Analysis of older adults' domestic kitchen storage practices in the United Kingdom: identification of risk factors associated with listeriosis

Quantitative microbiological risk assessment for the occurrence of listeriosis in Brazil due to the consumption of milk processed by pasteurization or thermosonication

This study aimed to estimate the risk of listeriosis from the consumption of pasteurized milk in Brazil, comparing conventional treatment with the technology of thermosonication. The Quantitative Microbiological Risk Assessment (QMRA) model was developed, covering the entire milk production chain, from milking to the moment of consumption. In general, higher risks were observed in association with higher initial concentrations of the pathogen and the vulnerable population. The highest risk predicted (3.67 × 10-5) was related to the scenario considering the initial concentration range of L. monocytogenes between 4 and 6 log CFU/mL, with conventional treatment and considering the vulnerable population, resulting in one case of listeriosis every 27,248 servings. When considering thermosonication treatment, lower risks have been predicted. The scenario analysis indicated that the steps related to storage conditions in retail and at the consumer's home (post-processing steps) are the most influential in the associated risk, in all scenarios. The predictive parameters of inactivation related to the applied treatment also have a considerable influence on the risk. The results point to the influence of the stages of the dairy production chain and the thermosonication treatment applied in the food safety of milk, subsidizing information for industrial application and for regulatory agencies.

Quantitative microbial risk assessment of haemolytic uremic syndrome associated with Argentinean kosher beef consumption in Israel

The aim of this study was to perform a quantitative microbial risk assessment (QMRA) of Shiga toxin-producing Escherichia coli hemolytic uremic syndrome (STEC-HUS) linked to the consumption of Kosher beef produced in Argentina and consumed in Israel in children under 14 years. A probabilistic risk assessment model was developed to characterize STEC prevalence and contamination levels in the beef supply chain (cattle primary production, cattle transport, processing and storage in the abattoir, for export and at retail, and home preparation and consumption). The model was implemented in Microsoft Excel 2016 with the @Risk add-on package. Results of 302 surveys with data collected in Israel were as follows: 92.3% of people consumed beef, mostly at home, and 98.2% preferred levels of cooking that ensured STEC removal from the surface of beef cuts. The preferred degree of ground beef doneness was "well-done" (48.2%). Cooking preference ranged from red to "medium-well done" (51.8%). Median HUS probability from Argentinean beef cut and ground beef consumption in children under 14 years old was <10-15 and 8.57x10-10, respectively. The expected average annual number of HUS cases and deaths due to beef cut and ground beef consumption was zero. Risk of infection and HUS probability correlated with salting effect on E. coli count, processing raw beef before vegetables, ways of storage and refrigeration temperature at home, joint consumption of salad and beef cuts, degree of beef doneness and cutting board washing with detergent after each use with beef and vegetables. The STEC-HUS risk in Israel from consumption of bovine beef produced in Argentina was negligible. The current QMRA results were similar to those of previous beef cut consumption QMRA in Argentina and lower than any of the QMRA performed worldwide in other STEC-HUS linked to ground beef consumption. This study confirms the importance of QMRA to estimate and manage the risk of STEC-HUS from beef consumption. The impact variables identified in the sensitivity analysis allowed us to optimize resources and time management, to focus on accurate actions and to avoid taking measures that would not have an impact on the risk of STEC-HUS.

Human Listeriosis

Listeria monocytogenes is a Gram-positive facultative intracellular pathogen that can cause severe invasive infections upon ingestion with contaminated food. Clinically, listerial disease, or listeriosis, most often presents as bacteremia, meningitis or meningoencephalitis, and pregnancy-associated infections manifesting as miscarriage or neonatal sepsis. Invasive listeriosis is life-threatening and a main cause of foodborne illness leading to hospital admissions in Western countries. Sources of contamination can be identified through international surveillance systems for foodborne bacteria and strains' genetic data sharing. Large-scale whole genome studies have increased our knowledge on the diversity and evolution of L. monocytogenes, while recent pathophysiological investigations have improved our mechanistic understanding of listeriosis. In this article, we present an overview of human listeriosis with particular focus on relevant features of the causative bacterium, epidemiology, risk groups, pathogenesis, clinical manifestations, and treatment and prevention.

