken meat and giblets often produces staphylococcal enterotoxin B (SEB) in non-refrigerated raw chicken livers

Methicillin-resistant Staphylococcus aureus (MRSA) is responsible for several difficult-to-treat infections and staphylococcal food poisoning (SFP). This study was conducted to investigate the prevalence and enterotoxigenicity of MRSA in broiler chicken meat and giblets. A total of 5.5% (8/144) of the examined samples were contaminated with mecA positive/mecC negative MRSA, with staphylococcal counts of approximately 10² colony forming units (CFU)/g in breast, leg and gizzard samples and approximately 3.3 × 10³ CFU/g in frozen liver samples. Most MRSA isolates (75%, 6/8) harboured the staphylococcal enterotoxin B (seb) gene. Reverse transcription-PCR (RT-PCR) showed that MRSA isolates initiated SEB production in experimentally contaminated chicken livers within 24 h of storage at temperatures over 8 °C. SEB was maximally produced at 24 °C when the MRSA counts reached 7.3 × 10³ ± 1.2 × 10³ CFU/g sample homogenate. The current study concludes that the main broiler chicken MRSA isolates in Egypt harbour the seb gene. To mitigate possible SEB production, especially in broiler chicken livers, a maximum "out of refrigeration" time limit should be implemented for cold chain poultry products.

Detection of Campylobacter jejuni liver dissemination in experimentally colonized turkey poults

Consumption of contaminated poultry products, including chicken livers, is the main source of human campylobacteriosis and approximately 90% of human cases are caused by Campylobacter jejuni subsp. jejuni (C. jejuni). Recent culinary trends that favor undercooked chicken livers may be responsible for outbreaks. Turkey is an emerging human protein source, and poultry livers are commonly prepared in popular cuisine such as pâté. The mechanism of how Campylobacter disseminates to poultry liver tissue is unknown. We have previously demonstrated that certain strains of C. jejuni persistently colonize turkeys with the highest density in the ceca. Whether C. jejuni disseminates to the liver of turkeys following intestinal colonization is unknown. In this study, 45 D of hatch turkey poults were co-housed for 30 D. Five poults were euthanized to screen for Campylobacter colonization, and were free of detectable Campylobacter. The remaining 40 poults were randomly split into 2 rooms, with 20 poults per room. At 35 D of age, poults were inoculated by oral gavage with 1 × 10⁶ cfu of C. jejuni isolate NCTC 11168 or mock-inoculated with sterile medium. Ten poults from each room were euthanized at 7 and 14 D post-inoculation (dpi), and cecal contents and livers were cultured and/or enriched for Campylobacter. Livers were harvested aseptically. The ceca of C. jejuni-inoculated poults were highly colonized at 7 and 14 dpi with approximately 10⁸ cfu/mL of cecal contents. At 7 and 14 dpi, 3 and 5 of 10 liver samples were positive for C. jejuni culture (8.6 × 10³ cfu/g of liver ± 4.43 × 10³ and 5.10 × 10³ cfu/g of liver ± 1.74 × 10³), respectively. At 14 dpi, liver samples were cultured by enrichment, and 6 of 10 were positive for Campylobacter. Some liver samples may be below the limit of detection for direct plate culturing. These data determined that turkey liver is a potential reservoir of C. jejuni following intestinal colonization, and identified a potential food safety consideration when turkey liver is prepared for human or pet food consumption.

An outbreak of campylobacteriosis at a hotel in England: the ongoing risk due to consumption of chicken liver dishes

