A Field Study Into Hong Kong's Wet Markets: Raised Questions Into the Hygienic Maintenance of Meat Contact Surfaces and the Dissemination of Microorganisms Associated With Nosocomial Infections

Insights into microbial contamination and antibiotic resistome traits in pork wholesale market: An evaluation of the disinfection effect of sodium hypochlorite

Chlorine and its derivatives, such as sodium hypochlorite (NaClO) and chlorine dioxide, are frequently employed as disinfectants throughout the pork supply chain in China. Nevertheless, the extensive use of NaClO has the potential to cause the creation of 'chlorine-tolerant bacteria' and accelerate the evolution of antibiotic resistance. This study evaluated the efficacy of NaClO disinfection by examining alterations in the microbiome and resistome of a pork wholesale market (PWM), and bacteria isolation and analysis were performed to validate the findings. As expected, the taxonomic compositions of bacteria was significantly different before and after disinfection. Notably, Salmonella enterica (S. enterica), Salmonella bongori (S. bongori), Escherichia coli (E. coli), Klebsiella pneumoniae (K. pneumoniae), and Pseudomonas aeruginosa (P. aeruginosa) were observed on all surfaces, indicating that the application of NaClO disinfection treatment in PWM environments for pathogenic bacteria is limited. Correlations were identified between antibiotic resistance genes (ARGs) associated with aminoglycosides (aph(3'')-I, aph(6')-I), quinolone (qnrB, abaQ), polymyxin (arnA, mcr-4) and disinfectant resistance genes (emrA/BD, mdtA/B/C/E/F). Furthermore, correlations were found between risk Rank I ARGs associated with aminoglycoside (aph(3')-I), tetracycline (tetH), beta_lactam (TEM-171), and disinfectant resistance genes (mdtB/C/E/F, emrA, acrB, qacG). Importantly, we found that Acinetobacter and Salmonella were the main hosts of disinfectant resistance genes. The resistance mechanisms of the ARGs identified in PWM were dominated by antibiotic deactivation (38.7%), antibiotic efflux (27.2%), and antibiotic target protection (14.4%). The proportion of genes encoding efflux pumps in the PWM resistome increased after disinfection. Microbial cultures demonstrated that the traits of microbial contamination and antibiotic resistane were consistent with those observed by metagenomic sequencing. This study highlights the possibility of cross-resistance between NaClO disinfectants and antibiotics, which should not be ignored.

"Smart markets": harnessing the potential of new technologies for endemic and emerging infectious disease surveillance in traditional food markets

Emerging and endemic zoonotic diseases continue to threaten human and animal health, our social fabric, and the global economy. Zoonoses frequently emerge from congregate interfaces where multiple animal species and humans coexist, including farms and markets. Traditional food markets are widespread across the globe and create an interface where domestic and wild animals interact among themselves and with humans, increasing the risk of pathogen spillover. Despite decades of evidence linking markets to disease outbreaks across the world, there remains a striking lack of pathogen surveillance programs that can relay timely, cost-effective, and actionable information to decision-makers to protect human and animal health. However, the strategic incorporation of environmental surveillance systems in markets coupled with novel pathogen detection strategies can create an early warning system capable of alerting us to the risk of outbreaks before they happen. Here, we explore the concept of "smart" markets that utilize continuous surveillance systems to monitor the emergence of zoonotic pathogens with spillover potential.IMPORTANCEFast detection and rapid intervention are crucial to mitigate risks of pathogen emergence, spillover and spread-every second counts. However, comprehensive, active, longitudinal surveillance systems at high-risk interfaces that provide real-time data for action remain lacking. This paper proposes "smart market" systems harnessing cutting-edge tools and a range of sampling techniques, including wastewater and air collection, multiplex assays, and metagenomic sequencing. Coupled with robust response pathways, these systems could better enable Early Warning and bolster prevention efforts.