Modelling viability of Listeria monocytogenes in paneer

Paneer is a fresh, soft ready-to-eat cheese that is susceptible to Listeria monocytogenes contamination, exemplified by product recalls in Australia, Canada, and the USA. Previous research demonstrates that L. monocytogenes grows in paneer, however there are no paneer-specific predictive models that quantify the effect of environmental conditions on L. monocytogenes viability. This study measured the viability of a five-strain cocktail of L. monocytogenes in freshly prepared paneer incubated at 4-40 °C. Growth rates were fitted with the extended Ratkowsky square root model, with growth rates ranging from 0.014 to 0.352 log₁₀ CFU/h. In comparison with published models, only the ComBase L. monocytogenes broth model acceptably predicted growth (B_f = 1.01, A_f = 1.12) versus the developed model. The influence of paneer pH (5.0-6.0) and storage temperature (41-45 °C) on L. monocytogenes growth at the upper temperature growth boundary was described using a logistic model. These models provide quantitative tools to improve the safety of paneer processing conditions, shelf-life estimation, food safety management plans, and risk assessment.

Quantitative risk assessment of haemolytic uremic syndrome associated with beef consumption in Argentina

We developed a quantitative microbiological risk assessment (QMRA) of haemolytic uremic syndrome (HUS) associated with Shiga toxin-producing Escherichia coli (STEC)-contaminated beef (intact beef cuts, ground beef and commercial hamburgers) in children under 15 years of age from Argentina. The QMRA was used to characterize STEC prevalence and concentration levels in each product through the Argentinean beef supply chain, including cattle primary production, cattle transport, processing and storage in the abattoir, retail and home preparation, and consumption. Median HUS probability from beef cut, ground beef and commercial hamburger consumption was <10-15, 5.4x10-8 and 3.5x10-8, respectively. The expected average annual number of HUS cases was 0, 28 and 4, respectively. Risk of infection and HUS probability were sensitive to the type of abattoir, the application or not of Hazard Analysis and Critical Control Points (HACCP) for STEC (HACCP-STEC), stx prevalence in carcasses and trimmings, storage conditions from the abattoir to retailers and home, the joint consumption of salads and beef products, and cooking preference. The QMRA results showed that the probability of HUS was higher if beef cuts (1.7x) and ground beef (1.2x) were from carcasses provided by abattoirs not applying HACCP-STEC. Thus, the use of a single sanitary standard that included the application of HACCP-STEC in all Argentinean abattoirs would greatly reduce HUS incidence. The average number of annual HUS cases estimated by the QMRA (n = 32) would explain about 10.0% of cases in children under 15 years per year in Argentina. Since other routes of contamination can be involved, including those not related to food, further research on the beef production chain, other food chains, person-to-person transmission and outbreak studies should be conducted to reduce the impact of HUS on the child population of Argentina.

Food Consumer Behavior and Salmonella Exposure Self-Perception in the Central Region of Mexico

In Mexico, there is limited information regarding food consumer behaviors at home. The knowledge of food consumption and food handling practices can help to determine more realistically the exposure to different hazards, such as Salmonella spp. on the population. The main goal of this study was to characterize the food consumption habits of five food groups (fruits and vegetables, fresh meat, dairy products, processed meat products, and seafood), food handling practices, and Salmonella exposure self-perception of the population of the central region of Mexico using an online survey. A total of 1,199 surveys were analyzed. The group of fruits and vegetables is the most consumed and one of the most related to the consumer self-perception of suffering from salmonellosis. Mexican consumers regularly use refrigeration as the principal food storage method for the five food groups (42.2% to 90.8%), and generally, they store the products between 2 and 3 days (26.5% to 38.1%). A total of 86.4% of consumers reported that they always wash their hands prior to food preparation. A total of 16.9% and 13.0% use the same cutting board and knife, respectively, to cut more than one product without applying sanitization. Men, people between 20 and 24 years, and people between 60 and 64 years, had the highest risk food handling practices at home. Finally, age (P < 0.0001), education level (P = 0.0004), and suffering from gastrointestinal diseases (P = 0.0005) showed significant effects with self-perception of having salmonellosis. PRACTICAL APPLICATION: Data presented in this study could be used in future risk and exposure assessment research to evaluate the public health risk from the consumption of contaminated food. In addition, it could be used by government agencies to design education campaigns in food safety area.