Despite a sizeable evidence base for the risk of campylobacteriosis associated with eating chicken liver pâté, associated outbreaks continue to occur. In January 2017, six cases of campylobacteriosis reported having eaten a Christmas set-menu meal at the same hotel in North Yorkshire, England on the same day. A retrospective cohort study was undertaken to test the null hypothesis that consumption of individual food items was not associated with an increased risk of illness. There were 19 cases of campylobacteriosis linked to the outbreak; seven confirmed and 12 probable cases. Chicken liver pâté was the food item most strongly associated with illness (P < 0.001) with a corresponding high crude relative risk (12.95). This relationship was supported by multivariable analysis, sensitivity analyses and a clear dose-response relationship. Three cases reported an incubation period of <24 h, consistent with other outbreaks of campylobacteriosis associated with consumption of poultry liver. The findings were suggestive of a single point source exposure with a strong association between the consumption of chicken liver pâté and campylobacteriosis. This outbreak highlights that despite evidence that simple cooking techniques can ensure that all campylobacter are killed during cooking, outbreaks continue to occur. Public and professional awareness needs to be raised through a strategic communication plan to reduce the risk of further outbreaks of campylobacteriosis linked to incorrectly cooked chicken liver dishes.

Characteristics of Campylobacter Gastroenteritis Outbreaks in Australia, 2001 to 2016

Campylobacter spp. are a globally important cause of bacterial gastroenteritis, with Australia experiencing higher rates of illness than many comparable high-income countries. Despite the high disease incidence, outbreaks of campylobacteriosis in Australia are infrequently detected and reported. We examined the epidemiology of Campylobacter outbreaks in Australia, with particular emphasis on assessing transmission routes and evidence as reported during public health investigations. A national register of enteric and foodborne disease outbreaks was used to summarize data on all Campylobacter outbreaks reported in Australia between 2001 and 2016. Outbreak data were reviewed and analyzed for trends over time. Additional information was sought from state and territory epidemiologists, to validate transmission routes. A total of 84 Campylobacter outbreaks were reported, with 51 (61%) being classified as foodborne. Specific food vehicles were identified for 33 (65%) outbreaks, with 28 (85%) implicating chicken or chicken-containing dishes. Although no increase in the proportion of foodborne Campylobacter outbreaks was observed, examination of specific food vehicles demonstrated a significant increase in outbreaks because of poultry-liver containing foods (p = 0.04). One quarter of all 1042 outbreak-associated cases occurred in aged-care facilities (ACFs), including 17 associated hospitalizations and three deaths. After review of evidence data, 23 outbreaks (27%) were determined to have an unknown route of transmission, including 10 (43%) outbreaks occurring in ACFs. Campylobacter spp. remain a less commonly reported cause of gastroenteritis outbreaks in Australia. Although many reported outbreaks can be linked to foodborne transmission, over a quarter were unable to identify either a food vehicle or transmission source, particularly for outbreaks occurring in aged care. Increased efforts to improve evidence collection and understanding of transmission dynamics for outbreaks of campylobacteriosis, particularly in aged care, are required.

Thermal Inactivation of Salmonella in Pâté Made from Chicken Liver

HIGHLIGHTS

Cooking may reduce the potential risk of salmonellosis associated with liver pâté. A 5-log reduction was achieved when inoculated pâté was cooked to an internal temperature of ≥73.8°C. A 5-log reduction was achieved when pâté was made with inoculated liver fried for >8 min at 140°C. Findings of this study may be useful for establishing cooking guidelines for liver and pâté.

Retail liver juices enhance the survivability of Campylobacter jejuni and Campylobacter coli at low temperatures

The high prevalence of Campylobacter spp. in retail liver products was previously reported and has been linked to several outbreaks of campylobacteriosis. The main objective of this study was to investigate the influence of retail liver juices on the survivability of several strains of C. jejuni and C. coli, which were previously isolated from various retail meats at 4 °C. All tested Campylobacter strains showed higher survival in beef liver juice (BLJ) and chicken liver juice (CLJ) as compared to beef and chicken juices (BJ and CJ) or Mueller Hinton broth (MHB) at 4 °C. Overall, C. jejuni strains showed greater survival in retail liver and meat juices as compared to C. coli. CLJ enhanced biofilm formation of most C. coli strains and supported growth in favorable conditions. When diluted, retail liver and meat juices enhanced survival of Campylobacter strains at low temperatures and increased aerotolerance. In conclusion, beef and chicken liver juices enhanced the survival of C. jejuni and C. coli strains at low temperatures, which helps explain the high prevalence of Campylobacter spp. in retail liver products.