Antimicrobial resistomes in food chain microbiomes

The safety and integrity of the global food system is in a constant state of flux with persistent chemical and microbial risks. While chemical risks are being managed systematically, microbial risks pose extra challenges. Antimicrobial resistant microorganism and persistence of related antibiotic resistance genes (ARGs) in the food chain adds an extra dimension to the management of microbial risks. Because the food chain microbiome is a key interface in the global health system, these microbes can affect health in many ways. In this review, we systematically summarize the distribution of ARGs in foods, describe the potential transmission pathway and transfer mechanism of ARGs from farm to fork, and discuss potential food safety problems and challenges. Modulating antimicrobial resistomes in the food chain facilitates a sustainable global food production system.

Composite Coating for the Food Industry Based on Fluoroplast and ZnO-NPs: Physical and Chemical Properties, Antibacterial and Antibiofilm Activity, Cytotoxicity

Bacterial contamination of meat products during its preparation at the enterprise is an important problem for the global food industry. Cutting boards are one of the main sources of infection. In order to solve this problem, the creation of mechanically stable coatings with antibacterial activity is one of the most promising strategies. For such a coating, we developed a composite material based on "liquid" Teflon and zinc oxide nanoparticles (ZnO-NPs). The nanoparticles obtained with laser ablation had a rod-like morphology, an average size of ~60 nm, and a ζ-potential of +30 mV. The polymer composite material was obtained by adding the ZnO-NPs to the polymer matrix at a concentration of 0.001-0.1% using the low-temperature technology developed by the research team. When applying a composite material to a surface with damage, the elimination of defects on a micrometer scale was observed. The effect of the composite material on the generation of reactive oxygen species (H₂O₂, •OH), 8-oxoguanine in DNA in vitro, and long-lived reactive protein species (LRPS) was evaluated. The composite coating increased the generation of all of the studied compounds by 50-200%. The effect depended on the concentration of added ZnO-NPs. The antibacterial and antibiofilm effects of the Teflon/ZnO NP coating against L. monocytogenes, S. aureus, P. aeruginosa, and S. typhimurium, as well as cytotoxicity against the primary culture of mouse fibroblasts, were studied. The conducted microbiological study showed that the fluoroplast/ZnO-NPs coating has a strong bacteriostatic effect against both Gram-positive and Gram-negative bacteria. In addition, the fluoroplast/ZnO-NPs composite material only showed potential cytotoxicity against primary mammalian cell culture at a concentration of 0.1%. Thus, a composite material has been obtained, the use of which may be promising for the creation of antibacterial coatings in the meat processing industry.

The Development of New Nanocomposite Polytetrafluoroethylene/Fe2O3 NPs to Prevent Bacterial Contamination in Meat Industry

The bacterial contamination of cutting boards and other equipment in the meat processing industry is one of the key reasons for reducing the shelf life and consumer properties of products. There are two ways to solve this problem. The first option is to create coatings with increased strength in order to prevent the formation of micro damages that are favorable for bacterial growth. The second possibility is to create materials with antimicrobial properties. The use of polytetrafluoroethylene (PTFE) coatings with the addition of metal oxide nanoparticles will allow to the achieving of both strength and bacteriostatic effects at the same time. In the present study, a new coating based on PTFE and Fe₂O₃ nanoparticles was developed. Fe₂O₃ nanoparticles were synthesized by laser ablation in water and transferred into acetone using the developed procedures. An acetone-based colloidal solution was mixed with a PTFE-based varnish. Composites with concentrations of Fe₂O₃ nanoparticles from 0.001-0.1% were synthesized. We studied the effect of the obtained material on the generation of ROS (hydrogen peroxide and hydroxyl radicals), 8-oxoguanine, and long-lived active forms of proteins. It was found that PTFE did not affect the generation of all the studied compounds, and the addition of Fe₂O₃ nanoparticles increased the generation of H₂O₂ and hydroxyl radicals by up to 6 and 7 times, respectively. The generation of 8-oxoguanine and long-lived reactive protein species in the presence of PTFE/Fe₂O₃ NPs at 0.1% increased by 2 and 3 times, respectively. The bacteriostatic and cytotoxic effects of the developed material were studied. PTFE with the addition of Fe₂O₃ nanoparticles, at a concentration of 0.001% or more, inhibited the growth of E. coli by 2-5 times compared to the control or PTFE without NPs. At the same time, PTFE, even with the addition of 0.1% Fe₂O₃ nanoparticles, did not significantly impact the survival of eukaryotic cells. It was assumed that the resulting composite material could be used to cover cutting boards and other polymeric surfaces in the meat processing industry.