Domestic Kitchen Microbiological Contamination and Self-Reported Food Hygiene Practices of Older Adult Consumers

Because of increased susceptibility, older adults have an increased risk of foodborne infection, and data suggest elevated incidence; therefore, food hygiene is essential to reduce the risk. Research suggests older adults' inadequate knowledge and negative attitudes toward food hygiene may increase implementation of unsafe food practices. Data on microbiological contamination of domestic kitchens of older adults are lacking. Therefore, this study aimed to determine microbiological contamination of domestic kitchens of older adults. Food contact surfaces and equipment (n = 1,292) in domestic kitchens (n = 100) of older adults (≥60 years) were analyzed to isolate aerobic bacteria, Enterobacteriaceae, Staphylococcus aureus, and Listeria spp.; self-reported hygiene practices were also recorded. Highest contamination levels were determined on in-use cleaning equipment (dish brushes, dishcloths, sponges) with aerobic bacteria <9.3 log CFU per item, Enterobacteriaceae <8.8 log CFU per item, and S. aureus <7.0 log CFU per item. Reported usage length of dish brushes was significantly correlated (P < 0.05) with Enterobacteriaceae contamination. Significant correlations (P < 0.05) were determined between contamination and reported cleaning frequency of refrigerators. Contamination of hand towels in single-occupant households was significantly greater (P < 0.05) than in multioccupant households. The study facilitates novel comparison between reported hygiene practices with microbial contamination, suggesting older adults fail to implement adequate and regular hygiene practices that may increase the possibility of cross-contamination in the domestic kitchen and the associated risk of foodborne illness. Data from this study have determined a need for older adults to improve food hygiene practices in the domestic kitchen.

The application of selected ion flow tube-mass spectrometry to follow volatile formation in modified-atmosphere-packaged cooked ham

Cooked pork products, i.e., sliced cooked hams maintained under modified-atmosphere-packaging (MAP), were analysed both microbiologically and with respect to volatile levels during storage. Three storage temperature ranges were compared (4-6 °C, 7-9 °C, and 11-13 °C), representing different refrigeration conditions at household level. The microbial loads were determined by plating samples on six different agar media, followed by (GTG)₅-PCR fingerprinting of genomic DNA of selected isolates, and identification of representative isolates by 16S rRNA, pheS, and rpoA gene sequencing. Carnobacterium maltaromaticum, Lactobacillus sakei, and Serratia proteamaculans were the major bacterial species found among the 619 isolates identified. The volatiles produced during storage were followed by selected ion flow tube-mass spectrometry (SIFT-MS) and the identity of the volatiles was confirmed by headspace solid-phase microextraction combined with gas chromatography and time-of-flight mass spectrometry (HS-SPME-GC-TOF-MS). SIFT-MS analysis showed that volatiles, such as 2,3-butanediol, acetoin, and ethanol, may serve as potential markers for spoilage development. Differences in volatile production between samples were likely due to discrepancies in the initial microbial load and the effect of storage conditions. In conclusion, this study combines the use of new mass spectrometric techniques to examine volatile production during spoilage as an additional source of information during microbiological community analysis.

Food Safety Knowledge and Self-Reported Food-Handling Practices in Cancer Treatment

OBJECTIVES

To explore awareness of foodborne infection risk during chemotherapy treatment, to assess knowledge of risk-reducing food safety practices in patients with cancer and their family caregivers, and to determine self-reported food-handling practices.

SAMPLE & SETTING

A convenience sample of 121 patients receiving chemotherapy and 51 family caregivers of patients receiving chemotherapy in the United Kingdom recruited in the community and using online advertising.

METHODS & VARIABLES

Participants completed a self-report questionnaire to determine food safety knowledge and self-reported food-handling practices.

RESULTS

Although patients receiving chemotherapy and family caregivers reported awareness of food safety practices, self-reported practices indicated that potentially unsafe practices may be used in relation to temperature control, handwashing, safe cooking, and adherence to use-by dates. Such practices may increase the risk of foodborne illness to patients receiving chemotherapy treatment.