Impact of Eimeria tenella Coinfection on Campylobacter jejuni Colonization of the Chicken

Eimeria tenella can cause the disease coccidiosis in chickens. The direct and often detrimental impact of this parasite on chicken health, welfare, and productivity is well recognized; however, less is known about the secondary effects that infection may have on other gut pathogens. Campylobacter jejuni is the leading cause of human bacterial foodborne disease in many countries and has been demonstrated to exert negative effects on poultry welfare and production in some broiler lines. Previous studies have shown that concurrent Eimeria infection can influence the colonization and replication of bacteria, such as Clostridium perfringens and Salmonella enterica serovar Typhimurium. Through a series of in vivo coinfection experiments, this study evaluated the impact that E. tenella infection had on C. jejuni colonization of chickens, including the influence of variations in parasite dose and sampling time after bacterial challenge. Coinfection with E. tenella resulted in a significant increase in C. jejuni colonization in the cecum in a parasite dose-dependent manner but a significant decrease in C. jejuni colonization in the spleen and liver of chickens. The results were reproducible at 3 and 10 days after bacterial infection. This work highlights that E. tenella not only has a direct impact on the health and well-being of chickens but can have secondary effects on important zoonotic pathogens.

Determinants of sporadic Campylobacter infections in Denmark: a nationwide case-control study among children and young adults

BACKGROUND

Each year more than 4,000 cases of campylobacteriosis are reported in Denmark, making it the most common bacterial gastrointestinal infection. Here we describe a case-control study to identify sources of infection with a focus on environmental factors.

METHODS

From January to December 2016, we conducted a prospective case-control study among Danish persons aged 1-30 years. Participants were invited by letter to complete an online questionnaire. Crude and adjusted ORs were calculated and final parsimonious multivariate models developed using logistic regression.

RESULTS

The study recruited 1366 cases and 4,418 controls, of whom 65% and 66%, respectively, completed the questionnaire. A multivariate model for domestically acquired cases showed, among others, increased risk of infection with bathing in fresh water (OR=5.1), contact to beach sand (OR=1.8), owning a pet dog with diarrhea (OR=4.6), and eating minced beef (OR=2.6) or chicken (OR=2.5). The model for children highlighted similar risk factors but also included bathing in a paddling pool (OR=13.6) and eating fresh strawberries (OR=5.3). A separate analysis for persons reporting foreign travel showed increased infection risk when traveling to Asia, Africa, or Turkey and that eating from street kitchens and having contact to water during traveling were also risk factors.

CONCLUSION

Environmental factors and animal contact account for a sizeable proportion of domestic Campylobacter infections in the age group studied. The study also re-confirmed handling/consumption of chicken as an important risk factor while highlighting minced beef as a potential new risk factor. Overall, these results contribute to a better understanding of the transmission dynamics of Campylobacter and will be used to improve national guidelines for prevention of infection.

Complete Genome Sequences of Plasmid-Bearing Campylobacter coli and Campylobacter jejuni Strains Isolated from Retail Chicken Liver

Complete genome sequences of Campylobacter coli strains WA333, YF2105, BG2108, MG1116, and BP3183 and Campylobacter jejuni strain IF1100 isolated from retail chicken liver showed the presence of 1,841,551-, 1,687,232-, 1,695,638-, 1,665,146-, 1,695,360-, and 1,744,171-bp circular chromosomes, respectively. These isolates also contained plasmids ranging in size from 5,209 to 55,122 bp.

Campylobacter bacteremia in London: A 44-year single-center study

PURPOSE

Campylobacter species are a well-recognized but rare cause of bloodstream infection.

METHODS

Here we reviewed 41 cases of Campylobacter bloodstream infection occurring at a single center in London over 44years, comprising 0.2% of all recorded episodes during this time period.

RESULTS

Patients had a mean age of 46years and, contrasting with previous reports, nearly 50% of our patients did not have significant comorbidities. Ciprofloxacin resistance increased over the study period with 35% of isolates overall being resistant compared with only 3% exhibiting macrolide resistance. Despite a minority of patients receiving appropriate empirical antibiotic therapy, overall mortality was only 7%.