Advances in emerging technologies for the decontamination of the food contact surfaces

Foodborne pathogens could be transferred to food from food contact surfaces contaminated by poor hygiene or biofilm formation. The food processing industry has various conditions favouring microbes' adherence, such as moisture, nutrients, and the microbial inoculums obtained from the raw material. The function of the ideal antimicrobial surface is preventing initial attachment of the microbes, killing the microbes or/and removing the dead bacteria. This review article provides detail about the challenges food industries are facing with respect to food contact materials. It also summarises the merits and demerits of several sanitizing methods developed for industrial use. Furthermore, it reviews the new and emerging techniques that enhance the efficiency of reducing microbial contamination. Techniques such as surface functionalisation, high-intensity ultrasound, cold plasma technologies etc. which have high potential to be used for the decontamination of food contact surfaces are discussed. The emerging designs of antibacterial surfaces provide the opportunity to reduce or eradicate the adhesion of microorganisms. The most important purpose of these surfaces is to prevent the attachment of bacteria and to kill the bacteria that come in contact. These emerging technologies have a high potential for developing safe and inert food contact materials for the food industry.

Fecal microbiota profiling in irritable bowel syndrome and inflammatory bowel disease patients with irritable bowel syndrome-type symptoms

BACKGROUND

The intestinal microbiota is thought to be involved in the occurrence of inflammatory bowel disease in remission with irritable bowel syndrome (IBS)-type symptoms, but the specific distinct profile of these bacteria remains unclear. This cross-sectional study aims to investigate the fecal microbiota profiling in patients with these diseases.

METHODS

Fecal samples from 97 subjects, including Crohn's disease patients in remission with IBS-type symptoms (CDR-IBS+) or without IBS-type symptoms (CDR-IBS-), ulcerative colitis patients in remission with IBS-type symptoms (UCR-IBS+) or without IBS-type symptoms (UCR-IBS-), IBS patients and healthy controls, were collected and applied 16S ribosomal DNA (rDNA) gene sequencing. The V4 hypervariable regions of 16S rDNA gene were amplified and sequenced by the Illumina MiSeq platform. The differences in the sample diversity index in groups were analyzed with R software.

RESULTS

The richness of the intestinal microbiota in the CDR-IBS group was markedly lower than those in the control and IBS groups based on the analysis of observed species and the Chao index (P < 0.05). The observed species index in the CDR-IBS+ group was higher than that in the CDR-IBS- group (median index: 254.8 vs 203, P = 0.036). No difference was found in alpha diversity between UCR patients with IBS-type symptoms and those without related symptoms. At the genus level, the number of Faecalibacterium in CDR patients with IBS-type symptoms increased significantly, while Fusobacterium decreased versus those without such symptoms (mean relative abundance of Faecalibacterium: 20.35% vs 5.18%, P < 0.05; Fusobacterium: 1.51% vs 5.2%, P < 0.05). However, compared with the UCR-IBS- group, the number of Faecalibacterium in the UCR-IBS+ group decreased, while the number of Streptococcus increased, but there was no significant difference in the genus structure. The abundance and composition of the microbiota of IBS patients were not distinct from those of healthy controls.