IMPLICATIONS FOR NURSING

Nursing research is required to explore the food safety training and awareness of healthcare providers. Highly focused and specifically targeted food safety interventions need to be developed and delivered to increase awareness and to implement food safety practices.

Older Adult Consumers' Attitudes and Perceptions of Risk, Control, and Responsibility for Food Safety in the Domestic Kitchen

Although vast amounts of consumer food safety knowledge and self-reported data exist, attitudinal data detailing perceptions of risk, control, and responsibility are lacking. Such data relating to vulnerable groups, including older adults, are particularly scarce. Perception determination is essential in consumer food safety research to facilitate a comprehensive understanding of the cognitive factors that may impact behavior. Previous research has indicated a relationship between food safety perceptions and behavior. Perceptual data can inform the development of targeted food safety educational interventions. This study was conducted to ascertain older adult consumers' cognitive perceptions regarding food safety. Older adults (≥60 years, n = 100) participated in a computer-assisted personal interview to determine perceived risk, control, and responsibility associated with food safety. Although the potential severity of foodborne illness may be understood, the association between foodborne illness and domestic food preparation may be underestimated. Significant differences were found between perceived personal risk, control, and responsibility and the risks, control, and responsibilities of others ( P > 0.001). Older adults perceived themselves to have lower levels of risk than other individuals have, suggesting perceptions of optimistic bias and personal invulnerability. Perceived greater levels of personal control and responsibility, compared with those of others, suggest perceptions associated with the illusion of control. Correlations were evaluated between personal perceptions of risk, control, and responsibility ( P < 0.05). Low levels of risk were correlated with high levels of control. Those respondents ≥80 years of age perceived higher levels of risk and lower levels of control and responsibility. Cumulatively, older adult consumers expressed perceptions of invulnerability, optimistic bias, and the illusion of control regarding food safety. Such perceptions may undermine attempts to provide education regarding food safety. Food safety messages for this audience must be tailored to overcome such perceptions.

Listeria monocytogenes sepsis in the nursing home community: a case report and short review of the literature

OBJECTIVE AND IMPORTANCE

Listeria monocytogenes is a rare foodborne pathogen, causing both outbreaks and sporadic infections. Severe, systemic infections are more prevalent in at-risk populations, such as pregnant women, but occur mostly in older people and immunocompromised individuals. In this case report, we describe the presentation, diagnosis, and treatment of Listeria monocytogenes sepsis in an older patient, and we briefly review the literature about listeriosis and the importance of safe food practices.

CLINICAL PRESENTATION

We report the case of a nursing home resident with multiple co-morbidities who presented with abdominal complaints and fever. We found diffuse tenderness on abdominal examination without guarding or rebound pain. No other neurologic symptoms were reported and neurologic evaluation showed a normal mental status, no movement disorders, no neck stiffness, and no focal neurologic deficit. Intervention (& Technique): Blood results revealed moderate inflammation, but a CT scan of the abdomen showed no abdominal focus of infection. Hemocultures became positive with Listeria monocytogenes the day after admission, indicating a diagnosis of Listeria sepsis. The patient was admitted to the hospital for intravenous rehydratation with a tentative diagnosis of viral gastroenteritis. After receipt of the positive hemocultures, treatment was initiated with aminopenicillin (amoxicillin 4 × 1 g per day) with good clinical result.

CONCLUSION

Listeriosis occurs more frequently in older patients than in pregnant women and still has a high mortality despite adequate treatment. Physicians, in particular geriatricians, should be aware of this potentially severe foodborne infection. In older adult consumers and long-term care facilities, recommendations for safe food handling and storage should be emphasized.

Food processing: criteria for dietary guidance and public health?