CONCLUSION

Campylobacter bacteremia remains a rare but significant cause of morbidity with a low associated mortality. Underlying immunosuppressive conditions are common but by no means universal. In our setting, macrolides would be favored as empirical agents to treat suspected Campylobacter enteritis, including cases with associated bacteremia.

An assessment of the microbiological quality of lightly cooked food (including sous-vide) at the point of consumption in England

This observational study aims to investigate the microbiological quality of commercially prepared lightly cooked foods with a major component of food of animal origin and collected as would be served to a consumer. A total of 356 samples were collected from catering (92%), retail (7%) or producers (1%) and all were independent of known incidents of foodborne illness. Using standard methods, all samples were tested for: the presence of Campylobacter spp. and Salmonella spp. and enumerated for levels of, Bacillus spp. including B. cereus, Clostridium perfringens, Listeria spp. including L. monocytogenes, Staphylococcus aureus, Escherichia coli, Enterobacteriacea and aerobic colony count (ACC). Results were interpreted as unsatisfactory, borderline or satisfactory according to the Health Protection Agency guidelines for assessing the microbiological safety of ready-to-eat foods placed on the market. Amongst all samples, 70% were classified as satisfactory, 18% were borderline and 12% were of unsatisfactory microbiological quality. Amongst the unsatisfactory samples, six (2%) were potentially injurious to health due to the presence of: Salmonella spp. (one duck breast); Campylobacter spp. (two duck breast and one chicken liver pâté); L. monocytogenes at 4·3 × 103 cfu (colony-forming units)/g (one duck confit with foie gras ballotin) and C. perfringens at 2·5 × 105 cfu/g (one chicken liver pâté). The remaining unsatisfactory samples were due to high levels of indicator E. coli, Enterobacteriaceae or ACC.

An assessment of the microbiological quality of liver-based pâté in England 2012-13: comparison of samples collected at retail and from catering businesses

The purpose of this study was to investigate the microbiological quality of liver pâté. During 2012-13, a total of 870 samples, unrelated to the investigation of food-poisoning outbreaks, were collected either at retail (46%), catering (53%) or the point of manufacture (1%) and were tested using standard methods to detect Salmonella spp. or Campylobacter spp., and to enumerate for Listeria spp., including Listeria monocytogenes, Clostridium perfringens, coagulase-positive staphylococci including Staphylococcus aureus, Bacillus spp., including Bacillus cereus, Escherichia coli, Enterobacteriaceae, and aerobic colony counts (ACCs). Seventy-three percent of samples were of satisfactory microbiological quality, 18% were borderline and 9% unsatisfactory. Salmonella spp. or Campylobacter spp. was not recovered from any sample. The most common causes of unsatisfactory results were elevated ACCs (6% of the samples) and high Enterobacteriaceae counts (4% of samples). The remaining unsatisfactory results were due to elevated counts of: E. coli (three samples); B. cereus (one sample at 2·6 × 105 cfu/g); or L. monocytogenes (one sample at 2·9 × 103 cfu/g). Pâté from retail was less likely to be contaminated with L. monocytogenes than samples collected from catering and samples from supermarkets were of significantly better microbiological quality than those from catering establishments.

The consequences of Campylobacter infection

PURPOSE OF REVIEW

The purpose of this review is to provide an update on the clinical, public health and economic consequences of Campylobacter infection.

RECENT FINDINGS

Campylobacter is a leading bacterial cause of food-related illness. Its importance is enhanced by the chronic sequelae that can result from acute infection. Recent advances include a new clinical classification system for neurological sequelae with the aim of speeding accurate diagnosis and appropriate treatment, a better understanding of the mechanisms underlying postinfectious functional gastrointestinal disorders, the emergence of Campylobacter concisus and Campylobacter showae as potential aetiological agents in inflammatory bowel disease, a new mechanism for antimicrobial resistance in campylobacters and a better appreciation of the economic costs.

SUMMARY

Campylobacter infection is very common and can lead to serious chronic sequelae and considerable personal, healthcare and societal costs.