CONCLUSIONS

The IBS-type symptoms in CD patients in remission may be related to an increase in Faecalibacterium and a decrease in Fusobacterium. The IBS-type symptoms in UC patients in remission cannot be explained by changes in the abundance and structure of the intestinal microbiota.

Questioning the source of identified non-foodborne pathogens from food-contact wooden surfaces used in Hong Kong's urban wet markets

In this study, a phylogenic analysis was performed on pathogens previously identified in Hong Kong wet markets' cutting boards. Phylogenetic comparisons were made between phylotypes obtained in this study and environmental and clinical phylotypes for establishing the possible origin of selected bacterial species isolated from wet market cutting board ecosystems. The results reveal a strong relationship between wet market bacterial assemblages and environmental and clinically relevant phylotypes. However, our poor knowledge of potential cross-contamination sources within these wet markets is further exacerbated by failing to determine the exact or presumed origin of its identified pathogens. In this study, several clinically relevant bacterial pathogens such as Klebsiella pneumoniae, Streptococcus suis and Streptococcus porcinus were linked to cutting boards associated with pork; Campylobacter fetus, Staphylococcus aureus, Escherichia coli, and A. caviae in those associated with poultry; and Streptococcus varanii, A. caviae, Vibrio fluvialis, and Vibrio parahaemolyticus in those associated with seafood. Identifying non-foodborne clinically relevant pathogens in wet market cutting boards in this study confirms the need for safety approaches for wet market meat, including cold storage. The presented study justifies the need for future systematic epidemiological studies to determine identified microbial pathogens. Such studies should bring about significant improvements in the management of hygienic practices in Hong Kong's wet markets and work towards a One Health goal by recognizing the importance of wet markets as areas interconnecting food processing with animal and clinical environments.

Zoonotic spillover: Understanding basic aspects for better prevention

The transmission of pathogens from wild animals to humans is called “zoonotic spillover”. Most human infectious diseases (60-75%) are derived from pathogens that originally circulated in non-human animal species. This demonstrates that spillover has a fundamental role in the emergence of new human infectious diseases. Understanding the factors that facilitate the transmission of pathogens from wild animals to humans is essential to establish strategies focused on the reduction of the frequency of spillover events. In this context, this article describes the basic aspects of zoonotic spillover and the main factors involved in spillover events, considering the role of the inter-species interactions, phylogenetic distance between host species, environmental drivers, and specific characteristics of the pathogens, animals, and humans. As an example, the factors involved in the emergence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) pandemic are discussed, indicating what can be learned from this public health emergency, and what can be applied to the Brazilian scenario. Finally, this article discusses actions to prevent or reduce the frequency of zoonotic spillover events.

A better classification of wet markets is key to safeguarding human health and biodiversity

Wet markets have been implicated in multiple zoonotic outbreaks, including COVID-19. They are also a conduit for legal and illegal trade in wildlife, which threatens thousands of species. Yet wet markets supply food to millions of people around the world, and differ drastically in their physical composition, the goods they sell, and the subsequent risks they pose. As such, policy makers need to know how to target their actions to efficiently safeguard human health and biodiversity without depriving people of ready access to food. Here, we propose a taxonomy of wet markets, oriented around the presence of live or dead animals, and whether those animals are domesticated or wild (either captive-reared or wild-caught). We assess the dimensions and levels of risk that different types of wet markets pose to people and to biodiversity. We identify six key risk factors of wet markets that can affect human health: (1) presence of high disease-risk animal taxa, (2) presence of live animals, (3) hygiene conditions, (4) market size, (5) animal density and interspecies mixing, and (6) the length and breadth of animal supply chains. We also identify key factors informing risk to biodiversity. Finally, we recommend targeted, risk-adjusted policies to more efficiently and humanely address the dangers posed by wet markets.