The NOVA food categorisation recommends ‘avoiding processed foods (PF), especially ultra-processed foods (UPF)’ and selecting minimally PF to address obesity and chronic disease. However, NOVA categories are drawn using non-traditional views of food processing with additional criteria including a number of ingredients, added sugars, and additives. Comparison of NOVA's definition and categorisation of PF with codified and published ones shows limited congruence with respect to either definition or food placement into categories. While NOVA studies associate PF with decreased nutrient density, other classifications find nutrient-dense foods at all levels of processing. Analyses of food intake data using NOVA show UPF provide much added sugars. Since added sugars are one criterion for designation as UPF, such a proof demonstrates a tautology. Avoidance of foods deemed as UPF, such as wholegrain/enriched bread and cereals or flavoured milk, may not address obesity but could decrease intakes of folate, calcium and dietary fibre. Consumer understanding and implementation of NOVA have not been tested. Neither have outcomes been compared with vetted patterns, such as Dietary Approaches to Stop Hypertension, which base food selection on food groups and nutrient contribution. NOVA fails to demonstrate the criteria required for dietary guidance: understandability, affordability, workability and practicality. Consumers’ confusion about definitions and food categorisations, inadequate cooking and meal planning skills and scarcity of resources (time, money), may impede adoption and success of NOVA. Research documenting that NOVA can be implemented by consumers and has nutrition and health outcomes equal to vetted patterns is needed.

Optimizing nutrition in older people

Older adults are at increased risk of malnutrition, for a variety of physiological and psychological reasons. This has implications for health, quality of life, independence and economic circumstances. Improvements in nutrition are known to bring tangible benefits to older people and many age-related diseases and conditions can be prevented, modulated or ameliorated by good nutrition. However, practical and realistic approaches are required to optimize diet and food intake in older adults. One area where improvements can be made relates to appetite. Encouraging older adults to prepare meals can increase appetite and food intake, and providing opportunities for older adults to eat a wide variety of foods, in company, is a simple strategy to increase food intake. The protein requirement of older adults is subject to controversy and although considered the most satiating macronutrient, it appears that protein does not elicit as great a satiating effect in older adults as it does in younger individuals. This indicates that there is potential to increase protein intake without impacting on overall energy intake. Other areas where simple practical improvements can be made include both packaging of foods that are easy to prepare and the education of older adults on the safe storage and preparation of food. Research into improving the diets and nutritional status of older adults has indicated that many of the strategies can be easily and cost-effectively undertaken.

Behavioral Observation and Microbiological Analysis of Older Adult Consumers' Cross-Contamination Practices in a Model Domestic Kitchen

The incidence of foodborne illness is higher in older adults because of their increased susceptibility; therefore, food safety practices are important. However, inadequate knowledge and negative attitudes toward food safety have been reported, which may increase use of unsafe food handling practices. Data on the actual food safety behaviors of older adults are lacking. In this study, food safety practices of older adults were observed and linked to microbiological analysis of kitchen surfaces to identify suspected routes of contamination. Older adults (≥60 years, n = 100) prepared a set meal in a model domestic kitchen sanitized according to a validated protocol to ensure minimal and consistent microbiological loads. Food safety behaviors were observed using ceiling-mounted cameras and recorded using a predetermined behavioral checklist. Surface microbiological contamination also was determined after food preparation. Overall, older adults frequently implemented unsafe food handling practices; 90% failed to implement adequate hand decontamination immediately after handling raw chicken. For older adults who used a larger number of adequate hand decontamination attempts, microbiological contamination levels in the kitchen following the food preparation session were significantly lower ( P < 0.001). The novel utilization of behavioral observation in conjunction with microbiological analysis facilitated identification of potentially unsafe food handling practices as suspected routes of microbiological cross-contamination in a model domestic kitchen. Findings indicate the potential impact on domestic food safety of unsafe food handling practices used by older adult consumers. This innovative approach revealed that a large proportion of older adults implement behaviors resulting in microbiological cross-contamination that may increase the risk of foodborne illness in the home.

An assessment of food safety information provision for UK chemotherapy patients to reduce the risk of foodborne infection

OBJECTIVES

Given the increased risk of foodborne infection to cancer patients receiving chemotherapy treatment, and the risk of listeriosis reportedly five-times greater to this immunocompromised patient group, there is a need to ensure the implementation of domestic food safety practices among chemotherapy patients and their family caregivers. However, information regarding the adequacy of resources to inform and enable patients to implement domestic food safety practices to reduce the risk of foodborne infection is limited. Consequently, this study aimed to evaluate the provision of food safety information available to UK chemotherapy patients.

STUDY DESIGN

In-depth semi-structured interviews and content analysis of online patient information resources.

METHODS

Interviews with patients and family caregivers (n = 15) were conducted to explore food-related experiences during chemotherapy treatment. Online food-related information resources for chemotherapy patients (n = 45) were obtained from 35 of 154 National Health Service chemotherapy providers in England, Scotland, and Wales, the Department of Health (DoH) and three of 184 identified UK cancer charities. Identified food-related information resources were reviewed using a content-analysis approach to assess the inclusion of food safety information for chemotherapy patients.

RESULTS

In-depth interviews established that many patients indicated awareness of immunosuppression during treatment. Although patients reported practicing caution to reduce the risk of communicable diseases by avoiding crowded spaces/public transport, food safety was reported to be of minimal concern during treatment and the risk of foodborne infection was often underestimated. The review of online food-related patient information resources established that many resources failed to highlight the increased risk of foodborne infection and emphasize the importance of food safety for patients during chemotherapy treatment. Considerable information gaps exist, particularly in relation to listeriosis prevention practices. Cumulatively, information was inconsistent, insufficient, and varied between resources.

CONCLUSION

The study has identified the need for an effective, standardized food safety resource specifically targeting chemotherapy patients and family caregivers. Such intervention is essential to assist efforts in reducing the risks associated with foodborne infection among chemotherapy patients.

Time-Temperature Profiling of United Kingdom Consumers' Domestic Refrigerators

Increased consumer demand for convenience and ready-to-eat food, along with changes to consumer food purchase and storage practices, have resulted in an increased reliance on refrigeration to maximize food safety. Previous research suggests that many domestic refrigerators operate at temperatures exceeding recommendations; however, the results of several studies were determined by means of one temperature data point, which, given temperature fluctuation, may not be a true indicator of actual continual operating temperatures. Data detailing actual operating temperatures and the effects of consumer practices on temperatures are limited. This study has collated the time-temperature profiles of domestic refrigerators in consumer kitchens (n = 43) over 6.5 days with concurrent self-reported refrigerator usage. Overall, the findings established a significant difference (P < 0.05) between one-off temperature (the recording of one temperature data point) and mean operating temperature. No refrigerator operated at ≤5.0°C for the entire duration of the study. Mean temperatures exceeding 5.0°C were recorded in the majority (91%) of refrigerators. No significant associations or differences were determined for temperature profiles and demographics, including household size, or refrigerator characteristics (age, type, loading, and location). A positive correlation (P < 0.05) between room temperature and refrigerator temperature was determined. Reported door opening frequency correlated with temperature fluctuation (P < 0.05). Thermometer usage was determined to be infrequent. Cumulatively, research findings have established that the majority of domestic refrigerators in consumer homes operate at potentially unsafe temperatures and that this is influenced by consumer usage. The findings from this study may be utilized to inform the development of shelf-life testing based on realistic domestic storage conditions. Furthermore, the data can inform the development of future educational interventions to increase safe domestic refrigeration practices.

Development of the Consumer Refrigerator Safety Questionnaire: A Measure of Consumer Perceptions and Practices

Food preparation and storage behaviors in the home deviating from the "best practice" food safety recommendations may result in foodborne illnesses. Currently, there are limited tools available to fully evaluate the consumer knowledge, perceptions, and behavior in the area of refrigerator safety. The current study aimed to develop a valid and reliable tool in the form of a questionnaire, the Consumer Refrigerator Safety Questionnaire (CRSQ), for assessing systematically all these aspects. Items relating to refrigerator safety knowledge (n =17), perceptions (n =46), and reported behavior (n =30) were developed and pilot tested by an expert reference group and various consumer groups to assess face and content validity (n =20), item difficulty and consistency (n =55), and construct validity (n =23). The findings showed that the CRSQ has acceptable face and content validity with acceptable levels of item difficulty. Item consistency was observed for 12 of 15 in refrigerator safety knowledge. Further, all 5 of the subscales of consumer perceptions of refrigerator safety practices relating to risk of developing foodborne disease showed acceptable internal consistency (Cronbach's α value > 0.8). Construct validity of the CRSQ was shown to be very good (P = 0.022). The CRSQ exhibited acceptable test-retest reliability at 14 days with the majority of knowledge items (93.3%) and reported behavior items (96.4%) having correlation coefficients of greater than 0.70. Overall, the CRSQ was deemed valid and reliable in assessing refrigerator safety knowledge and behavior; therefore, it has the potential for future use in identifying groups of individuals at increased risk of deviating from recommended refrigerator safety practices, as well as the assessment of refrigerator safety knowledge and behavior for use before and after an intervention.