The use of multi-pronged screening strategy to understand the epidemiology of carbapenemase-producing Enterobacteriaceae in Hong Kong: transition from epidemic to endemic setting

A multi-pronged carbapenemase-producing Enterobacteriaceae (CPE) screening strategy was implemented in Hong Kong West healthcare network. Of 199,192 fecal specimens from 77,194 patients screening from 1 July 2011 to 30 June 2019, the incidence of CPE per 1000 patient admission significantly increased from 0.01 (2012) to 1.9 (2018) (p<0.01). With appropriate infection control measures, the incidence of nosocomial CPE per 1000 CPE colonization day decreased from 22.34 (2014) to 10.65 (2018) (p=0.0094). Exposure to wet market for purchasing raw pork (p=0.007), beef (p=0.017), chicken (p=0.026), and vegetable (p=0.034) for >3 times per week significantly associated with community acquisition of CPE. Strategic CPE control measures should be implemented in both the hospital and the community.

Risk factors of non-typhoidal Salmonella gastroenteritis in hospitalised young children: a case-control study

OBJECTIVE

To explore risk factors associated with non-typhoidal Salmonella gastroenteritis in young children in Hong Kong.

DESIGN

A case-control study.

SETTING

Paediatrics wards at three public hospitals in Hong Kong.

PARTICIPANTS

Cases were children aged above 30 days to below 5 years hospitalised for gastroenteritis at three public hospitals in Hong Kong with culture confirmed non-typhoidal Salmonella infection. Controls were age-matched (±2 months) children admitted for a reason other than gastroenteritis.

MAIN OUTCOMES MEASURES

A face-to-face interview by using standardised questionnaire on exposures 3 days prior to illness. Adjusted OR (aORs) and 95% CIs were calculated using multivariable logistic regression.

RESULTS

A total of 102 cases and 204 age-matched controls were included in the analysis. Multivariable logistic regression revealed that having food purchased from places other than a supermarket, that is, from wet market/restaurant/farm (aOR, 2.64; 95% CI, 1.03 to 6.77; p=0.044) was a significant risk factor for non-typhoidal Salmonella infection. Having a household member with gastroenteritis symptoms (aOR, 2.03; 95% CI, 0.94 to 4.39; p=0.072) was of borderline significance and playing at a children's indoor playroom was a protective factor (aOR, 0.28; 95% CI, 0.09 to 0.85; p=0.024).

CONCLUSIONS

Consumption of food purchased from places other than a supermarket was the identified determinant factor for non-typhoidal Salmonella gastroenteritis in Hong Kong. Parents/caregivers should be alerted to this risk when choosing foods for their young children. The protective effect of playing in an indoor playroom could be confounded by socioeconomic factors and further investigation is required to better understand its potential implication. There was some support for person-to-person transmission and good family hygiene needs to be emphasised.

Impacts of Wet Market Modernization Levels and Hygiene Practices on the Microbiome and Microbial Safety of Wooden Cutting Boards in Hong Kong

Accessing food through wet markets is a common global daily occurrence, where fresh meat can be purchased to support an urbanizing world population. Similar to the wet markets in many other metropolitan cities in Asia, Hong Kong wet markets vary and are characterized by differing hygiene routines and access to essential modern technologies. The lack of risk assessments of food contact surfaces in these markets has led to substantial gaps in food safety knowledge and information that could help improve and maintain public health. Microbial profiling analyses were conducted on cutting boards that had been used to process pork, poultry, and seafood at 11 different wet markets. The markets differed in hygiene protocols and access to modern facilities. Irrespective of whether wet markets have access of modern infrastructure, the hygiene practices were largely found to be inefficient based on the prevalence of bacterial species typically associated with foodborne pathogens such as Campylobacter fetus, Clostridium perfringens, Staphylococcus aureus, and Vibrio parahaemolyticus; indicator organisms such as Escherichia coli; as well as nonfoodborne pathogenic bacterial species potentially associated with nosocomial infections, such as Klebsiella pneumoniae and Enterobacter cloacae. Other Vibrio species, V. parahaemolyticus and V. vulnificus, typically associated with contaminated raw or undercooked seafood with the potential to cause illness in humans, were also found on wooden cutting boards. This study indicated that the hygienic practices used in Hong Kong wet markets are not sufficient for preventing the establishment of spoilage or pathogenic organisms. This study serves as a basis to review current hygiene practices in wet markets and provides a framework to reassess existing safety protocols.