Older Adult Consumer Knowledge, Attitudes, and Self-Reported Storage Practices of Ready-to-Eat Food Products and Risks Associated with Listeriosis

Consumer implementation of recommended food safety practices, specifically relating to time and temperature control of ready-to-eat (RTE) food products associated with listeriosis are crucial. This is particularly the case for at-risk consumers such as older adults, given the increased listeriosis incidence reported internationally among adults aged ≥60 years. However, data detailing older adults' cognitive risk factors associated with listeriosis are lacking. Combining data about knowledge, self-reported practices, and attitudes can achieve a cumulative multilayered in-depth understanding of consumer food safety behavior and cognition. This study aims to ascertain older adults' cognition and behavior in relation to domestic food handling and storage practices that may increase the risks associated with L. monocytogenes. Older adults (≥60 years) (n = 100) participated in an interview and questionnaire to determine knowledge, self-reported practices, and attitudes toward recommended practices. Although the majority (79%) had positive attitudes toward refrigeration, 84% were unaware of recommended temperatures (5°C) and 65% self-reported "never" checking their refrigerator temperature. Although most (72%) knew that "use-by" dates indicate food safety and 62% reported "always" taking note, neutral attitudes were held, with 67% believing it was safe to eat food beyond use-by dates and 57% reporting doing so. Attitudes toward consuming foods within the recommended 2 days of opening were neutral, with 55% aware of recommendations and , 84% reporting that they consume RTE foods beyond recommendations. Although knowledgeable of some key practices, older adults self-reported potentially unsafe practices when storing RTE foods at home, which may increase risks associated with L. monocytogenes. This study has determined that older adults' food safety cognition may affect their behaviors; understanding consumer food safety cognition is essential for developing targeted food safety education.

Prevalence, seasonality, and growth of enterococci in raw and pasteurized milk in Victoria, Australia

This study investigated the prevalence, seasonality, and species variety of enterococci present in raw milk factory silos and pasteurized milk in 3 dairying regions in Victoria, Australia, over a 1-yr period. Additionally, the growth ability of thermoduric enterococci isolated in this study (Enterococcus faecalis, E. faecium, E. hirae, and E. durans) was determined in milk at temperatures likely to occur during storage, transport, and distribution, and before domestic consumption (4 and 7°C). Enterococci were detected in 96% of 211 raw milk samples, with an average count of 2.48 log10 cfu/mL. Counts were significantly lower in winter than summer (average 1.84 log10 cfu/mL) and were different between factories but not regions. Enterococcus faecalis was the most prevalent species isolated from raw milk in every factory, comprising between 61.5 and 83.5% of enterococcal species across each season. Enterococci were detected in lower numbers in pasteurized milk than in raw milk and were below the limit of detection on spread plates (<10 cfu/mL) after factory pasteurization. Residual viable cells were only detected following enrichment using 100-mL samples of milk, with 20.8% of the samples testing positive; this equated to a decrease in the average raw milk enterococci count of >4 log10 cfu/mL following pasteurization. Although E. faecalis predominated in raw milk and E. durans was found in only 2.9% of raw milk samples, E. durans was the most prevalent species detected in pasteurized milk. The detection of enterococci in the pasteurized milk did not correlate with higher enterococci counts in the raw milk. This suggested that the main enterococci populations in raw milk were heat-sensitive and that thermoduric enterococci survived pasteurization in a small numbers of instances. All of the thermoduric enterococci that were assessed for growth at likely refrigeration temperatures were able to grow at both 4 and 7°C in sterile milk, with generation times of 35 to 41h and 16 to 22h, respectively. Thermoduric enterococci were detected in pasteurized milk stored at 4°C for 2 wk (typically 1 to 9 cells/100mL, up to 2.82 log10 cfu/mL), demonstrating the potential of enterococci to survive pasteurization and contribute to milk spoilage at refrigeration temperatures. This is particularly relevant for milk that is aseptically packaged to exclude gram-negative psychrotrophic bacteria and kept above the recommended storage temperature of ≤5°C.