Insights into the Microbiological Safety of Wooden Cutting Boards Used for Meat Processing in Hong Kong's Wet Markets: A Focus on Food-Contact Surfaces, Cross-Contamination and the Efficacy of Traditional Hygiene Practices

Hong Kong's wet markets play a crucial role in the country's supply of safe, fresh meat to satisfy the dietary needs of its population. Whilst food safety regulations have been introduced over the past few years to maintain the microbial safety of foods sold from these wet markets, it remains unclear whether the hygiene maintenance that is performed on the wooden cutting boards used for meat-processing is effective. In fact, hygiene maintenance may often be overlooked, and hygiene standards may be insufficient. If so, this may lead to the spread of harmful pathogens through cross-contamination, thereby causing severe risks to public health. The aim of this study was to determine the level of microbial transfer between wooden cutting boards and swine meat of various qualities, using 16S metagenomic sequencing, strain identification and biofilm screening of isolated strains. The results established that: (a) the traditional hygiene practices used for cleaning wooden cutting boards in Hong Kong's wet markets expose the surfaces to potentially harmful microorganisms; (b) the processing of microbially contaminated meat on cutting boards cleaned using traditional practices leads to cross-contamination; and (c) several potentially pathogenic microorganisms found on the cutting boards have good biofilm-forming abilities. These results reinforce the need to review the traditional methods used to clean wooden cutting boards after the processing of raw meat in Hong Kong' wet markets so as to prevent cross-contamination events. The establishment of proper hygiene protocols may reduce the spread of disease-causing microorganisms (including antibiotic-resistant microorganisms) in food-processing environments.

Three-Year Longitudinal Study: Prevalence of Salmonella Enterica in Chicken Meat is Higher in Supermarkets Than Wet Markets from Mexico

Worldwide, chicken meat is considered one of the main sources of Salmonella enterica in humans. To protect consumers from this foodborne pathogen, international health authorities recommend the establishment of continuous Salmonella surveillance programs in meat. However, these programs are scarce in many world regions; thus, the goal of the present study was to perform a longitudinal surveillance of S. enterica in chicken meat in Mexico. A total of 1160 samples were collected and analyzed monthly from 2016 to 2018 in ten chicken meat retailers (supermarkets and wet markets) located in central Mexico. The isolation and identification of S. enterica was carried out using conventional and molecular methods. Overall, S. enterica was recovered from 18.1% (210/1160) of the chicken meat samples. Remarkably, during the three years of evaluation, S. enterica was more prevalent (p < 0.0001) in supermarkets (27.2%, 158/580) than in wet markets (9.0%, 52/580). The study was 3.8 times more likely (odds ratio = 3.8, p < 0.0001) to recover S. enterica from supermarkets than wet markets. Additionally, a higher prevalence (p < 0.05) of this pathogen was observed during the spring, summer, autumn, and winter in supermarkets compared with wet markets. Moreover, the recovery rate of S. enterica from supermarkets showed a gradual increase from 20.78% to 42% (p < 0.0001) from 2016 to 2018. Interestingly, no correlation (p > 0.05) was observed between the S. enterica recovery rate in chicken meat and reported cases of Salmonella infections in humans. Higher levels of S. enterica in chicken meat retailed in supermarkets are not unusual; this phenomenon has also been reported in some European and Asian countries. Together, these results uncover an important health threat that needs to be urgently addressed by poultry meat producers and retailers.